Effect of isotretinoin on the quality of life of patients with acne.

Acne is the commonest skin disease, and affects 85% of teenage boys and 80% of teenage girls. More than half of teenagers with acne will obtain advice on treatment from family, friends and pharmacists. However, in 1992 there were approximately 3.5 million consultations for acne with primary care physicians in the UK. Of these, approximately 51 000 were referred for specialist advice. It is clear that rationalisation of acne treatment based on cost-effective analysis will have potential benefit in terms of usage of resources. This article reviews the current epidemiological data on acne, and demonstrates that acne now affects members of a population who are no longer at school, but are in work or tertiary education. This article argues that, due to this shift, the social and economic consequences of acne are quite different from those that occurred 10 years ago. Finally, the article discusses the cost effectiveness of competing therapies for acne, and examines isotretinoin in terms of cost per disease-free years and the utility of the treatment in cost per quality-adjusted life years (QALYs).