Acne TOP TEN research priorities announced following a very successful final workshop in London

Tuesday 04 March saw the culmination of 16 months hard work for the Acne PSP. After a day of lively debate, the 24 patients and health care professionals who came and batted hard for the unanswered questions they felt were most important, finally reached agreement about the TOP TEN priority areas for acne treatment research to address.

Participants at the workshop were given a list of the 18 questions (from the shortlist of 30) that received the highest scores in the online vote, which we ran from 22 December to 10 Feb and in which over 3,000 people took part. During the morning session, delegates were split into three groups, each with a trained facilitator. By lunchtime, each group had ordered the questions from most to least important. In the afternoon session, Lester Firkins, chairman of our Steering Group, led another round of discussion based on the aggregate ranks from the morning session, this time in one large group, and expertly steered us towards a final decision. One of the patient delegates told us 'I found the free ranging discussions with clinicians informative and rewarding. We had a better understanding of each other priorities as a result.' A clinician reflected 'It was very useful to find out what patients want to know compared to what I thought they wanted to know.'

So what was deemed to be the most important question for new research to address and what else made it into the TOP TEN? Our top priority was:

1. What management strategy should be adopted for the treatment of acne in order to optimise short and long-term outcomes?

Here are the others that made the TOP TEN:

2. What is the correct way to use antibiotics in acne to achieve the best outcomes with least risk?
3. What is the best treatment for acne scars?
4. What is the best way of preventing acne?
5. What is the correct way to use oral isotretinoin (Roaccutane) in acne in order to achieve the best outcomes with least risk of potentially serious adverse effects?
6. Which lifestyle factors affect acne susceptibility or acne severity the most and could diet be one of them?"
7. What is the best way of managing acne in mature women who may/may not have underlying hormonal abnormalities?
8. What is the best topical product for treating acne?
9. Which physical therapies including lasers and other light based treatments are safe and effective in treating acne?
10. How long do acne treatments take to work and which ones are fastest acting?

It has taken a couple of days to agree the new wording of three questions (1, 5 and 6) which delegates wanted to expand by merging them with other questions on the shortlist.

Dr Alison Layton, clinical lead of the PSP said 'As a specialist who has been looking after patients suffering from acne for many years, it has been fascinating to understand what matters most to all those people with acne who I never see in my hospital-based clinic. It has also been revealing to find out what my fellow healthcare professionals and those who treat acne outside the NHS regard as priorities for acne treatment research. We've listened to and learnt from all of them. It's amazing how much we still don't know about widely used treatments. Our number one priority might seem very broad but it reflects the fact that acne is a chronic condition that requires a radically new approach to long-term management if we are to meet people's expectations of high quality care.'

Lester Firkins of the JLA, chairman of the Acne PSP Steering Group, ended the workshop by reminding everyone that the TOP TEN isn't an end but a beginning. 'The final workshop was a massive credit to all who took part. The larger than normal group was able to debate, argue and adapt without any form of bad feeling where compromises on people's "favourites" had to be made. It was exciting for me to see so many younger people in the mix. Their insights and positive attitude were something I personally have not had the opportunity to experience on a previous PSP. Given that acne predominantly affects teenagers and young adults, it was essential that their voices were heard loud and clear. It's now up to the research community to rise to the challenge and provide the answers patients and professionals want to increase the benefits and lower the risks of acne treatments. In addition, every single treatment uncertainty suggested, whether in the TOP TEN or not, will be recorded within the publicly available database, UK DUETs (, for future reference. Nothing will have been lost.'

What happens next?

We will disseminate the ACNE TOP TEN as widely as possible using as many mechanisms as possible. We'll submit a paper to a medical journal and we'll write about the TOP TEN in articles for magazines. Partner organisations will be invited to email members and the TOP TEN will be added to the JLA web site. In addition, every single treatment uncertainty suggested, whether in the TOP TEN or not, will be recorded within the publicly available database, UK DUETs (, for future reference. Nothing will be lost. Acne researchers here in the UK and overseas use DUETs to identify the topics their work should address.

Over the next few months, we'll be changing our website to be more interactive and provide the information many of you have already told us you'd like to see. In the meantime, don't forget to read our weekly Question and Answer and look at the archive for any you've missed. All the questions were submitted by people who took part in our survey last summer. We've got so many, it will take most of this year to work through them all. Remember, these are questions we can answer, in whole or in part, without new research.