[Treatment of acne in daily clinical practice: an opinion poll among Spanish dermatologists]

Knowledge, Attitude, and Practice Regarding the Use of Isotretinoin in Saudi Arabia

Background Acne vulgaris is a widespread chronic inflammatory dermatological disease with a worldwide prevalence of 9.4%, affecting a large percentage of the young population in the Kingdom of Saudi Arabia. This study aimed to measure the knowledge, attitude, and practice toward the use of isotretinoin among the Saudi population. Methodology This cross-sectional study was conducted among the general population in Saudi Arabia between April 2023 and July 2023. A self-administered questionnaire was distributed across five regions of Saudi Arabia (central, eastern, western, southern, and northern) using Google Survey. The questionnaire included sociodemographic data, the pattern of isotretinoin used, and a 24-item questionnaire to assess the knowledge about isotretinoin. Results Of the 3,001 participants, 77.1% were females, and 55.4% were aged between 16 and 25 years. The prevalence of participants who previously used isotretinoin was 30.6%. The total mean knowledge score was 10.4 (SD = 5.99) out of 24 points, with more than half (52.9%) considered to have poor knowledge, 39.1% moderate knowledge, and only 7.9% good knowledge. Younger participants, female gender, Saudi nationality, never been married, and previous use of isotretinoin were associated with increased knowledge. Conclusions The knowledge of the general population regarding isotretinoin use was lacking. However, younger Saudi females who had previous isotretinoin usage tended to be more knowledgeable about isotretinoin compared to the rest of the participants. Increasing the general public's knowledge regarding isotretinoin and its safe use is necessary.

Challenges and Solutions in Oral Isotretinoin in Acne: Reflections on 35 Years of Experience

Acne vulgaris affects more than 80% of adolescents and young adults and forms a substantial proportion of the dermatologist's and general practitioner's caseload. Severity of symptoms varies but may result in facial scarring and psychological repercussions. Oral isotretinoin is highly effective but can only be prescribed by specialists. Side effects are recognized and mostly predictable, ranging from cosmetic effects to teratogenicity. These can affect patients' quality of life and treatment adherence. This article provides a commentary on 4 key areas: the use of oral isotretinoin vs oral antibiotics, including the importance of early recognition of nonresponse to treatment, the psychological effects of acne and isotretinoin treatment, the side effects of isotretinoin therapy, and cosmetic treatment options that can help alleviate predictable side effects. The authors, who have all participated in various international expert groups, draw on relevant literature and their extensive professional experience with oral isotretinoin in the treatment of acne. The aim of this article is to provide an informative and practical approach to managing oral isotretinoin treatment in patients with acne, to help optimize treatment of this skin disease.

Consensus-Based Acne Classification System and Treatment Algorithm for Spain

Acne is a chronic inflammatory disease whose psychosocial effects can greatly impair quality of life. Various scales are used to classify the severity of acne, and several treatment algorithms are currently applied: no consensus on a common scale or treatment guidelines has been reached. A group of Spanish experts therefore met to identify a scale the majority could accept as the most appropriate for classifying severity and treating accordingly. The group chose the following classifications: comedonal acne, mild or moderate papulopustular acne, severe papulopustular acne, moderate nodular acne, and nodular-cystic acne (or acne tending to leave scars). Consensus was reached on first- and second-choice treatments for each type and on maintenance treatment. The experts also issued specific recommendations on antibiotic use (starting with mild or moderate papulopustular acne), always in combination with retinoids and/or benzoyl peroxide. The use of isotretinoin (starting at severe papulopustular or moderate nodular acne) was also covered.