Sociodemographic, clinical, and behavioral determinants of treatment adherence in acne vulgaris: a multicenter study

This multicenter study aimed to evaluate treatment adherence and satisfaction among patients with acne vulgaris. A total of 2,349 patients from 18 dermatology centers across Türkiye completed structured questionnaires. The participants were predominantly female (79.4%) with a mean age of 21.6 years. Overall, 48% reported consistent adherence to therapy, with significantly lower adherence among males (p < 0.001). The most frequent reasons for nonadherence were forgetfulness (28.7%), dislike of the treatment (26.4%), and reluctance to maintain long-term therapy (21.5%). Treatment adherence was positively associated with higher educational levels (p = 0.006) and greater acne severity (p < 0.001). Logistic regression revealed that systemic oral therapy (OR = 4.37, 95% CI: 3.147–6.086; p < 0.001) and oral isotretinoin (OR = 4.81, 95% CI: 3.379–6.869; p < 0.001) significantly increased adherence compared to topical therapy. Oral treatment was also independently associated with greater satisfaction (OR = 2.33, 95% CI: 1.767–3.095; p < 0.001). Moreover, mild acne severity (OR = 1.67, 95% CI: 1.216–2.297; p = 0.002) and older age (per year; OR = 1.05, 95% CI: 1.020–1.088; p = 0.001) predicted higher satisfaction. Systemic therapies—particularly oral isotretinoin—were associated with improved adherence and satisfaction.