Racial disparities in the management of acne: evidence from the National Ambulatory Medical Care Survey, 2005–2014

Abstract

Purpose: Racial health disparities are widespread in the United States, but little is known about racial disparities in the management of dermatological conditions.

Materials and methods: Nationally representative data on the management of acne vulgaris were gathered from the National Ambulatory Medical Care Survey (NAMCS) for the years 2005–2014. Visits to any specialist were included. Rao-Scott chi-square tests and multivariate adjusted logistic regressions were used to identify differences in patient demographics, visit characteristics and acne medications across races.

Results: Black patients are less likely than white patients to visit a dermatologist (adjusted odds ratio (aOR) 0.48, p = 0.001), receive any acne medication (aOR 0.64, p = 0.01), receive a combination acne medication (aOR 0.52, p = 0.007) or receive isotretinoin (aOR 0.46, p = 0.03). Adjusting for management by a dermatologist eliminated the association between race and the prescription of any acne medication as well as between race and the prescription of isotretinoin.

Conclusion: Among outpatient visits for acne in the United States, racial disparities exist in the likelihood of seeing a dermatologist and receiving treatment. Treatment disparities are less common when care is provided by a dermatologist. More research is needed to better understand the causes of disparities in acne management and other dermatological conditions.

Keywords:

• Acne vulgaris
• disparities
• race
• isotretinoin

Disclosure statement

The authors report no conflicts of interest.