Views and experiences of people with acne vulgaris and healthcare professionals about treatments: systematic review and thematic synthesis of qualitative research

Abstract

ObjectivesThe objective of this study was to systematically review and synthesise qualitative papers exploring views and experiences of acne and its treatments among people with acne, their carers and healthcare professionals (HCPs).DesignSystematic review and synthesis of qualitative papers.MethodsPapers were identified through Medline, EMBASE, PubMed, PsychINFO and CINAHL on 05 November 2019, forward and backward citation searching, Google Scholar and contacting authors. Inclusion criteria were studies reporting qualitative data and analysis, studies carried out among people with acne, their carers or HCPs and studies comprising different skin conditions, including acne. The title and abstracts of papers were independently screened by three researchers. Appraisal was carried out using the adapted Critical Appraisal Skills Programme tool. Thematic synthesis was used to synthesise findings.ResultsA total of 20 papers were included from six countries. Papers explored; experiences living with acne, psychosocial impact of acne, views on causation of acne, perceptions of acne treatments, ambivalence and ambiguity in young people’s experience of acne and HCPs’ attitudes towards acne management. Findings suggest that people often viewed acne as short-term and that this had implications for acne management, particularly long-term treatment adherence. People often felt that the substantial impact of acne was not recognised by others, or that their condition was ‘trivialised’ by HCPs. The sense of a lack of control over acne and control over treatment was linked to both psychological impact and treatment adherence. Concerns and uncertainty over acne treatments were influenced by variable advice and information from others.ConclusionsPeople need support with understanding the long-term management of acne, building control over acne and its treatments, acknowledging the impact and appropriate information to reduce the barriers to effective treatment use.PROSPERO registration numberCRD42016050525.

Comparison of fractionated frequency-doubled 1,064/532 nm picosecond Nd:YAG lasers and non-ablative fractional 1,540 nm Er: glass in the treatment of facial atrophic scars: a randomized, split-face, double-blind trial

“…Acne is the most common chronic inflammatory disease of hair follicles and sebaceous glands in adolescents and adults. Studies showed that about 80% of people over 20 years old had ever suffered from acne (1,2), and about 95% of acne patients would have acne scars of varying degrees (3). Facial atrophic scars can cause damage to the patient's appearance, often adversely affect the patient's social activities and mental health, and seriously affect the patient's quality of life (4,5).…”

Topical combination products for facial acne

“…Despite the lack of conclusive evidence, 9 many patients believe their acne is related to diet, lack of face washing, or sun exposure. 10 Topical combination products should be trialed for 2 to 3 months before trying other treatments.…”

Acne Vulgaris Burden, Risk Factors, Lifestyle Modification Influence and Treatment Options – A Review

“…In UK, a study investigated the psychological sequelae of acne and assessed the participants help-seeking behaviors found a significant correlation between the severity of acne and CADI, moreover, the feeling of embarrassment and unsuitable schedules were observed as obstacles to help seeking among young adults [17]. In a systematic review carried out by Athena et al, found that myths and misconceptions regarding causes of acne do exist, and poor experience between the patient and health care provider with the latter not recognizing the magnitude of psychological impact of acne may lead to misperception and self-blame [18]. Furthermore, including the family members in the management and encouraging their support have shown a positive impact and did improve the experience and make it less uncomfortable [18].…”

“…In a systematic review carried out by Athena et al, found that myths and misconceptions regarding causes of acne do exist, and poor experience between the patient and health care provider with the latter not recognizing the magnitude of psychological impact of acne may lead to misperception and self-blame [18]. Furthermore, including the family members in the management and encouraging their support have shown a positive impact and did improve the experience and make it less uncomfortable [18].…”