To the Editor We read with interest the research letter by Cohen and colleagues1 that described a mobile application (app) to provide peer-reviewed education to individuals with acne and to identify users’ characteristics. As noted in the research letter1 and accompanying commentary,2 mobile apps have significant potential to provide information to large numbers of dermatology patients. However, these apps can and should go far beyond the role of surveying users and providing information and basic education.3 Dermatology apps should use evidence-based approaches and sophisticated programming to facilitate the promotion, inhibition, and self-monitoring of behaviors (eg, treatment adherence, UV exposure and protection, skin self-examination, and diet), symptoms, and other important outcomes (eg, quality of life). Additionally, apps can provide content that is tailored (ie, personalized to individuals’ behaviors and other characteristics), customized (ie, incorporating user-selected features or content), interactive, and dynamic, which may facilitate user experiences, engagement, and attainment of targeted outcomes. Apps can harness the myriad functions of smartphones and tablets, including taking photographs, video conferencing, text and multimedia messaging, instant messaging, and geographic locating (via global positioning system [GPS]).
In the context of acne education and treatment, a mobile app might incorporate a host of features beyond text-based education and information, including audio, video, graphic, and animated material. The app could promote (eg, via instant or text message, e-mail, or pop-up reminders) and assess adherence to topical and systemic therapies; provide local UV index and weather forecasts (based on the user’s GPS-determined location) while prompting and evaluating appropriate sun protection measures; prospectively track treatment adverse effects and acne status via self-report and more objective metrics such as photographs; track concomitant behaviors and outcomes (eg, diet, stress, distress, social anxiety, and other psychosocial factors); facilitate support via social networking with other patients; and enable the exchange of information to and from health care providers.
Dermatology mobile apps should not only take advantage of current technology but be grounded in science and subjected to rigorous evaluation. Hundreds of dermatology mobile apps have already been disseminated through widely used commercial app stores with almost no empirical validity.4 Studies testing these and other newly developed apps should be conducted using randomized and/or nonrandomized research designs with iterative, adaptive, and/or quality improvement methods.5 Research is also needed to examine the dissemination, implementation, sustainability, and cost-effectiveness of such apps. The considerable potential for the role of mobile apps in dermatology will be realized through systematic efforts to develop evidence-based apps and examine their impact on clinical and public health outcomes.