Despite the large number of English-language controlled trials regarding acne therapy, their methodological limitations prevent our ability to evaluate the comparisons among therapies, and may limit the conclusions that others may draw in the future from this evidence base, even when coupled with expert knowledge. Multiple treatments, inconsistent information about baseline characteristics, and heterogeneity of assessment schemes and outcomes make it difficult to synthesize the evidence about best approaches to acne management. For future research to provide results for comparison, standardization among researchers is needed in these different areas. Research is needed to define the optimal sequence of acne therapy, and to define the relative roles of specialists and generalists in the care of acne.