Investigators have found that a large proportion of patients with acne may receive drug prescriptions that don't align with current guidelines.
In the observational, cross-sectional study, published in the Journal of Clinical and Aesthetic Dermatology, the investigators identified patterns in the pharmacologic management and potentially inappropriate prescriptions among patients with acne.
They used a Colombian health system database to analyze the prescription data of 21,604 patients with a median age of 20.8 years, 60.7% (n = 13,120) of whom were female. Antibiotics were found to be the most prescribed treatment, with 79.9% (n = 17,269) of patients receiving them—particularly doxycycline (66.0%, n = 14,257). Retinoids were prescribed among 55.7% (n = 12,023) of the patients.
The investigators discovered that 17.2% (n = 3,723) of the patients received potentially inappropriate prescriptions, including drugs with an undoubted causal relationship with acne, drugs with a considerable causal relationship with acne but with insufficient data, and drugs occasionally related to acne. The most common inappropriate prescriptions were progestogens with androgenic properties, affecting 8.9% (n = 1,921) of the patients. Female patients and those with comorbidities such as systemic lupus erythematosus (odds ratio [OR] = 18.61, 95% confidence interval [CI] = 7.23–47.93) and rheumatoid arthritis (OR = 10.80, 95% CI = 5.02–23.23) were more likely to receive these prescriptions. The risk increased with each additional year of age (OR = 1.02, 95% CI = 1.02–1.03).
“Approximately one-fifth of patients receive some potentially inappropriate medication that could exacerbate their skin lesions,” stressed the study authors. "Some of these medications, such as corticosteroids, immunosuppressants, or disease-modifying [antirheumatic] drugs, cannot be withdrawn in patients with rheumatologic pathologies, but androgenic progestogens should be avoided in favor of those with antiandrogenic properties,” they underscored.
The investigators found that systemic antibiotics were frequently used, which may not always align with clinical practice guidelines, indicating a need for more careful prescribing practices.
The authors report no conflicts of interest.