Condition

Acne

Common skin condition causing pimples and inflammation

231.2M
People Affected
9
Active Trials
117.4M
New Cases/Year

Treatment Rankings

Ranked by evidence volume first. Medicine has spent centuries ranking things by vibes. This is an improvement.

1
Isotretinoin
90% Effectiveness• 95% Confidence• 50% Safety• 45 trials• 75K participants
HIGH EvidenceGood ValueDose: 0.5-1 mg/kg/day
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Comparative Safety Scale(Higher is safer)

Cyanide☠️
Meth💀
Cigarettes🚬
Chemo☢️
Alcohol🍺
Morphine💊
Antibiotics💉
Tylenol💊
Exercise🏃
Water💧
50
DangerousModerateSafe

Time to Effect

1-2 months

Duration

4-6 months

Response Rate

88%

Remission Rate

70%

Number Needed to Treat (NNT)

3

Number Needed to Harm (NNH)

1

Common Side Effects:

Dry lips: 95%
Dry skin: 85%
Dry eyes: 60%
Nosebleeds: 40%
Muscle/joint aches: 30%
Photosensitivity: 25%
Elevated triglycerides: 20%
Elevated liver enzymes: 5%
Mood changes/depression: 2%
Teratogenicity: 100%

Annual Cost of Care

Drug Cost

$1,000

Monitoring

$1,350

Side Effects

$150

Total Annual

$2,500

Cost-Effectiveness

GOOD

QALYs Gained

0.2

Cost per Remission

$3,571.43

Cost per Responder

$2,840.91

Treatment Outcomes
Primary Outcomes
Total Lesion Count70 lesions
-85% (-60 lesions)
Inflammatory Lesion Count30 lesions
-92% (-28 lesions)
Acne Global Severity (IGA)IGA score: 4/5 (severe)
-75% (-3 points on IGA scale)
Sebum Production Rate2.5 µg/cm²/min
-85% (-2.1 µg/cm²/min)
Secondary Benefits
Acne-Specific Quality of LifeAcnes-QOL score: 40/100 (lower score = poorer QOL)
+60% (+24 points on Acnes-QOL)
HADS Anxiety ScoreHADS Anxiety score: 10/21 (mild anxiety)
-35% (-3.5 points on HADS Anxiety scale)
Patient Global SatisfactionPatient satisfaction: 30/100 (VAS)
+150% (+45 points on satisfaction VAS)
Common Side Effects
Dry lips
+95%
Dry skin
+85%
Dry eyes
+60%

Clinical Trial Phases:

Phase 4
2
Topical Retinoids (e.g., Adapalene, Tretinoin)
78% Effectiveness• 90% Confidence• 80% Safety• 2000 trials• 200K participants
HIGH EvidenceExcellent ValueDose: Applied once daily
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Comparative Safety Scale(Higher is safer)

Cyanide☠️
Meth💀
Cigarettes🚬
Chemo☢️
Alcohol🍺
Morphine💊
Antibiotics💉
Tylenol💊
Exercise🏃
Water💧
80
DangerousModerateSafe

Time to Effect

4-12 weeks

Duration

Long-term (years)

Response Rate

75%

Remission Rate

55%

Number Needed to Treat (NNT)

4

Number Needed to Harm (NNH)

3

Common Side Effects:

Dryness: 30%
Redness: 30%
Peeling: 20%
Burning/Stinging: 15%
Photosensitivity: 20%

Annual Cost of Care

Drug Cost

$50

Monitoring

$200

Side Effects

$50

Total Annual

$300

Cost-Effectiveness

EXCELLENT

QALYs Gained

0.08

Cost per Remission

$545.45

Cost per Responder

$400

Treatment Outcomes
Efficacy Outcomes
Overall Effectiveness
+78%
Response Rate
+75%
Remission Rate
+55%
Common Side Effects
Dryness
+30%
Redness
+30%
Peeling
+20%

Clinical Trial Phases:

Phase 4
3
Benzoyl Peroxide
70% Effectiveness• 90% Confidence• 80% Safety• 179 trials• 50K participants
HIGH EvidenceExcellent ValueDose: Applied once or twice daily (2.5-10%)
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Comparative Safety Scale(Higher is safer)

Cyanide☠️
Meth💀
Cigarettes🚬
Chemo☢️
Alcohol🍺
Morphine💊
Antibiotics💉
Tylenol💊
Exercise🏃
Water💧
80
DangerousModerateSafe

Time to Effect

2-5 weeks

Duration

Long-term (years)

Response Rate

65%

Remission Rate

45%

Number Needed to Treat (NNT)

7

Number Needed to Harm (NNH)

7

Common Side Effects:

Dryness: 20%
Redness: 20%
Peeling: 15%
Irritation: 10%
Bleaching fabric: 50%

Annual Cost of Care

Drug Cost

$30

Monitoring

$300

Side Effects

$20

Total Annual

$350

Cost-Effectiveness

EXCELLENT

QALYs Gained

0.05

Cost per Remission

$111.11

Cost per Responder

$76.92

Treatment Outcomes
Primary Outcomes
Inflammatory Lesion Count28 lesions
-45% (-13 lesions)
Non-inflammatory Lesion Count35 lesions
-35% (-12 lesions)
Investigator's Global Assessment (IGA) ScoreIGA score: 3/5 (Moderate)
-40% (-1.2 points)
Secondary Benefits
Total Lesion Count63 lesions
-40% (-25 lesions)
Acne-Specific Quality of Life (Acne-QoL) ScoreAcne-QoL score: 12/30 (higher indicates worse QoL)
-25% (-3 points)
Common Side Effects
Dryness
+20%
Redness
+20%
Peeling
+15%

