Evaluation of acne vulgaris patient care in outpatient clinics: guideline adherence and patient education.

Background/aim: Acne vulgaris, affecting over 85% of adolescents, is the most prevalent chronic inflammatory skin disorder. Its management is severity-based, with specific drug selections and combinations according to guidelines. However, adherence to these guidelines and the adequacy of patient counseling remain uncertain in real-world practice. The aim in this study was to evaluate prescribing patterns in acne management, assess compliance with guidelines, and promote awareness among healthcare professionals. Materials and methods: A prospective observational study was conducted in the dermatology outpatient clinic of a tertiary hospital in Türkiye between February and May 2025. Demographic and clinical data were collected, and acne severity was graded according to the Türkiye Dermatology Association (TDA) criteria. Prescriptions were evaluated for guideline concordance with American Dermatology Association (ADA) 2016/2024, National Institute for Health and Care Excellence (NICE) 2021, and TDA 2018. Potential drug-drug interactions and the adequacy of clinical teaching for acne medication were also assessed through a multidisciplinary evaluation. Statistical analyses were performed using descriptive methods, the Kruskal-Wallis test, Pearson's chi-squared test, and Fisher's exact test, as appropriate. Results: Oral isotretinoin, topical retinoids, and topical antibiotics were the most frequently prescribed agents. While isotretinoin use was largely appropriate, deviations from guideline recommendations, particularly oral antibiotic monotherapy, were observed. Some drug-drug interactions and limitations in structured patient counseling were also identified. Among the clinical guidelines, adherence was highest to the ADA guidelines, followed by the TDA guidelines. Moreover, the severity of the disease appeared to influence which guideline was followed. Conclusion: Although treatment largely followed severity-based recommendations, gaps in guideline adherence and patient education highlight the need for improved prescribing practices and interprofessional collaboration in acne management.