Views of oral antibiotics and advice seeking about acne: a qualitative study of online discussion forums

Abstract

Background

Acne vulgaris is common and can significantly impair quality of life, yet little is known about patients' understanding of acne and its treatments. Oral antibiotics are widely used for acne, despite concerns about antibiotic resistance. People are increasingly turning to online discussion forums for advice and information on these sites may influence health beliefs and treatment adherence.

Objective

To explore understandings about the use of oral antibiotics for acne and advice shared amongst messages posted on online forums.

Methods

We systematically searched for online forums and identified four where acne was frequently discussed. Discussion threads relating to oral antibiotics were analysed thematically. NVivo 11 facilitated data handling.

Results

We extracted 136 pages of data; 65 discussions amongst 294 participants. We found a wide range of perceptions around effectiveness of antibiotics for acne and concerns about adverse effects. The delayed onset of action of antibiotics was a source of frustration and compounded dissatisfaction with healthcare providers, who people perceived as 'fobbing them off' with prolonged courses of ineffective treatment. Advice ranged from costly cleansers to when to ask for, or insist on, referral. Posts related to a wide range of severities, from 'spots' to severe acne, which may make it confusing for users to assess appropriateness of information.

Conclusions

Online forums offer opinions that could be confusing or lead to early abandonment of treatments, challenging consultations and patient dissatisfaction. Users expressed frustration about the delayed onset of action of antibiotics for acne, perceptions of only temporary effectiveness and adverse effects.

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