| Objective: To assess the efficacy and safety of topical retinoids in the treatment of acne vulgaris, specifically to compare with placebo or other drugs (antibiotics, benzoyl peroxide, sulfur preparation).Method: The electronic databases were searched including MEDLINE (1969-2002), EMBASE (1984-2002), Chinese Biology and Medicine disc (CBM)(1978-2002), CCTR, the Skin Group's Specialised Register. According to cochrane Reviewer's Handbook and search strategy of the cochrane skin group. References of above searched articles, Chinese Journal of Dermatology, Chinese Journal of Dermatovenereology, Journal of Clinic Dermatology, China Journal of Leprosy and Skin Disease, Journal of Dermatology and Venereology, and Foreign Medical Sciences (Section of dermatology and venereology) were hand searched. Also acne experts and pharmaceutical companies were contacted to acquire published and unpublished studies. The RCT studies meeting the inclusion criteria were selected. Two independent reviewers did data extraction and evaluation oftrials. Forms were used to show the characteristics of the trials. Jadad scale and degree of randomization allocation concealment were used to evaluate methodological quality of trials. Homogeneity, Meta-analysis and sensitivity analysis were made. If Meta-analysis can't be done, qualitative descriptions were made.Results: Up to 2002,15 studies (with 2439 patients) met the inclusion criteria.4 trials showed topical retinoids was much more effective especially in noninflamed lesions than placebo.3 trials showed topical retinoids was more effective than sulfur preparations. From 7 trials comparing retinoids with benzoyl peroxide and 3 trials comparing retinoids with antibiotics, no definite conclusion could be drawn. All trials described the local side effects, e.g. erythma, scale, dryness, burning. No evidence showed systematic side effect when topical retinoids were used. But prescription to pregnant women must be very cautious.Conclusion: Topical retinoids is effective in the treatment of acne vulgaris and is better than sulfur preparation. It is too week to recommend which is better when topical retinoids compared with benzoyl peroxide and antibiotics. Local side effects are found. There is no evidence showed systematic side effect. So it is necessary that rigorously designed high quality, large-scale randomized controlled trials are required. The update version of this review will provide new information.version of this review will provide new information.
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