Acne therapy. Medication use and sources of care in office-based practice.

BACKGROUND AND DESIGN

This study quantifies visits to office-based physicians for the treatment of acne from 1980 through 1991 and describes treatments prescribed. Data were collected from the National Ambulatory Medical Care Survey, a multistage probability survey conducted in 1980, 1981, 1985, 1989, 1990, and 1991, and were used to estimate visits with specific characteristics. Of 276 689 visits sampled in these surveys, 3075 included a diagnosis of acne and 2678 were principally for acne.

RESULTS

Visits for acne as a primary complaint decreased from 7.5 million per year in 1980 and 1981 to 5.4 million per year in 1989 to 1991. The proportion of visits to physicians other than dermatologists increased 2.1-fold from 1980 and 1981 to 1989 through 1991. Differences in the rate of prescribing oral antibiotics between dermatologists and nondermatologists narrowed from 1980 to 1991. Of drugs available throughout the study, topical tretinoin had the greatest increase in usage. Oral isotretinoin was more often prescribed at visits for men than for women. The proportion of acne visits at which isotretinoin was prescribed was comparable for dermatologists and nondermatologists.

CONCLUSIONS

Acne remains one of the most frequent reasons for visiting dermatologists. By 1991, nondermatologists provided 23% of care for this disease. From 1980 to 1991, the pattern of prescribing medications for acne by dermatologists and nondermatologists became more alike. Demand for dermatologists' services for acne treatment is decreasing.