E-Visits Show Comparable Acne Management Outcomes to In-Person Care

In a healthcare system increasingly challenged by primary care access and staffing limitations, asynchronous electronic visits (e-visits) are emerging as a scalable option for managing common outpatient conditions.

While convenience is often cited as their primary advantage, new evidence from a large cross-sectional analysis within Kaiser Permanente Northern California (KPNC) suggests that for certain conditions like acne, e-visits may offer comparable resolution outcomes to traditional care modalities.

A Study Designed for Real-World Comparison

The study, conducted within KPNC’s integrated care system, analyzed over 73,000 initial visits in 2024 for four selected conditions: urinary tract infection, seasonal allergy, acne, and international travel health. These were chosen for their frequency and range of acuity, as well as their amenability to structured remote care.

Patients could self-select their visit modality—e-visit, telephone, video, or in-person appointment—to help uncover common preferences and clinical outcomes in a setting with equitable access to all types of care. For acne, the study included 6,426 initial visits, of which 24% (1,532) were conducted via e-visit.

Comparable Follow-Up Rates for Acne Management

Point-of-care resolution was assessed using the rate of related follow-up visits within seven days. Just 2.11% of e-visits for acne resulted in a follow-up encounter. This low rate of follow-up was similar to other visit modalities, and importantly, it was not associated with patient age, race/ethnicity, insurance type, or socioeconomic status.

That suggests that the asynchronous, structured questionnaire model used in these e-visits—where patient responses trigger physician review and a tailored clinical response—can be as effective as synchronous visits for managing acne in the short term.

Age and Adoption Patterns

Interestingly, the study found that e-visit use for acne was more likely in older adults aged 30 to 49 years compared with the 18 to 29 age group, who are often assumed to be the most digitally engaged.

This may reflect greater comfort navigating health systems among older patients or a higher likelihood of previous e-visit use; both factors have been associated with increased uptake in this and prior studies.

Workflow Implications

From a systems perspective, asynchronous care may offer notable workflow efficiencies. In this study, KPNC physicians responded to e-visits within 30 to 60 minutes during service hours, without requiring a scheduled interaction.

And so for dermatologic concerns like acne, which often follow predictable treatment pathways, this model may free up time for complex in-person cases while still maintaining care quality.

Limitations and Interpretive Caution

While encouraging, these findings are not without caveats. The study was observational and conducted in a high-access, integrated system. This limits its generalizability to other settings, particularly those without robust patient portals or integrated follow-up mechanisms.

Additionally, follow-up visits were used as a proxy for clinical resolution, and the study did not capture patient-reported outcomes or satisfaction, which are critical elements in acne management.

Moreover, patients self-selected visit types, introducing potential bias. Those opting for e-visits may have had milder disease or prior familiarity with acne treatments, which could skew outcomes toward favorable resolution without further follow-up.

A Measured Role for Asynchronous Dermatologic Care

But even with these limitations in mind, these findings reinforce the potential utility of e-visits in managing mild to moderate acne. With structured workflows and physician oversight, asynchronous care may support timely intervention while reducing demand on in-person services. However, for patients with treatment-resistant or scarring acne or for those requiring physical examination, traditional modalities remain essential.

As e-visits continue to evolve, further research should assess longer-term outcomes, antibiotic stewardship, and patient-centered measures, particularly in dermatology where visual assessment often guides decision-making.

Reference:

Lieu TA, Huang J, Tran K, Nguyen D, Reed ME. Electronic Visit Use and Resolution Rates for Adult Outpatient Conditions in an Integrated Care Setting. JAMA Netw Open. 2025;8(11):e2545761. doi:10.1001/jamanetworkopen.2025.45761