Your Scores are Telling Me What Your Lips are Not

A young adult female came to clinic with a 5-year history of facial acne with scarring on her face, upper back and upper chest. She could not tolerate birth control pills and did not want to start Accutane. Her PRO scores at her first visit were:

First Visit – PRO – Dermatology Scores

Skindex-16 Emotions 88

Skindex-16 Symptoms 63

Skindex-16 Functioning 50

After discussing treatment options, she wanted to start oral antibiotics for her acne. Two months later, she returned for a follow-up visit. Her new PRO scores were:

Second Visit – PRO – Dermatology Scores

Skindex-16 Emotions 36

Skindex-16 Symptoms 21

Skindex-16 Functioning 10

The patient reports that her acne is much better and that she is much happier with it. Her improvement in PRO scores match what she is telling the dermatologist. The plan is to keep her on the same treatment for a couple more months to see what additional improvement can be achieved.

Third Visit – PRO – Dermatology Scores

Skindex-16 Emotions 40

Skindex-16 Symptoms 29

Skindex-16 Functioning 13

At her third visit, the dermatologist wanted to wean her off the oral antibiotics. The patient told the dermatologist that her acne had gotten much better from her second visit. However, the dermatologist saw that her PRO scores had not improved at all. When asked about her scores, the patient admitted that she hadn’t seen more improvement since last visit, but she was happy with where her acne was and didn’t want to wean off the medication.

Because the dermatologist had all the relevant information, the patient was continued on the oral antibiotics and a discussion was started about transitioning to another long-term oral acne treatment option.