Clinical Trial Phases:

Phase 4
4
Oral Antibiotics (e.g., Doxycycline)
68% Effectiveness• 85% Confidence• 65% Safety• 400 trials• 40K participants
MODERATE EvidenceModerate ValueDose: Doxycycline 20mg BID or 50-100mg daily/BID
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Comparative Safety Scale(Higher is safer)

Cyanide☠️
Meth💀
Cigarettes🚬
Chemo☢️
Alcohol🍺
Morphine💊
Antibiotics💉
Tylenol💊
Exercise🏃
Water💧
65
DangerousModerateSafe

Time to Effect

3-6 weeks

Duration

3-6 months (limited)

Response Rate

65%

Remission Rate

15%

Number Needed to Treat (NNT)

5

Number Needed to Harm (NNH)

7

Common Side Effects:

GI upset/nausea: 20%
Photosensitivity: 15%
Vaginal candidiasis: 10%
Antibiotic resistance: 5%
Esophageal irritation: 1%

Annual Cost of Care

Drug Cost

$250

Monitoring

$200

Side Effects

$50

Total Annual

$500

Cost-Effectiveness

MODERATE

QALYs Gained

0.05

Cost per Remission

$3,333.33

Cost per Responder

$769.23

Treatment Outcomes
Efficacy Outcomes
Overall Effectiveness
+68%
Response Rate
+65%
Remission Rate
+15%
Common Side Effects
GI upset/nausea
+20%
Photosensitivity
+15%
Vaginal candidiasis
+10%

Clinical Trial Phases:

Phase 4
5
Oral Contraceptives (combined estrogen-progestin)
65% Effectiveness• 85% Confidence• 60% Safety• 350 trials• 60K participants
HIGH EvidenceGood ValueDose: Once daily
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Comparative Safety Scale(Higher is safer)

Cyanide☠️
Meth💀
Cigarettes🚬
Chemo☢️
Alcohol🍺
Morphine💊
Antibiotics💉
Tylenol💊
Exercise🏃
Water💧
60
DangerousModerateSafe

Time to Effect

2-3 months

Duration

Long-term (years)

Response Rate

65%

Remission Rate

45%

Number Needed to Treat (NNT)

6

Number Needed to Harm (NNH)

8

Common Side Effects:

Nausea: 15%
Breast tenderness: 15%
Headache: 10%
Mood changes: 8%
Weight changes: 7%
Blood clots (VTE): 0.1%
Hypertension: 0.5%

Annual Cost of Care

Drug Cost

$350

Monitoring

$200

Side Effects

$20

Total Annual

$570

Cost-Effectiveness

GOOD

QALYs Gained

0.1

Cost per Remission

$1,266.67

Cost per Responder

$876.92

Treatment Outcomes
Efficacy Outcomes
Overall Effectiveness
+65%
Response Rate
+65%
Remission Rate
+45%
Common Side Effects
Nausea
+15%
Breast tenderness
+15%
Headache
+10%

Clinical Trial Phases:

Phase 4
6
Spironolactone
62% Effectiveness• 80% Confidence• 60% Safety• 3 trials• 10K participants
MODERATE EvidenceGood ValueDose: 25mg to 100mg daily
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Comparative Safety Scale(Higher is safer)

Cyanide☠️
Meth💀
Cigarettes🚬
Chemo☢️
Alcohol🍺
Morphine💊
Antibiotics💉
Tylenol💊
Exercise🏃
Water💧
60
DangerousModerateSafe

Time to Effect

2-3 months

Duration

Long-term (years)

Response Rate

65%

Remission Rate

45%

Number Needed to Treat (NNT)

7

Number Needed to Harm (NNH)

7

Common Side Effects:

Menstrual irregularities: 20%
Breast tenderness: 15%
Dizziness/lightheadedness: 10%
Fatigue: 7%
Hyperkalemia: 2%

Annual Cost of Care

Drug Cost

$200

Monitoring

$300

Side Effects

$20

Total Annual

$520

Cost-Effectiveness

GOOD

QALYs Gained

0.08

Cost per Remission

$1,155.56

Cost per Responder

$800

Treatment Outcomes
Primary Outcomes
Inflammatory Lesion Count30 lesions
-60% (-18 lesions)
Total Lesion Count70 lesions
-50% (-35 lesions)
Investigator Global Assessment (IGA) Score3 (Moderate) on a 0-4 scale
-66.67% (-2 grades improvement)
Secondary Benefits
Dermatology Life Quality Index (DLQI) Score15 (Moderate impact) on a 0-30 scale
-40% (-6 points)
Sebum Excretion Rate (Forehead)200 µg/cm²/hr
-30% (-60 µg/cm²/hr)
Patient-Reported Acne Severity Scale7 (Moderate) on a 0-10 scale
-57.14% (-4 points)
Common Side Effects
Menstrual irregularities
+20%
Breast tenderness
+15%
Dizziness/lightheadedness
+10%

Clinical Trial Phases:

Phase 4