Understanding peoples’ experiences and views of acne treatments

Abstract

Acne vulgaris is a common skin condition that predominately affects young people. Topical treatments are first-line but adherence is poor, and many people progress to long courses of oral antibiotics. The aim of this research was to explore people’s views and experiences of acne treatments; to develop a behavioural intervention to support self-management of acne; and to provide preliminary evaluation of this intervention in a feasibility trial.

The intervention was developed using a theory, evidence and person-based approach. A systematic review and synthesis of qualitative literature, and a secondary analysis of 25 qualitative interviews of young people with acne were conducted to explore people’s perceptions of acne and its treatments. The findings highlighted that the intervention needed to: build on a feeling of ‘control’; acknowledge the psychological impact of acne; address concerns around speed of onset of topicals, side effects and management of these; address confusion about different topicals available; and concerns and necessity around other acne treatments. These findings, along with complementary theory-based activities (behavioural analysis and construction of logic model), informed the development of a web-based intervention (built in LifeGuide software), which was refined through think-aloud interviews with 19 young people.

A feasibility randomised trial of the intervention was conducted amongst 53 people aged 14-25 years recruited through primary care practices. The feasibility trial primary outcome (Skindex-16) response rate was 87% at 4 weeks, 6 weeks or both time-points. Intervention usage data showed a high uptake of core intervention content although uptake for other modules were low. The changes observed in the outcome measures showed that the intervention group reported trends in the direction of benefit however, this will need to be explored further due to the feasibility aims of the trial.

This research demonstrated the feasibility of delivering a trial of a web-based intervention to support self-management for young people with acne. However, more work is needed to enhance engagement with the intervention, recruitment and follow-up rates. Recommendations are presented in the discussion chapter and a pilot study is suggested prior to a full trial. The intervention could support people to manage their acne in a way that avoids resorting to oral antibiotics.

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Identifiers

ORCID for Miriam Santer: orcid.org/0000-0001-7264-5260

ORCID for Adam Geraghty: orcid.org/0000-0001-7984-8351

ORCID for Paul Little: orcid.org/0000-0003-3664-1873

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