TOPLINE:

In a cross-sectional survey of underserved pediatric patients, most reported administrative, pharmacy, or financial barriers to isotretinoin use, and one third experienced treatment gaps despite high perceived effectiveness.

METHODOLOGY:

• Researchers conducted a cross-sectional survey of 42 patients aged 14 years and above (40.5% female; 52.4% Hispanic or Latino, 16.7% Asian, and 16.7% Black; 76.2% publicly insured and 7.1% uninsured) who had completed at least 1 month of isotretinoin treatment at the Pediatric Dermatology Clinic at Boston Medical Center, an urban safety-net hospital from June 2023 to April 2025.
• Surveys were administered in person or by phone in English or Spanish and assessed demographics, treatment experience, and barriers to access and continuity.
• Underserved populations were defined as patient groups experiencing structural barriers to healthcare, including a high prevalence of public insurance or uninsured status and limited English proficiency.
• Outcomes included patient-reported treatment gaps, appointment difficulties, pharmacy-related barriers, and perceived treatment success.

TAKEAWAY:

• Overall, 64.3% of those surveyed reported experiencing at least one appointment, pharmacy, or financial-related difficulty during isotretinoin treatment.
• Treatment gaps occurred in 33.3% of patients, often due to scheduling issues, missed appointments, adverse effects, long travel distances, and challenges related to iPLEDGE-related challenges, the federally mandated Risk Evaluation and Mitigation Strategy for isotretinoin, which requires monthly monitoring.
• Appointment logistics were a barrier for 35.7% of patients, including difficulty securing appointments and conflicts with school or activities, while medication access issues affected 31.0%, commonly due to pharmacy stock limitations and iPLEDGE-related delays.
• Despite administrative challenges, 97.6% of patients reported that isotretinoin treatment was successful.

IN PRACTICE:

These findings “offer insight into the isotretinoin treatment experiences of a diverse, underserved pediatric population,” the authors wrote, adding that “iPLEDGE requirements may magnify access barriers by adding requirements that interact with existing challenges in scheduling, transportation, pharmacy access, and health literacy.”

SOURCE:

The study was led by Charles B. Lau, Boston University School of Medicine, Boston, and was published online on March 26 in Pediatric Dermatology.

LIMITATIONS:

The study did not include a control group of patients who received other acne therapies and a comparison group of a more socioeconomically advantaged population. Patients lost to follow-up or unable to initiate isotretinoin were not captured in the study.

DISCLOSURES:

The authors reported no funding source and declared having no conflicts of interest.

This article was created using several editorial tools, including AI, as part of the process. Human editors reviewed this content before publication.