Acne management in Norway: GP and dermatologist prescriptions (2012-2019): a nationwide overview

Acne is common and associated with negative psychosocial health and risk of permanent skin alterations. GPs prescribe the main portion of antibiotics used for acne. Increased isotretinoin prescription by GPs can potentially reduce overall antibiotic use, but prescription practice and trends are unknown.

To examine acne treatment in Norway and quantify prescription and initiation of isotretinoin and tetracyclines.

An observational study linking data from health registries. Data were collected from the Norwegian Prescription Database (NorPD), the national GP claims register (KUHR database), and the Regular General Practitioner (RGP) registry.

All patients aged 12-39 years who received an acne diagnosis or were prescribed acne medication in Norway 2012-2019 were included. Linear regression was used to explore time trends.

In total, 316 075 patients were included (63% female). Yearly prevalence of systemic treatment increased from 1.9 in 2012 to 2.4% in 2019; isotretinoin increased by +123%, tetracyclines by +4% as measured in defined daily doses (DDDs). Topical treatment increased by +13% as measured by number of prescriptions. GP prescription of tetracyclines decreased 11%; however, courses had a mean duration of 160 days, which is longer than the recommended 90 days, and only 26% had a co-occurring topical treatment prescription. GPs initiated 5% of isotretinoin courses in 2012, versus 10% in 2019, and 19% (n = 1339) of GPs initiated isotretinoin at least once during the study period.

GPs reduced their prescription of tetracyclines, but our data still show potential for further improvements in prescribing practice. Increased isotretinoin prescription by GPs may lead to reduced antibiotic use and better treatment regimens for moderate-to-severe acne.