New Research Highlights Significant Knowledge Gaps in Patients Using Oral Acne Medication

New research has examined the knowledge, attitudes, and practices related to oral medication therapy among patients with moderate to severe acne via an online questionnaire, with the aim of identifying gaps that may influence adherence and treatment outcomes.¹

“By gaining insight into patient needs and concerns, the findings may support clinicians in developing more scientific and personalized treatment strategies, thereby better meeting patient needs and improving treatment success rates and compliance,” the authors wrote.

The cross-sectional study was conducted at the tertiary Dingxi People’s Hospital in China between March and June 2024 and included 561 patients diagnosed according to national acne guidelines. Two-thirds of participants were under 24 years old, and the cohort was predominantly female. Many also lived in urban settings, reflecting the demographic profile of patients commonly seeking care for more severe acne. Prior literature has confirmed that the incidence of acne is increasing annually, especially among urban adolescents in China.²

Results

Although the majority of respondents reported confidence in their understanding of routine acne management and satisfaction with current treatment effectiveness (72.72%), detailed assessment revealed substantial knowledge deficits regarding oral therapies. Between 40% and 59% of patients selected “unsure” when asked about commonly prescribed oral medications, including antibiotics, isotretinoin, and oral contraceptives. Awareness of potential adverse effects was similarly limited, with many patients uncertain about risks such as hepatotoxicity or neurocognitive effects. Notably, more than two-thirds of respondents either denied or were unsure about the role of genetic predisposition in acne, highlighting a fundamental misunderstanding of disease etiology that may impair realistic treatment expectations.

While patients generally expressed positive views toward medical care and treatment efficacy, anxiety about long-term outcomes remained prominent. Over 75% worried that residual scarring or dyspigmentation would negatively affect social interactions, and nearly two-thirds expressed concern about systemic medication adverse effects. The authors noted that these fears may contribute to hesitancy toward oral therapies, despite clinical indications.

Reported practices suggested partial but inconsistent engagement with recommended self-management behaviors. Most patients felt capable of managing acne after clinical visits, yet a subset reported rarely seeking additional information or guidance. Responses to adverse drug reactions raised particular concern. Some patients indicated they would continue medication at the same or reduced dose without consulting a clinician, underscoring potential safety risks associated with unsupervised decision-making.

Overall, higher knowledge scores were significantly associated with more positive attitudes and better practices (p = 0.002). These high knowledge levels were associated with higher income and student status, whereas rural residence was linked to less favorable attitudes. Knowledge emerged as the strongest predictor of appropriate practices, reinforcing its central role in patient self-management.

Clinical Implications

From a clinical perspective, this study highlights a mismatch between patients’ perceived and actual understanding of oral acne therapies. Overestimation of knowledge may reduce openness to counseling and follow-up, while misconceptions about genetics and pharmacology may foster unrealistic expectations or inappropriate medication use. For dermatologists, these findings emphasize the need for structured, targeted patient education that goes beyond routine counseling. Clear explanations of acne pathophysiology, the rationale for oral and combination therapies, anticipated timelines, and management of adverse effects are needed.

Incorporating brief assessments of patient understanding into routine visits, using plain language, visual aids, or digital tools, may help identify gaps early. Emphasizing shared decision-making and confirming comprehension can improve adherence and safety. Ultimately, this research emphasizes that aligning educational strategies with patients’ actual knowledge and concerns may optimize outcomes for those requiring long-term oral therapy for acne.

“Future research should aim to refine knowledge, attitudes, and practices assessment tools, expand study populations across multiple clinical sites, and test educational interventions that address specific knowledge gaps and behavioral patterns,” the study authors concluded.

References

1. Wang J, Bai D, Yao X, Song X, Yang X, Yuan Y. Knowledge, Attitudes, and Practices of Patients with Moderate to Severe Acne Regarding Oral Medication Therapy: A Structural Equation Modeling Analysis. 2026. Clinical, Cosmetic and Investigational Dermatology, 19, 1–12. https://doi.org/10.2147/CCID.S554435

2. Wang Y, Xiao S, Ren J, Zhang Y. Analysis of the epidemiological burden of acne vulgaris in China based on the data of global burden of disease 2019. Front Med (Lausanne). 2022;9:939584. Published 2022 Oct 4. doi:10.3389/fmed.2022.939584