For the clinician there are two outstanding reasons for the clinical assessment of acne: to monitor the patient's progress and to contribute towards our greater understanding of the disease  through clinical trials.  The immediate concern is for the patient and by continuous assessment the efficacy of a particular treatment can be confirmed. In the long  term, however,  the need for improvement in existing treatments cannot be denied. It is in the interest of producing even more effective treatments than the existing, albeit impressive, preparations that clinicians should devote some part of their resources to this aspect of research.

  This chapter discusses in some detail the methodology of a clinical trial and for this no apology is made. Assessment is not without its problems of subjectivity, in particular in methods of grading. From the experience of many trials we have evolved a methodology that avoids over-subjective interpretation as far as possible. doctor, but  there were no  significant  differences. Assessment  of noninflamed lesions was less  accurate than of inflamed lesions. Noninflamed lesions Noninflamed lesions  are blackheads and whiteheads and each type should be assessed. The many intermediate lesions of this type that occur should be taken into account and scored depending upon their major component.

  Prominent follicles, small milia or trichostasis spinulosa are extremely common and should not be regarded as acne lesions. Prominent follicles are easily confused with comedones  around the nose and on the chin, especially in mid-teenagers. Hence in trials it is recommended that noninflamed lesions are not counted either on the nose or around the edges of the nose.