Patient Expectations, Safety Concerns, and Adherence to Topical Acne Medications: Findings from a Web-Based Survey

Suboptimal adherence to first-line topical medications (eg, topical retinoids, benzoyl peroxide, and topical antibiotics) is a major barrier to effective acne vulgaris (AV) management. The influence of patients' pre-treatment expectations and concerns about adverse effects on adherence behavior remains inadequately quantified.

To evaluate young patients' perceptions of acne and their expectations, concerns, and adherence regarding topical medications.

A web-based cross-sectional survey was conducted from December 2023 to January 2024. Patients aged 16-29 with a history of AV and topical medication use were recruited. Data on demographics, disease perception, medication knowledge, usage patterns, and adherence were collected via a structured questionnaire and analyzed using descriptive and comparative statistics.

A total of 501 valid questionnaires were collected. Patients acquired their knowledge about acne through various channels, with dermatologists being the most reliable source of information. Although 82.83% of patients recognized AV as a chronic disease, substantial misconceptions regarding its etiology and treatment persisted. Topical medications were commonly used, most frequently adapalene (40.92%), tretinoin (32.93%), benzoyl peroxide (24.75%), and clindamycin (20.96%). However, patients demonstrated limited knowledge regarding the proper application. Expectations for the onset of topical medications were overly optimistic, whereas the actual duration of use was often inadequate. The information that respondents had the strongest desire to access included the side effects, method of use, onset time, and duration of use. Medication discontinuation was primarily attributed to perceived slow efficacy or concerns about adverse effects, which contributed to a relatively high recurrence rate following treatment cessation.

Young patients demonstrated limited comprehension of AV and lacked knowledge of topical medications and their appropriate application, as well as unrealistic expectations regarding onset time. Enhanced education on the nature of AV, along with detailed instructions on topical medication use, is crucial for improving patients' disease awareness and treatment adherence.