A Cross-Sectional Study Analyzing Recent Trends in the Treatment of Acne Vulgaris: Prescription Patterns and...

Acne vulgaris is one of the most common inflammatory skin conditions worldwide, with notable psychosocial ramifications. Despite the availability of multiple treatment options, evolving clinical guidelines and healthcare policies may influence prescription practices over time. This study examines the latest trends in acne management using recent data from the National Ambulatory Medical Care Survey (NAMCS).

We analyzed 2018-2019 NAMCS data to characterize acne treatment patterns across all age groups in outpatient settings in the United States. Treatments encompassed oral isotretinoin; hormonal therapies, such as oral contraceptive pills (OCPs) and spironolactone; systemic antibiotics, including minocycline, doxycycline, sarecycline, and tetracycline; and topical therapies, such as benzoyl peroxide, topical antibiotics, topical retinoids, azelaic acid, and salicylic acid.

A total of 8,756,594 acne-related visits were recorded, with 41.5% occurring among patients aged 13-19 years. Female patients constituted 65.4% of visits. Isotretinoin emerged as the most frequently prescribed treatment among women (31.1%), followed by oral antibiotics (17.4%) and spironolactone (11.2%). Spironolactone usage nearly doubled compared to prior data (5.1%-11.2%), while oral antibiotic prescriptions decreased from 22.9% to 17.4%. The use of OCPs slightly declined (5.7%-4.5%).

Our findings indicate a shift in acne management patterns, characterized by a rise in antiandrogenic therapies and a reduction in oral antibiotic use, suggesting heightened antibiotic stewardship efforts. The elevated frequency of isotretinoin prescriptions likely reflects the iPledge program requirements for periodic follow-up visits rather than an actual increase in disease severity. While these trends underscore ongoing changes in clinical practice, further longitudinal research is warranted to assess how these prescription shifts influence long-term patient outcomes.