Consumer preferences of top-rated over-the-counter acne treatment products: a cohort study

Over 70% of patients with acne vulgaris wait at least 1 year before seeing a dermatologist and instead use over-the-counter (OTC) acne treatments. This study determined the association between product characteristics (ingredients, vehicles, and marketing claims) and consumer-reported positive and negative features of top-rated acne OTCs. This cohort study evaluated the top 1% of acne OTCs across the five largest online retailers. Products were analyzed for product characteristics and consumer-reported features. Artificial intelligence data scraper software was utilized to collect reviews, and a natural language processing algorithm was used to tag key phrases within reviews and categorize them based on characteristics and sentiment (positive or negative). An inter-rater reliability test compared reliability of results between a human rater and the software. In this cohort of 149 products, the most frequent ingredients were salicylic acid (33.6%) and benzoyl peroxide (19.5%). Over one-third of top-selling products contained solely "natural" ingredients. Product ingredients, over product vehicle, price, marketing claims, or packaging, were most associated with consumer-reported product effects. Products with active ingredients were reported more frequently as effective in treating acne (p < 0.001) and with side effects, such as erythema (p = 0.054) and hypersensitivity reactions (p = 0.0016). Products with "natural" ingredients were associated with improving skin texture (p = 0.008) and application ease (p = 0.04). Product ingredients, over vehicle, price, marketing claims, and packaging were the greatest indicator of a consumer's experience with acne OTCs. Given the wide array of and heavy reliance on OTCs to treat acne, information on product experience inform dermatologists on consumer preferences.