{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,8,1]],"date-time":"2026-08-01T02:00:45Z","timestamp":1785549645139,"version":"3.56.0"},"reference-count":22,"publisher":"Oxford University Press (OUP)","issue":"3","license":[{"start":{"date-parts":[[2026,4,2]],"date-time":"2026-04-02T00:00:00Z","timestamp":1775088000000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0\/"}],"content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":[],"published-print":{"date-parts":[[2026,5,29]]},"abstract":"<jats:title>Abstract<\/jats:title>\n                  <jats:p>Over the past decade, nonprescription skincare has gained significant attention. However, evidence supporting many skincare trends often lacks the rigorous testing seen in randomized controlled trials (RCTs) for prescribed medications. Vehicle arms in RCTs, which test nonmedicated treatments, provide insights that support the advocacy of basic skincare practices. This narrative literature review explores the lessons drawn from vehicle arms of RCTs in the management of conditions like acne vulgaris, actinic keratoses, melasma, postinflammatory hyperpigmentation and rosacea. A literature search was performed on MEDLINE and Embase to identify RCTs involving vehicle arms for the dermatological conditions. Data on outcomes, study design and sample size were extracted and analysed. Basic skincare practices such as cleansing, moisturizing and sun protection have consistently demonstrated meaningful improvements in dermatological outcomes, even without active treatments. Vehicle arms often achieve a substantial proportion of the efficacy seen in active treatments, frequently exceeding half of the efficacy seen in active treatments, emphasizing the potential of simple skincare regimens. For acne vulgaris, two identical international phase III RCTs (involving 2817 participants) demonstrated up to 25.7% improvement in facial acne severity and 51.2% reduction in inflammatory lesions with vehicle treatment. In actinic keratoses, an RCT (n = 468) showed up to 24% reduction in lesion count and 17% complete clearance in the vehicle arm. In melasma, an RCT (n = 48) demonstrated up to 66.6% improvement in severity with vehicle treatment. In postacne vulgaris postinflammatory hyperpigmentation, a phase IV trial (n = 123) showed up to 44.9% improvement in overall disease severity with vehicle treatment. For rosacea, a multicentre RCT (n = 120) showed up to 27% reduction in erythema in the vehicle arm. Basic skincare is an essential component of dermatological treatment. Evidence from placebo-controlled trials reinforces the value of skincare routines, which should be incorporated into treatment plans alongside active therapies to enhance efficacy and optimize patient outcomes.<\/jats:p>","DOI":"10.1093\/skinhd\/vzag020","type":"journal-article","created":{"date-parts":[[2026,2,14]],"date-time":"2026-02-14T12:40:07Z","timestamp":1771072807000},"page":"207-213","source":"Crossref","is-referenced-by-count":1,"title":["Clinical implications of skincare: lessons from placebo-controlled dermatology trials"],"prefix":"10.1093","volume":"6","author":[{"ORCID":"https:\/\/orcid.org\/0009-0006-7848-8669","authenticated-orcid":false,"given":"Chawalpat","family":"Siripanich","sequence":"first","affiliation":[{"name":"School of Medicine and Dentistry, University of Lancashire , Preston ,","place":["UK"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0009-0007-4891-8231","authenticated-orcid":false,"given":"Yan Ching","family":"Chow","sequence":"additional","affiliation":[{"name":"School of Medicine and Dentistry, University of Lancashire , Preston ,","place":["UK"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-8588-791X","authenticated-orcid":false,"given":"Faisal R","family":"Ali","sequence":"additional","affiliation":[{"name":"School of Medicine and Dentistry, University of Lancashire , Preston ,","place":["UK"]},{"name":"East Cheshire Dermatology Department, Mid Cheshire NHS Foundation Trust , Macclesfield ,","place":["UK"]},{"name":"Dermatological Surgery and Laser Unit, St John\u2019s Institute of Dermatology , Guy\u2019s and St Thomas\u2019 NHS Foundation Trust, London ,","place":["UK"]}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"286","published-online":{"date-parts":[[2026,4,2]]},"reference":[{"key":"2026052905170743500_vzag020-B1","doi-asserted-by":"crossref","first-page":"1247","DOI":"10.1093\/ced\/llae170","article-title":"Foundations first: the unchanging significance of cleansing in the era of fourth-generation retinoids","volume":"49","author":"Chow","year":"2024","journal-title":"Clin Exp Dermatol"},{"key":"2026052905170743500_vzag020-B2","author":"National Institute for Health and Care Excellence"},{"key":"2026052905170743500_vzag020-B3","doi-asserted-by":"crossref","first-page":"1691","DOI":"10.1016\/j.jaad.2019.02.044","article-title":"Randomized phase 3 evaluation of trifarotene 50 \u03bcg\/g cream treatment of moderate facial and truncal acne","volume":"80","author":"Tan","year":"2019","journal-title":"J Am Acad 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Dermatol"},{"key":"2026052905170743500_vzag020-B6","doi-asserted-by":"crossref","first-page":"14","DOI":"10.1159\/000081498","article-title":"Efficacy