Ref (type)	Population	Outcome, Interventions	Results and statistical analysis	Effect size	Favours
Improvement in fine wrinkles
Systematic review	681 people with moderate to severe facial photodamage, and mild to severe photodamage of arms and hands Data from 1 RCT	Improvement in fine facial wrinkles 36 weeks with topical isotretinoin 0.1% (0.5 g) (applied once-daily for 36 weeks) with vehicle cream (applied once-daily for 36 weeks)	WMD 4.90 95% CI 3.79 to 6.01	Effect size not calculated	isotretinoin 0.1%
Systematic review	681 people with moderate to severe facial photodamage, and mild to severe photodamage of arms and hands Data from 1 RCT	Improvement in fine wrinkles of the forearm 36 weeks with topical isotretinoin 0.1% (0.5 g) (applied once-daily for 36 weeks) with vehicle cream (applied once-daily for 36 weeks)	WMD 3.0 95% CI 2.17 to 3.83	Effect size not calculated	isotretinoin 0.1%
RCT	776 people in 17 US centres, aged 20–76 years, with mild to moderate facial photodamage	Physician-assessed improvement of fine facial wrinkling (change from baseline measured on 100 mm VAS: –50 = worse, 0 = no change, +50 = better) 36 weeks +7.4 with topical isotretinoin 0.05% (applied once-daily for 12 weeks), followed by isotretinoin 0.01% (applied for the next 24 weeks) +5.3 with vehicle cream (applied for 36 weeks)	P <0.01	Effect size not calculated	isotretinoin
RCT	776 people in 17 US centres, aged 20–76 years, with mild to moderate facial photodamage	Participant-assessed improvement of fine facial wrinkling (change from baseline measured on 100 mm VAS: –50 = worse, 0 = no change, +50 = better) 36 weeks +11.7 with topical isotretinoin 0.05% (applied once-daily for 12 weeks), followed by isotretinoin 0.01% (applied daily for the next 24 weeks) +7.9 with vehicle cream (applied for 36 weeks)	P <0.01	Effect size not calculated	isotretinoin
Improvement in coarse wrinkles
Systematic review	681 people with moderate to severe facial photodamage, and mild to severe photodamage of arms and hands Data from 1 RCT	Improvement in coarse facial wrinkles 36 weeks with topical isotretinoin 0.1% (0.5 g) (applied once-daily for 36 weeks) with vehicle cream (applied once-daily for 36 weeks)	WMD 3.0 95% CI 2.17 to 3.83	Effect size not calculated	isotretinoin 0.1%
Improvement in wrinkles (global)
RCT	776 people in 17 US centres, aged 20–76 years, with mild to moderate facial photodamage	Physician-assessed overall skin appearance (change from baseline measured on 100 mm VAS: –50 = worse, 0 = no change, +50 = better) 36 weeks +8.3 with topical isotretinoin 0.05% (applied once-daily for 12 weeks), followed by isotretinoin 0.01% (applied for the next 24 weeks) +6.4 with vehicle cream (applied for 36 weeks)	P <0.01	Effect size not calculated	isotretinoin
RCT	776 people in 17 US centres, aged 20–76 years, with mild to moderate facial photodamage	Participant-assessed overall skin appearance (change from baseline measured on 100 mm VAS: –50 = worse, 0 = no change, +50 = better) 36 weeks with topical isotretinoin 0.05% (applied once-daily for 12 weeks), followed by isotretinoin 0.01% (applied for the next 24 weeks) with vehicle cream (applied for 36 weeks)	Reported as not significant P value not reported		Not significant