An Open-Label, Single-Center, Evaluator-Blinded, Randomized, Pilot Study on Perceptions of Efficacy, Self-image, and Adherence in the Treatment of Acne Vulgaris in Teenagers

Acne vulgaris can be a psychologically disturbing disease and many clinicians believe that patients who are bothered by their disease will better adhere to treatment.

In this study, 61 teenagers with moderate to severe acne vulgaris were enrolled in a study to test 3 adherence interventions and assess if their perceptions of disease severity and medication effectiveness impacted adherence to medical therapy. Adherence was monitored using Medication Event Monitoring System (MEMS) caps. At the end of the study, participants were asked: “Do you believe that the treatment was effective at treating your acne?” and “Overall, how do you feel about your appearance?” Participants’ responses were matched with their respective adherence rates. Of the 46 participants that completed the study, adherence rates ranged from 8% to 99%. Survey questions on treatment effectiveness and participant perception of appearance yielded mean responses (SD) of 7.6 (2.4) and 7.9 (2.0), respectively. No correlation was found between treatment adherence rates and survey responses. The study concluded that poor correlation between the psychological impact of disease and treatment adherence may be a general phenomenon. Clinicians should not expect patients who are psychologically distressed by their disease to adhere to treatment simply because they are distressed.