and safety of 0.1% retinaldehyde\/6% glycolic acid (Diacn\u00e9al) for mild to moderate acne vulgaris: a multicentre, double-blind, randomized, vehicle-controlled trial","volume":"210","author":"Poli","year":"2005","journal-title":"Dermatology"},{"key":"2026052905170743500_vzag020-B7","doi-asserted-by":"crossref","first-page":"3085","DOI":"10.1007\/s13555-023-01042-7","article-title":"Trifarotene reduces risk for atrophic acne scars: results from a phase 4 controlled study","volume":"13","author":"Schleicher","year":"2023","journal-title":"Dermatol Ther (Heidelb)"},{"key":"2026052905170743500_vzag020-B8","doi-asserted-by":"crossref","first-page":"20","DOI":"10.1111\/bjd.15107","article-title":"British Association of Dermatologists\u2019 guidelines for the care of patients with actinic keratosis 2017","volume":"176","author":"Berker","year":"2017","journal-title":"Br J Dermatol"},{"key":"2026052905170743500_vzag020-B9","doi-asserted-by":"crossref","first-page":"94","DOI":"10.1046\/j.1365-2133.2002.04561.x","article-title":"Topical treatment of actinic keratoses with 3.0% diclofenac in 2.5% hyaluronan gel","volume":"146","author":"Rivers","year":"2002","journal-title":"Br J Dermatol"},{"key":"2026052905170743500_vzag020-B10","doi-asserted-by":"crossref","first-page":"952","DOI":"10.1001\/jamadermatol.2015.0502","article-title":"Long-term efficacy of topical fluorouracil cream, 5%, for treating actinic keratosis","volume":"151","author":"Pomerantz","year":"2015","journal-title":"JAMA Dermatol"},{"key":"2026052905170743500_vzag020-B11","author":"British Association of Dermatologists"},{"key":"2026052905170743500_vzag020-B12","first-page":"868","article-title":"Topical isotretinoin for melasma in Thai patients: a vehicle-controlled clinical trial","volume":"82","author":"Leenutaphong","year":"1999","journal-title":"J Med Assoc Thai"},{"key":"2026052905170743500_vzag020-B13","doi-asserted-by":"crossref","first-page":"173","DOI":"10.1080\/09546630050517333","article-title":"A double-blind, comparative, placebo-controlled study of the efficacy and tolerability of 4% hydroquinone as a depigmenting agent in melasma","volume":"11","author":"Ennes","year":"2000","journal-title":"J Dermatolog Treat"},{"key":"2026052905170743500_vzag020-B14","author":"Ngan"},{"key":"2026052905170743500_vzag020-B15","first-page":"25","article-title":"Efficacy and safety of clindamycin phosphate 1.2% and tretinoin 0.025% gel for the treatment of acne and acne-induced post-inflammatory hyperpigmentation in patients with skin of color","volume":"5","author":"Callender","year":"2012","journal-title":"J Clin Aesthet Dermatol"},{"key":"2026052905170743500_vzag020-B16","author":"National Institute for Health and Care 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A double-blind study","volume":"108","author":"Nielsen","year":"1983","journal-title":"Br J Dermatol"},{"key":"2026052905170743500_vzag020-B19","doi-asserted-by":"crossref","first-page":"178","DOI":"10.1177\/120347549900300403","article-title":"Needs survey of Canadian rosacea patients","volume":"3","author":"Shear","year":"1999","journal-title":"J Cutan Med Surg"},{"key":"2026052905170743500_vzag020-B20","doi-asserted-by":"crossref","first-page":"2516","DOI":"10.1111\/jocd.16396","article-title":"Challenges and real-world solutions for adoption of holistic skincare routine (cleansing, treatment, moisturization, and photoprotection) in acne, rosacea, atopic dermatitis, and sensitive skin: an expert consensus","volume":"23","author":"Goh","year":"2024","journal-title":"J Cosmet Dermatol"},{"key":"2026052905170743500_vzag020-B21","doi-asserted-by":"crossref","first-page":"e14287","DOI":"10.1111\/dth.14287","article-title":"The application of skin care product in acne treatment","volume":"33","author":"Zhao","year":"2020","journal-title":"Dermatol Ther"},{"key":"2026052905170743500_vzag020-B22","doi-asserted-by":"crossref","first-page":"e70042","DOI":"10.1111\/exd.70042","article-title":"Ceramides and skin health: new insights","volume":"34","author":"Yong","year":"2025","journal-title":"Exp Dermatol"}],"container-title":["Skin Health and Disease"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/academic.oup.com\/skinhd\/article-pdf\/6\/3\/207\/67725168\/vzag020.pdf","content-type":"application\/pdf","content-version":"vor","intended-application":"syndication"},{"URL":"https:\/\/academic.oup.com\/skinhd\/article-pdf\/6\/3\/207\/67725168\/vzag020.pdf","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2026,5,29]],"date-time":"2026-05-29T09:17:16Z","timestamp":1780046236000},"score":1,"resource":{"primary":{"URL":"https:\/\/academic.oup.com\/skinhd\/article\/6\/3\/207\/8572459"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2026,4,2]]},"references-count":22,"journal-issue":{"issue":"3","published-online":{"date-parts":[[2026,4,2]]},"published-print":{"date-parts":[[2026,5,29]]}},"URL":"https:\/\/doi.org\/10.1093\/skinhd\/vzag020","relation":{},"ISSN":["2690-442X"],"issn-type":[{"value":"2690-442X","type":"electronic"}],"subject":[],"published-other":{"date-parts":[[2026,6]]},"published":{"date-parts":[[2026,4,2]]}}}