Deborah
Age at interview: 25
Age at diagnosis: 12
Brief Outline: Deborah first began to get spots around age 12. Contrary to what Deborah expected initially, her acne has stayed with her into her twenties. She has used over-the-counter products, steroids creams and prescribed tablets but has never felt ‘acne-free’.
Background: Deborah is 25 years old. Her ethnicity is White British.
More about me...
Deborah started to get spots at the age of 12. At first, she felt glad that her spots would be “out of the way by sixth form”, but acne has remained with her into her twenties. When Deborah was younger, she found that her spots were concentrated on her face around the t-zone. More recently, her acne affects mostly her jawline and across the shoulders, back and chest – parts of the body which she finds harder to treat acne. Deborah says that her skin has changed as she has got older; for example, she used to have oily skin, whereas now thinks that she has larger pores which are open and so clog up easily. Deborah still gets some breakouts, especially in response to certain triggers including as stress and hormonal changes such as around her menstrual period. Deborah also avoids dairy as she thought it might be triggering her acne.
Deborah says that it didn’t occur to her until only a few years ago that a person could see their GP about acne. She has since visited her doctor and tried a number of prescription treatments, including the contraceptive pill, steroid creams and antibiotic tablets. The first treatment she tried was a gel, but it was time-consuming to apply and made her skin itchy. Deborah has also seen a dermatologist in Australia whilst living there. She was given some tablets which worked well, but she couldn’t get the same medication when she returned to the UK. She is not taking any prescription medicines for her acne at the moment as she hasn’t found anything which helped much and she doesn’t like the connotations implied of acne being an ‘illness’.
Acne began to affect Deborah’s life more seriously around the age of 15 as she began to feel much more self-aware of her skin. She bought make-up and over-the-counter products like vitamin supplements, which made her feel that she had some control over the condition. Deborah has tried many different skincare products, such as tea tree oil, and she takes care to keep her make-up brushes clean. Deborah also tries to find ways to avoid touching her skin, such as by taking the arms off her office chair at work so she can’t rest her head on her hands. Having spots on her back and chest can be especially difficult, as it is extremely painful if she accidentally knocks or catches a spot. Sometimes Deborah also wears clothes with high collars to cover these areas up. Deborah worries about the impression that having spots as an adult can give, for example that her colleagues might perceive her to be less professional because of break-outs. When she was younger, she also felt like people might think she was dirty because of her acne. Deborah says it can be annoying to have to deal with spots when at work or out with friends. She takes a kit out with her that includes different products and make-up removers, so that she can fix her skin whilst away from home.
Deborah thinks it might be useful for pharmacists and nurses at schools to be able to prescribe acne treatment, rather than for young people to have to go to the doctors for these. Deborah encourages healthcare professionals to take more time in listening to people with acne. Her advice to other people with acne is “to not let it define you,” adding that it’s not the most important part of a person. Deborah says that having acne can feel isolating, but having friends and family who provide emotional support helps. She also finds YouTube tutorials and blogs helpful for make-up tips and advice on acne, and that they can open up dialogue about acne.
Deborah says that it didn’t occur to her until only a few years ago that a person could see their GP about acne. She has since visited her doctor and tried a number of prescription treatments, including the contraceptive pill, steroid creams and antibiotic tablets. The first treatment she tried was a gel, but it was time-consuming to apply and made her skin itchy. Deborah has also seen a dermatologist in Australia whilst living there. She was given some tablets which worked well, but she couldn’t get the same medication when she returned to the UK. She is not taking any prescription medicines for her acne at the moment as she hasn’t found anything which helped much and she doesn’t like the connotations implied of acne being an ‘illness’.
Acne began to affect Deborah’s life more seriously around the age of 15 as she began to feel much more self-aware of her skin. She bought make-up and over-the-counter products like vitamin supplements, which made her feel that she had some control over the condition. Deborah has tried many different skincare products, such as tea tree oil, and she takes care to keep her make-up brushes clean. Deborah also tries to find ways to avoid touching her skin, such as by taking the arms off her office chair at work so she can’t rest her head on her hands. Having spots on her back and chest can be especially difficult, as it is extremely painful if she accidentally knocks or catches a spot. Sometimes Deborah also wears clothes with high collars to cover these areas up. Deborah worries about the impression that having spots as an adult can give, for example that her colleagues might perceive her to be less professional because of break-outs. When she was younger, she also felt like people might think she was dirty because of her acne. Deborah says it can be annoying to have to deal with spots when at work or out with friends. She takes a kit out with her that includes different products and make-up removers, so that she can fix her skin whilst away from home.
