Alexandra

Alexandra developed acne on her back when she was 13. She went to see a GP at 16 but when conventional treatment did not work, she sought help at a specialist dermatology clinic in her home country of the Netherlands.

Alexandra developed acne on her back when she was 13. Her triggers for breakouts include stress, not eating enough fruit, alcohol, and a lack of sleep. Alexandra initially did not seek help for her skin, but eventually went to a GP at 16. The GP initially put her on oral contraceptive pills, which were unsuccessful in clearing her acne, before prescribing a topic cream. Although the cream worked quite well, her acne continued to be painful and sore, and Alexandra found that it dried her skin out a lot. She visited a beautician on one occasion who offered to extract the acne on her back. However, this experience made her acne worse because the beautician used baby lotion and her spots became infected. Alexandra finally sought help at a specialist dermatology clinic, which offered her a fruit acid peel treatment. Alexandra underwent this treatment for two years, with a treatment once every week in the first six months and gradually becoming less frequent towards the end. The process was painful, expensive and left her skin highly sensitive, causing pain and discomfort around her bra straps; however, Alexandra feels that the treatment was worth it because it helped her skin. Alexandra’s dermatologist explained the process of treatment in full detail and properly examined her skin during each visit; in contrast, Alexandra found that her GP did not know much about acne and did not explain enough about the prescribed course of action.

Alexandra found the experience of having acne at a young age quite lonely because her peers did not have spots at the time. She felt uncomfortable about revealing her acne to others. She learned to adapt her clothing to hide the spots; she avoided wearing backless or open tops, wearing white, wearing necklaces, and kept her hair relatively long to cover her neck. She also bought make-up to cover her spots and she looked specifically for make-up products that were designed for acne-prone skin. With regards to dating, Alexandra felt that boys were very understanding and that she often worried about her acne more than they did. She is more comfortable and happy with her skin now.

Alexandra’s advice to young people with acne is to open up to others (e.g. parents or close friends) and to ask for help if you want treatment. She is thankful to the support she received from her parents and advices other parents of young people with acne to talk to their children about it. She also believes that parents should do their own research about acne treatment so they can give their children several options. Alexandra advises healthcare professionals treating young people with acne to carefully explain the prescribed treatments and available alternatives. Her advice to GPs specifically is to refer patients on to specialists if the acne does not respond to conventional treatment. Alexandra also thinks it is important to remember that everyone’s skin is different and this can mean trying different treatments to find one which works for you.

Alexandra is very aware about partners seeing her body acne. She prefers to date boys who don’t have completely clear skin themselves.

Age at interview 22

Gender Female

Age at diagnosis 13

Yeah, well you do feel uncomfortable showing boys, you know, your back or you feel kind of, I feel always really exposed when there’s a lot of light and then he can see spots for instance or still do sometimes. You know, it’s not I don’t have the big acne spots now but sometimes you do have little, little pimples or something, you don’t and you’re really like, OK, fine, a little one is fine. But you would still feel very aware that he might see it or I guess, I don’t know, I always felt more comfortable dating a guy who also sometimes has a little spot somewhere or something than someone who has a completely clear skin.

So I would always feel a bit uncomfortable with someone who didn’t have anything, you know.

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Alexandra uses expensive brands and feels they make a big difference to her skin.

Age at interview 22

Gender Female

Age at diagnosis 13

The skin products that I use now, so Clinique, I use two special lotions one for the night and one just for shower gel.

And it really, it’s really nice, it really works. Makes me feel very OK about my skin so that’s why I use it. And it’s around, each product is around £30 as well.

And then yeah. This the-, Garnier spot they have a special one with charcoal in it, a scrub for my back. I think I use that twice a week at the moment, just because I’m so used to scrubbing my back to keep the skin quite thin I don’t want it to get thick again, because then I’m afraid that might, the bigger spots will return. So it would, yeah, it would take, that takes me into 10, £10 each bottle every time and I use it every two times a week so that’s, yeah, I think all in all out of the things I spend most money on is, it’s the skin, for me, yeah, skin for me and shoes.

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Alexandra found it most helpful seeing pictures of other people’s back acne so she could compare it to her own acne.

