Real-World Acne Treatment Patterns, Preferences, and Adherence in Thailand: A Cross-Sectional Analysis.

Background: Acne vulgaris is a common, chronic skin condition that affects both physical appearance and psychological well-being. Effective management requires long-term, personalized strategies that prioritize maintenance and adherence. Most research has focused on Western populations, primarily examining topical and oral therapies, while procedural treatments are more prevalent in Thailand. This study aims to explore treatment preferences among individuals with acne, the factors influencing their choices, and adherence patterns. Materials and Methods: A cross-sectional survey was conducted among 1,237 Thai participants aged 18 to 45 years, utilizing a validated 22-item self-administered questionnaire. The questionnaire assessed demographics, treatment usage, preferences, decision-making factors, satisfaction, and adherence. Statistical analyses included descriptive statistics, chi-square tests, t-tests, and multivariate logistic regression analyses. Results: Topical treatments were the most used (68.07%), although only 16.25% of patients relied on them alone. Comedone extraction was reported by 51.90% of patients, and 42.28% used over-the-counter products. Oral therapies were less common, with antibiotics used by 16.01% and isotretinoin by 10.67%. Overall, most patients reported using combination therapies. The treatment preferences of the participants closely aligned with their actual usage. Adherence to acne treatment was only observed in 33.71% of participants. Factors significantly associated with higher adherence included a longer treatment duration, the use of multiple treatment modalities, a greater impact of acne on quality of life, and high satisfaction with treatment and communication with healthcare providers. Key barriers to adherence included the cost of treatment, lack of noticeable results, and side effects. Conclusion: This study reveals real-world patterns of acne treatment in Thailand, where patients commonly favor topical and procedural therapies, while oral treatments are underutilized. Gender differences, cultural norms, and social influences shape choices. These findings underscore the need for culturally sensitive patient education and evidence-based guidance to improve adherence, satisfaction, and treatment outcomes.