Patient Perspectives on the Lived Experience of Acne and Its Treatment Among Adult Women With Acne

Abstract

cne is responsible for a greater global burden of disease than psoriasis, cellulitis, and melanoma. [1][2][3] Not only can acne be associated with physical disfigurement, such as permanent scarring, but its emotional impact can lead to social isolation, depression, and suicidality. In fact, treatment of acne is associated with reduced symptoms of depression. [4][5][6] Given the profound association of acne with quality of life, several qualitative studies [7][8][9][10][11] have sought to understand the lived experience of acne among adolescents. These studies [7][8][9][10][11] have highlighted that acne can have important effects on social and emotional functioning, relationships, school, and work. 12 However, few studies have specifically explored the lived experience of acne in adult populations, and these studies 13,14 have been limited by small sample sizes. Because acne often persists into adulthood in women, understanding their perspectives on acne and its treatment is important to guide clinical management in this population. 15 The purpose of this study was to examine the lived experience of acne and its treatment among a large cohort of adult women. Methods Study ParticipantsFemale patients 18 to 40 years of age with moderate to severe acne were recruited from clinics at the University of Pennsylvania Health System and Dermatologists of Southwest Ohio (a INTRODUCTION Acne often persists into adulthood in women. However, few studies have specifically explored the lived experience of acne in adult populations.OBJECTIVE To examine the lived experience of acne and its treatment among a cohort of adult women. DESIGN, SETTING, AND PARTICIPANTSA qualitative analysis was conducted from free listing and open-ended, semistructured interviews of patients at a large academic health care system (University of Pennsylvania Health System) and a private practice (Dermatologists of Southwest Ohio). Fifty women 18 to 40 years of age with moderate to severe acne participated in interviews conducted between August 30, 2019, and December 31, 2020. MAIN OUTCOMES AND MEASURESFree-listing data from interviews were used to calculate the Smith S, a measure of saliency for each list item. Semistructured interviews were examined to detect themes about patient perspectives regarding their acne and its treatment.RESULTS Fifty participants (mean [SD] age, 28 [5.38] years; 24 [48%] White) described acne-related concerns about their appearance that affected their social, professional, and personal lives, with many altering their behavior because of their acne. Depression, anxiety, and social isolation were commonly reported. Participants described successful treatment as having completely clear skin over time or a manageable number of blemishes. Many participants described frustration with finding a dermatologist with whom they were comfortable and with identifying effective treatments for their acne. CONCLUSIONS AND RELEVANCEThe results of this qualitative study suggest that women with acne have strong concerns about appearance and exp...

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