INTRODUCTION
Acne vulgaris is a common, chronic dermatologic condition with an estimated global prevalence of 9.4% across age groups.1,2 The condition presents as open or closed comedones, papules, pustules, or nodules on the face or torso and is associated with complications such as scars, postinflammatory erythema, and postinflammatory hyperpigmentation (PIH).2-4 Patients may also experience negative mental health impacts such as poor self-esteem, depression, and anxiety.3,4
Acne treatment can be complicated by its complex and chronic nature. Owing to the various factors that contribute to acne pathogenesis, including inflammation, abnormal keratinization, overactive sebum production, and proliferation of Cutibacterium acnes in the follicle,2 multiple treatment types targeting different mechanisms of disease pathogenesis may be necessary. As most treatments do not demonstrate efficacy until after several weeks of use, it can take months to years of diligent treatment application to resolve acne.
As such, adherence to acne treatment is critical for efficacy.5-7 Premature discontinuation of treatment can lead to symptom recurrence and exacerbation of sequelae such as scarring and PIH.8,9 Moreover, a positive correlation has been observed between adherence and acne-specific quality of life.10 Unfortunately, adherence to acne treatment is typically poor and is a major barrier to treating the condition.5 There are 2 types of treatment adherence: primary and secondary. Poor primary adherence occurs when medication is not started for the first time, and poor secondary adherence occurs when medication is started but not taken as directed.11 Different factors play a role in primary vs secondary adherence and should be taken into account when optimizing patient adherence to treatment.
In this review, we summarize reported adherence rates to different acne medications and present major factors that influence adherence to acne treatment. Additionally, we explore potential strategies that may mitigate treatment noncompliance with the goal of improving patient outcomes.
Acne treatment can be complicated by its complex and chronic nature. Owing to the various factors that contribute to acne pathogenesis, including inflammation, abnormal keratinization, overactive sebum production, and proliferation of Cutibacterium acnes in the follicle,2 multiple treatment types targeting different mechanisms of disease pathogenesis may be necessary. As most treatments do not demonstrate efficacy until after several weeks of use, it can take months to years of diligent treatment application to resolve acne.
As such, adherence to acne treatment is critical for efficacy.5-7 Premature discontinuation of treatment can lead to symptom recurrence and exacerbation of sequelae such as scarring and PIH.8,9 Moreover, a positive correlation has been observed between adherence and acne-specific quality of life.10 Unfortunately, adherence to acne treatment is typically poor and is a major barrier to treating the condition.5 There are 2 types of treatment adherence: primary and secondary. Poor primary adherence occurs when medication is not started for the first time, and poor secondary adherence occurs when medication is started but not taken as directed.11 Different factors play a role in primary vs secondary adherence and should be taken into account when optimizing patient adherence to treatment.
In this review, we summarize reported adherence rates to different acne medications and present major factors that influence adherence to acne treatment. Additionally, we explore potential strategies that may mitigate treatment noncompliance with the goal of improving patient outcomes.
