Effect of Quality of Life Impact and Clinical Severity on Adherence to Topical Acne Treatment

Background: Topical medications are the most commonly prescribed treatments for acne patients. However, adherence to these treatments and possible associations with clinical severity and quality of life (QoL) impact are unclear. Purpose: We evaluated the association between sociodemographic factors, clinical severity, and QoL impact and adherence to topical acne treatments. Methods: This was an observational study of acne patients referred for usual care to community-based dermatologists. Adherence was assessed with questionnaires after 2 months of acne therapy. The associations of adherence with factors of interest were evaluated by chi-square analysis and Spearman rank correlation. Results: In 152 acne patients treated with topical medications, low adherence was observed in 26%, medium in 49%, and high in 24%. Age, gender, duration of acne, education level, third-party drug plan coverage, smoking history, recreational drug use, ingestion of alcohol, and number of prescribed topical agents were not significantly associated with adherence. Adherence was significantly positively correlated with QoL impact (r = .24, p = .003), with the role-emotional and self-perception domains having the highest correlations. In contrast, adherence was weakly negatively correlated with facial acne severity (r = .16, p = .047). Limitations: This study focused on facial acne, and adherence was based on patient reporting. Conclusions: Adherence to topical acne therapy increases with impact on QoL but decreases with increasing acne severity.