Mohammad KA Basra; Muhammad Shahrukh


Expert Rev Pharmacoeconomics Outcomes Res. 2009;9(3):271-283. 

In This Article


Acne is the most common skin condition treated by doctors.[78] In the USA, acne vulgaris affects nearly 40-50 million people.[79] Although most of the sufferers are adolescents and young adults, acne can affect patients of any age group and patients with postadolescent acne are increasingly being referred for dermatological care. In one study almost 18% of women were found to have true late-onset disease, with an onset after the age of 25 years.[80]

Owing to its visible nature and the resulting scarring, acne is associated with a significant psychosocial impact on the patient's life that could be comparable to the psychosocial impact of some major chronic medical conditions such as asthma, diabetes, epilepsy and arthritis.[81] On the other hand, psychosocial distress itself can be a provocative factor in acne flares.[82] The QoL impact is independent of the clinical severity of acne and even mild forms of acne can be severely disabling psychosocially.[83] Patients with mild-to-moderate acne can have considerable psychological morbidity, including depression and suicidal ideation. The prevalence of suicidal ideation in mild-to-moderate facial acne was shown to be similar to that in severely affected psoriasis patients.[84] Acne sufferers also have been shown to have higher levels of anxiety compared with a control population.[85] Studies have further found that school-going adolescents with acne feel embarrassed because of their facial appearance, are socially isolated and more self-conscious than their companions.[86] Their relationship with family members can also be affected.[87] Moreover, patients with acne have a lower chance of being selected for employment.[88]

In addition to its huge impact on a patient's QoL, acne can have economic consequences. The annual cost of nonprescription drugs for acne has been estimated to be approximately $100 million.[89] Visits to primary care physicians for acne-related disorders have increased tremendously from 400,000 per year in 1980-1981 to 900,000 per year in 1989-1991.[90] A 16- to 20-week course of isotretinoin costs approximately US$500-700.[91] Although the treatment options are similar in different skin types, patients with darker skin may suffer from additional costs due to the higher incidence of postinflammatory hyperpigmentation and keloidal scarring.[92] These may be caused not only by acne lesions but also due to the destruction of the skin due to the injudicious use of over-the-counter products.


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