Age at interview 22

Gender Female

Age at diagnosis 13

I have looked at some pictures before about acne, making sure, if, in what kind, I wanted to know in kind of what category I was basically, if I had like severe, very severe acne or if there were, if there were people that had even worse spots than I had. And I think I was kind of in the middle, so I wasn’t the worst case. I’ve seen pictures of people whose entire backs are covered and then I felt very sorry for them and, yeah, those were very bad pictures to see. And then, strangely enough, that makes me feel a little bit less, you know, oh wow, I have so many spots, if you, you know, what there is out there. I didn’t really, I’d get, I, from the skin treatment I did get some leaflets about acne itself, a little bit more but I didn’t really look into it that much myself, no.

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Alexandra researched about different bra fastenings which she hoped might be less painful with back acne.

Age at interview 22

Gender Female

Age at diagnosis 13

With the bra fastenings

Yeah.

is that something that you did research on, when you looked up about

Oh, yeah. I did look up some stuff about that. Like, for instance, you have bras that can do a clip in the middle so you get the bra straps instead of being like that you get them to cross. But it’s, as I say, it’s quite difficult for my size at the moment, I’m quite small but my cup size is quite big so it’s kind of difficult to get the good bra straps for that. And I would like to feel comfortable in that department as well, that you don’t walk around feeling like, OK you can, everyone can see, so I’m quite comf-, used to looking at clothing that fits every part of the body that I have now and how it also interacts with my skin. So I still feel comfortable, more comfortable with various clothes that kind of cover my spots up a little bit, even if I have tiny little spots, then I would still want to cover them up as much as I feel comfortable in, yeah.

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Before starting a chemical peel treatment, Alexandra had a bad experience with another beauty treatment.

Age at interview 22

Gender Female

Age at diagnosis 13

And what happened when she did it, she didn’t use that special fruit lotion she, she just used baby lotion, so she kind of infected one spot with the other one when she went all over the back with it. So, I was a bit, it didn’t help at all, it made it a- worse actually. So, and it hurts a lot to let people see your back and then, you know, get all the pus out and, yeah, it’s not nice. So, she yeah, I don’t know, she was OK with, then my mum and I we went to look for something else to really, make sure it really was OK.

So then we ended up in this little clinic and they had skin treatment thingies, laser as well, so everything for people what they needed. And she showed, she was really nice in the beginning, the first appointment was just really making you feel comfortable, showing you that they do know what they’re doing and making sure that if we start the treatment that you can also be like, OK, this is not working. Fine, it’s not working, but you have to give it a, a shot. So I had to at least make sure I would give it half a year to try and see if it gets better. So that was every week for a half year and then from there on it got into two weeks, maybe once a month.

OK.

So it got better gradually.

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Alexandra explains how she thinks parents can give support to their children with acne.

Age at interview 22

Gender Female

Age at diagnosis 13

I think if you see your child that they have acne or they’re beginning to get acne, just try and see if you can open up to them about that and be very supportive. So ask if they are in pain or ask if they really wanna do something about it and also maybe that parents do their own research online, because my mum found this little clinic, clinic in [city in the Netherlands] so she was really like, Maybe you should go to that instead of going to the doctor’s all the time who’s just not giving you any good advice at the moment. There are more people who know really what they’re doing in this kind of field.

So, she kind of looked it up for me. So I think if parents wanna be supportive of their children that they give them also like, OK, we could try this. Or Have you ever considered looking into for instance this skin treatment, or maybe using a bit more of this cream? Or, are you sure that I can’t do a bandage on that for you, for instance, if you feel pain there?

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Alexandra wore a bandage under her bra to help with pain and reduce spots popping on her back.

Age at interview 22

Gender Female

Age at diagnosis 13

I do know that from my, my peers and my friends none of them had acne on their back, so I did feel a bit like, OK, am I the only one here? Now some of them sometimes had a little bit of, like a spot or something. But that was one [laughs].

And I didn’t have that, I had lots of them and very severe ones as well, and painful ones, and I my mom used to help me as well, so she would sometimes with the bigger ones, if they were under my bra strap and they would hurt she would get a bandage on it. So my mom used to help me as well, so she would sometimes with the bigger ones, if they were under my bra strap and they would hurt she would get a bandage on it. So I sometimes had four bandages on my back during a day. And that did help a little bit, you know, it released some of the pain.

And then if it would erupt, yeah, it’s not like I could really clearly feel them popping or something, that would sound very weird, but you do sometimes when I went to the loos in in my secondary school building I would check sometimes if something had happened, yeah. Because it would, you know, you don’t want to get it, to be on your shirt or something and people could see that. So I used to never wear anything white for instance.

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