Presentation and management of acne in primary care: a retrospective cohort study

Abstract

Background: Acne is the most common skin disorder in young people, affecting up to 80% of teenagers.

Aims: To ascertain the incidence, prevalence, demographic distribution and severity of acne in primary care and to document the management of these patients for a two-year period after presentation.

Design of study: Retrospective cohort study using data from the medical records of 798 patients who had been treated for acne during a one-year identification period.

Setting: Fourteen general practices in a mixed urban area in north-east England.

Method: Patients aged 13 to 25 years who had acne were identified from computerised practice medical records using diagnostic codes and medication records. The medical records of these patients were then hand-searched for data for two years after presentation.

Results: Data were collected for 798 patients from 14 practices. The prevalence of acne in 13- to 25-year-olds was 3.1%, and the incidence was 1.6%. The ratio of male to female patients with acne was 1:1.02. Median age at presentation was 15 years for male subjects and 16 years for female subjects. Recording of site and severity was rare (18.3%). In total, 55% of patients had two or more different prescriptions for acne, 21% of patients had six or more consultations during the two-year follow-up period, and 8.5% were referred to a dermatologist.

Conclusion: Given previous estimates of community prevalence, it is clear that the majority of young people with acne do not present to primary care. These findings have implications for the provision of effective and appropriate health care for young people with acne.