Deborah thinks it might be useful for pharmacists and nurses at schools to be able to prescribe acne treatment, rather than for young people to have to go to the doctors for these. Deborah encourages healthcare professionals to take more time in listening to people with acne. Her advice to other people with acne is “to not let it define you,” adding that it’s not the most important part of a person. Deborah says that having acne can feel isolating, but having friends and family who provide emotional support helps. She also finds YouTube tutorials and blogs helpful for make-up tips and advice on acne, and that they can open up dialogue about acne.
Deborah talks about how her acne has changed over time.
Deborah talks about how her acne has changed over time.
Yeah. Yeah, absolutely. I've always had oily skin, with my acne. But while I was a teenager it was incredibly oily. My skin's sort of normalised more from that now. But I've found as I've become less oily skin, I've got larger pores. Which now is my main problem with acne, because the larger pores are more prone to it, rather than it being the oily skin. So now I'm more focused on getting the right moisturisers, getting - staying hydrated, drinking lots of water, things like that. Whereas when I was a teenager it was all just oil control. Which make-ups can I use, which things can I take to sixth form to wash my face with at lunch, or you know, you can buy those little towel bits of paper that soak up all the oil and things. So I think it definitely has changed quite a bit. I mean, even before, when I first got my breakouts - I can't even remember what my skin was like then. I was 12, you know? I think my skin was just changing so often. I do have quite sensitive skin as well, I've always had that. So that's sort of been an added complexity to all of it, because you can't just throw lots of chemicals at my skin without it reacting badly. So yeah, it's definitely different now than how it was before.
Deborah’s careful to avoid getting an infection from popped acne spots.
Text only
Read below
Deborah’s careful to avoid getting an infection from popped acne spots.
HIDE TEXT
PRINT TRANSCRIPT
I was going to ask you about infections, and your experiences, if you've ever had any skin infections from acne spots?
Nothing that serious, thankfully. There have been a couple that I can tell have got considerably worse for being knocked. And therefore presumably they've got infected a little, but nothing that hasn't healed by itself and by my regime. Some of my friends have had things get quite badly infected, and have needed to go to a doctor's and see things then.
The main body parts affected by acne have changed for Deborah over time.
The main body parts affected by acne have changed for Deborah over time.
Deborah sometimes accidentally knocks spots on her jaw and nose.
Deborah sometimes accidentally knocks spots on her jaw and nose.
Deborah mentioned about acne at the end of her doctor’s appointment, rather than going to talk specifically about it.
Text onlyRead below
Deborah mentioned about acne at the end of her doctor’s appointment, rather than going to talk specifically about it.
HIDE TEXT
PRINT TRANSCRIPT
Could you tell me a bit more about making the decision to go see the GP for the first time?
I don't think it was the main reason for me going to the GP. Are you one of those sort of people that saves up things when you go the GP? I think I'd gone with two or three things. So it was more of a side note, "Oh, while I'm here, my skin's really been painful recently. Is there anything that you can do for that?" So it was a sort of side note at the end, where I hadn't really thought about it, it was just spur of the moment kind of thing.
Deborah put off seeing a doctor about acne because she didn’t want to feel she was ‘sick’ or ‘ill’.
Deborah put off seeing a doctor about acne because she didn’t want to feel she was ‘sick’ or ‘ill’.
No. That is probably one of the things that I have struggled with while seeking help. Because at one side of the spectrum I want to take control, I want to take ownership of it, I want it to be something that I don't let impact my life as much as it could. But at the other end, I don't - I don't like the, a large amount of medical intervention, cos it's not - it's not an illness, it's not a sickness, it's not something that you need to declare on health forms or things like that, so. I do sometimes struggle with that. And again, that's something that I am still working on. But I really don't like the idea of the, the tablets and having to get your prescription filled, and be in line with everyone else that probably is genuinely sick and needs those sort of things. I think maybe that's sometimes why on the odd occasion where I have had a bad experience with a GP, it's maybe what, what they're thinking as well, that it's not - it's definitely not as serious as other things you can go to your GP about, it's not something that's making me sick, making me feel bad physically, sort of thing. So I don't know, it - it would be nice if there was a different channel for it. I mean it's still a medical thing, but it's definitely not an illness. It's, it's a condition but - you know - everyone has a condition, life is a condition, it's a state of being, you know? So I don't, I don't see it as a diagnosis, I guess. And I don't like feeling like it is as a diagnosis. Because it's - it's just a thing, you know? It shouldn't be - it almost makes it feel worse, when you have to go to a doctor about it, because - you know - you see doctors when you're sick, so. I don't, I don't like that connotation. But there's not a lot you can do about that really, it's just something I'll have to make peace with.
Deborah had first taken antibiotics for acne whilst living abroad and found the pills in the UK were much bigger.
