INTRODUCTION
Acne vulgaris (acne) is a common dermatological condition, with a peak prevalence in adolescence but that may also extend into or develop during adulthood.1 Approximately 91% to 95% of adolescent males and 79% to 82% of adolescent females are affected, and 3% and 12% of adult men and women are affected, respectively.2 The associated direct and indirect costs of acquiring acne treatment from a clinician may prohibit some patients from doing so.2 This may be particularly true in younger patients, for whom acne has a predilection; and, despite an increased prevalence of acne in adolescents, the average age of presentation to a physician for acne treatment is 24 years old.2
Many patients opt for over-the-counter (OTC) treatments because of their increased accessibility compared with prescription medications.2 However, this phenomenon is not limited to younger patients as many adult patients may also face barriers to care.2 Barriers to care may influence patient preferences for treatment, and while both OTC and prescription acne treatments may be efficacious, preferences for OTC or prescription acne medications are not well established.1 The objective of our study was to assess adult patients’ experience with acne, over-the-counter and prescription acne treatments, and the barriers they face in acquiring treatment.
Many patients opt for over-the-counter (OTC) treatments because of their increased accessibility compared with prescription medications.2 However, this phenomenon is not limited to younger patients as many adult patients may also face barriers to care.2 Barriers to care may influence patient preferences for treatment, and while both OTC and prescription acne treatments may be efficacious, preferences for OTC or prescription acne medications are not well established.1 The objective of our study was to assess adult patients’ experience with acne, over-the-counter and prescription acne treatments, and the barriers they face in acquiring treatment.
MATERIALS AND METHODS
After Institutional Board Review approval, 529 subjects ≥ 18 years old from the United States were recruited through Amazon Mechanical Turk (MTurk), an online crowdsourcing platform used extensively in social science research.3 Subjects were surveyed via Qualtrics (Provo, UT) regarding whether they had acne currently or in the past, their experience and preferences with acne treatments, expenditure of treatments, and any barriers to care. An attention check was used to exclude any inattentive respondents from the analysis. Chi squared analysis was used for percent differences using SAS software 9.4.
RESULTS
A total of 500 out of 529 recruited subjects completed the survey (response rate 94.5%). After excluding responses that failed attention checks, 450 responses were analyzed, with mean age 36.5 (SD 10.6), 42% male, female 54%, 74.9% Caucasian. Most had completed a 4-year college degree or higher (74.7%) and lived in an urban or suburban area (86%); only 8.7% were uninsured (Table 1).
Of total analyzed respondents (n=450), 390 (86.7%) respondents stated that they currently had acne and 54 (12.0%) had a history of acne (Table 2). The majority of respondents who currently had acne were receiving treatment (308/390, 79.0%); OTC
Of total analyzed respondents (n=450), 390 (86.7%) respondents stated that they currently had acne and 54 (12.0%) had a history of acne (Table 2). The majority of respondents who currently had acne were receiving treatment (308/390, 79.0%); OTC
