Young people's perceptions of acne and acne treatments: secondary analysis of qualitative interview data

Abstract

Summary Background Acne vulgaris is a common skin condition affecting approximately 95% of adolescents to some extent. First‐line treatments are topical preparations but nonadherence is common. A substantial proportion of patients take long courses of oral antibiotics, associated with antibiotic resistance. Objectives This study aimed to explore young people's views and experiences of acne and its treatments. Methods We report a secondary thematic analysis of interview data collected by researchers in the Health Experiences Research Group (HERG), University of Oxford. A total of 25 transcripts from young people aged 13–24 years with acne were included. Results Acne is often perceived as a short‐term self‐limiting condition of adolescence and this appears to have implications for seeking treatment or advice. Participants widely perceived topical treatments as being ineffective, which seemed related to unrealistic expectations around speed of onset of action. Many participants felt they had tried all available topical treatments, although were unsure what was in them or unaware of differences between cosmetic and pharmaceutical treatments. They had concerns around how to use topicals ‘properly’ and how to avoid side‐effects. They were also concerned about the side‐effects or necessity of oral treatments, although few seemed aware of antibiotic resistance. Conclusions People with acne need support to manage their condition effectively, particularly a better understanding of different topicals, how to use them and how to avoid side‐effects. Unrealistic expectations about the onset of action of treatments appears to be a common cause of frustration and nonadherence. Directing people towards accessible evidence‐based information is crucial. What's already known about this topic? There is a common perception that acne is a short‐term condition that will resolve without treatment. Previous research has shown that nonadherence to topical treatments is common and that oral antibiotics are the most commonly prescribed treatment for acne in the U.K. Further research is needed to understand how young people perceive acne treatments and the implications of this for treatment adherence and self‐management. What does this study add? People often said they had tried all available topical preparations for acne, but seemed confused between cosmetic and pharmaceutical treatments. People seemed unsure how to use topical treatments ‘properly’ or how to avoid side‐effects. This was rarely discussed with health professionals. People's perception of acne as a short‐term condition appeared to influence their expectations around onset of action of treatment and their views about its effectiveness and necessity. What are the clinical implications of the work? The perception of acne as a short‐term condition has implications for self‐management and motivation to seek and adhere to treatments. Providing advice about onset of action of treatments and how to prevent side‐effects is crucial, including directing people towards acc...

Views and experiences of people with acne vulgaris and healthcare professionals about treatments: systematic review and thematic synthesis of qualitative research

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GPs’ perspectives on acne management in primary care: a qualitative interview study

“…Qualitative research into patients with acne has similarly found a perception of low effectiveness of topical treatments in comparison with oral antibiotics. 18 However, to the authors’ knowledge, the present study is the first to show that many GPs also hold this view and to explore the implications of GPs’ perceptions of patient expectations about antibiotic prescribing for acne. One previous qualitative study of GPs’ views of acne management found that GPs perceived patients’ non-adherence to topical treatments as a barrier to treatment success but that they rarely signposted patients to written information sources.…”

“…Semi-structured interviews were conducted by telephone between March 2018 and March 2019 by one author (DP). The interview guide was based on the available literature (2,18) and study aims and is shown in Box 1. The guide was developed and piloted prior to commencing interviews and minor revisions to wording made following the first two interviews.…”

Acne, the new trend? A discussion of the emerging social movement to embrace acne vulgaris

“…On the other hand, acne vulgaris is not only a highly treatable condition but also one that should be taken seriously and treated early. It has been shown that patients often delay treatments for up to 1 year after symptom occurrence, and that some may view acne as a short‐lived, self‐resolving condition not requiring treatment 4 . Furthermore, primary nonadherence for acne treatments is already high, with up to 27% of patients not initiating medications within 3 months of prescription 5 .…”