Deborah had first taken antibiotics for acne whilst living abroad and found the pills in the UK were much bigger.
Deborah used the hormonal contraceptive pill to help her acne.
Deborah used the hormonal contraceptive pill to help her acne.
Yeah, absolutely. They do, they do get a little better when I'm on the pill. And sometimes I'm just on the pill just because it does mediate my skin a bit better. Rather than I'm needing them for contraception. So I definitely do prefer to be on the pill because it, it helps my skin. Doesn't make it go away entirely, and I still get a monthly fluctuation in my skin. But it's less noticeable. I do try and have a, a couple of months off every, every year or so when I'm on the pill. And I can definitely notice then my skin get considerably worse. I haven't noticed a difference between them, though. Like I've tried quite a few different pills, and I don't, I haven't found one that's miraculously cured everything. So just sort of pick them on the other side of things, rather than acne being my main, main prioritisation. I don't think there's any other medication that's impacted them that much though.
Deborah usually takes a “little kit” with her when she goes out with her friends in case she needs to take her make-up off. She describes one occasion when she forgot her kit.
Text onlyRead below
Deborah usually takes a “little kit” with her when she goes out with her friends in case she needs to take her make-up off. She describes one occasion when she forgot her kit.
HIDE TEXT
PRINT TRANSCRIPT
Deborah felt isolated because friends didn’t understand what it was like to have acne. She thinks getting emotional support from friends, rather than practical advice, is really important.
Deborah felt isolated because friends didn’t understand what it was like to have acne. She thinks getting emotional support from friends, rather than practical advice, is really important.
And there isn't a one size fits all for supporting someone with acne, but. I think it's more recognising the emotional support is needed, rather than the physical support. I guess that's something that some of my friends have fallen into, they've tried to help by suggesting things I can do to make it better. And I get really quite frustrated at that, because I know all the things I can do to make it better. And people will say, "Oh have you tried this, this cream? I found it was really helpful when I had chickenpox." And I'm like, 'that's, that's a nice sentiment but it's not chickenpox, it's - I've tried all the creams that are out there, you can't - there won't be just some offhand general knowledge comment that can help.' But what I need is the emotional support, and I need for people to say, "Oh you're so much more than that, I know this is difficult now but it'll get better." All those sort of more personal support than the practical support is needed. Which sometimes - especially practical people tend to fall into. Perfectly well-meaning, I know they mean to help. But sometimes it's, it's not helpful at all. Cos it just makes you feel more isolated, that they don't understand what you're going through. And fair enough, why should they understand? But until you've been through it, I don't think you can. But you can be supportive through anything. You can make sure that you’re there, make sure you're reminding them that they're there more than that, that they're, that they’re your friends, they're there for you in whatever way. And they want to help, if you show them how to. You can't just expect them to know, know how to off the bat, so. I think that would be my main thing to friends and family, is it's emotional support not the physical support that they need.
Although she thinks it shouldn’t affect her work, Deborah says she’s less likely to interact with others when she has a “bad breakout” of acne.
Although she thinks it shouldn’t affect her work, Deborah says she’s less likely to interact with others when she has a “bad breakout” of acne.
I think it definitely is more, more the professional side of things that I feel it bothers me socially. And it's a very teenage-associated thing. As an adult with acne, it makes me feel like I should have grown out, out of this by now. And that - I don't know, it just makes you feel slightly less prepared. Slightly less in control, maybe that's what it is. I don't, if I don't even have control over my skin. So I do definitely tend to talk less or interact less when I've got a bad breakout, because I don't want to draw attention to. So I try, I really try not to let it get in the way, but that's because I'm putting the effort in. If I was just left to my own devices it would probably stop me going out and making new business clients, or interacting in a way that would be, be best for me. So yeah, it does bother me quite a lot, even now. Which again makes me feel bad, because I feel like it shouldn't bother me because - you know - it's just skin. But you have to live in your skin every day. So it's still something that I don't know, bothers me because it is there, constantly. There's no, no, no escape from it. And you wouldn't want people to, to judge you for it. So yeah, as well if you're going out on a night out as well, even with your friends, I may swap what side I'm on in a photo, to minimise how much acne you can see, and things like that. So it's not that bad, with my friends. It's more with work that it makes me feel unprofessional for.
Deborah talks about the cost of make-up.
Deborah talks about the cost of make-up.
While there is a lot of information about acne for teenage skin, Deborah thinks there is not enough about acne for adult skin.
Text onlyRead below
While there is a lot of information about acne for teenage skin, Deborah thinks there is not enough about acne for adult skin.
HIDE TEXT
PRINT TRANSCRIPT