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Acne (young people)

Seeing a medical professional about acne

This section is about seeing medical professionals (like GPs and dermatologists) about acne. It links to the section on diagnosis/‘realising you have acne’, about young people starting to get spots and what they did about it (such as trying shop-bought products). There’s also more about continuing to see medical professionals and getting referrals for acne here. After a while, or if the acne became worse, young people thought about seeing a doctor or had it suggested to them by their parents.
 

Deborah mentioned about acne at the end of her doctor’s appointment, rather than going to talk specifically about it.

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Deborah mentioned about acne at the end of her doctor’s appointment, rather than going to talk specifically about it.

Age at interview: 25
Sex: Female
Age at diagnosis: 12
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It wasn't until I was probably in my twenties that I thought about going to the doctor for it. While I was a teenager, I just sort of considered it was something that was happening to me that I didn't have any control over. Which probably isn't the best mind frame. Maybe if, if more people - maybe if I knew that I could go to the doctor about it, and there were things, medical interventions, that you could have to help, then maybe it wouldn't have bothered me as much because I would have been getting the help earlier.

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.
 

Kosta wasn’t sure about seeing a GP about his spots at first, but found his appointment helpful.

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Kosta wasn’t sure about seeing a GP about his spots at first, but found his appointment helpful.

Age at interview: 14
Sex: Male
Age at diagnosis: 13
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I suppose I felt quite uncomfortable at the beginning talking about spots, I suppose not as serious as other conditions that people could talk to a doctor about. But they were quite helpful and provided me with more solutions for the issue.

Can you tell me a bit more about some of the suggestion that they had?

Obviously I should avoid picking them, washing or rinsing my face three to four times a day to avoid oily skin and then applying the creams twice a day in the morning and at night before bed.
Almost everyone we talked to did eventually go see a doctor about their acne and for treatments, but Kosta says he hasn’t seen a doctor because he accepts his skin will clear up in time. A few people had seen their first doctor about acne in another country than the UK, such as in America and China.

For those who had wanted medical professional help, the main sources were:
  • General Practitioners (GPs)
  • dermatologists (healthcare professionals specialising on skin)
  • pharmacists
Some young people saw just one kind of medical professional for their acne. Most GPs offered a choice of different medications (like topical treatments and antibiotics) to see if these would clear up acne. This worked for some people, but others found their spots continued. After trying treatments prescribed by their GPs without much success, some people were referred to a dermatologist, who can prescribe isotretinoin (e.g. Roaccutane) tablets

Most people hadn’t talked to pharmacists about managing acne, but a couple found it helpful. Tom’s mum got a shop-bought cream recommended by a pharmacist which he used as well as face washes when he first developed spots. Marga was told by pharmacists to be careful with benzoyl peroxide topical treatments because they can bleach/stain fabrics.

What help can I get from medical professionals for acne?

Young people visited medical professionals for a range of things, like:
  • getting a diagnosis of acne – although most knew already that they had ‘spots’ but some hadn’t heard the word ‘acne’ before
  • for treatment, like topical gels/creams, antibiotics or isotretinoin (e.g. Roaccutane) and advice about how to use them (including possible side effects)
  • information about alternative and complementary medicines
  • check-ups – e.g. to see if treatments are working or have side effects (some people’s GPs also prescribed or recommended shop-bought moisturisers to counteract the side effect of dry skin caused by some acne treatments like topical creams)
  • a referral – for example, a GP can ‘refer’ to a dermatologist
  • mental health help for dealing with the emotional side of acne
  • medical treatment for acne scarring – for example, Emma had steroid injections for keloid scars on her chest
Deciding to see a doctor

For those who had seen a doctor about acne, there was often a gap between when they got some spots and when they made the first appointment. This gap varied from a few months to several years. They usually went when their acne got more severe, painful or lasted for a long time. Marga booked an appointment with her GP about acne only when she “reached the end of my tether” with shop-bought treatments. Harriet saw her GP because an acne spot caused a gland in her neck to swell up. Some people saw their GP for a different health reason and asked about acne whilst they were at the appointment.

Some people didn’t see a doctor earlier because they hadn’t known they could get medical help for acne. This might be because they thought of acne as a ‘beauty’ concern, rather than a medical one. Some didn’t want to feel ‘sick’ or ‘ill’ for having spots. Marga worried that she would be ‘wasting’ the doctor’s time by going about acne. Some people, like Ollie and Deborah, said they wished they had seen a doctor sooner.
 

Hester didn’t know at first that she could go to the GP about acne.

Hester didn’t know at first that she could go to the GP about acne.

Age at interview: 21
Sex: Female
Age at diagnosis: 15
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I think I got a bit frustrated because after a year or so it was like 'surely it has to clear up at some point?' And I think I was-, I didn't really think it was something you could see the doctor about, because I thought 'yeah, I'm quite spotty but...' When I went to the see the GP for the first time it was like, “What's wrong with you?” And I was like, “I've got spots” [laughs]. It felt like the most like menial thing to say, but I think I also had it quite badly on my back at that point, and yeah the doctor was like, “You should have come a lot, lot sooner.” Because it left like a bit of scarring. Yeah. And I think I didn't really realise that it was something that the doctors could do anything about until a friend of mine at school- this must have been when I was, yeah, about 16. Or a little bit before then. She, she'd been to see the doctor about acne on her back and he’d given her cream which works wonders. But until then I didn't know it was a thing that the doctors could do anything for.
 

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’.

Age at interview: 25
Sex: Female
Age at diagnosis: 12
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You've said a couple of times about sickness, and sort of the identity as a sick person, you think is something that you don't see yourself, or don't want to be seen as?

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.
At the first appointment about acne

Often GPs reassured the young person it was good they had come for medical help. Many young people had worried their doctors wouldn’t take it seriously. Hester had a positive experience because her GP made her feel acne was a “genuine” problem she would be helped with. Sometimes the doctor examined the person’s skin by looking and touching some spots. Ish found this an uncomfortable experience, but many people said they didn’t mind because they wanted the doctor to help. Sometimes the GP asked the person how acne made them feel or if others teased them about it. This reassured some people that the doctor understood their feelings about acne, but made others uncomfortable.
 

Being asked by her GP whether acne made her feel upset made Emma feel more self-conscious.

Being asked by her GP whether acne made her feel upset made Emma feel more self-conscious.

Age at interview: 20
Sex: Female
Age at diagnosis: 10
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I think you said it was your GP that did ask how it was affecting you and like the more emotional side of it?

Yeah. They did, I remember my first, I think one of the first GP appointments I went to they sort of said, you know, ‘are people sort of talking, saying stuff about you?’ And I’d never actually really thought about what other people were saying to that extent and how that was affecting me. I hadn’t really thought about it until that point. So, in some ways, that was quite a changing moment and I, it sort of made me worry a little bit more about what people were saying. but, yeah, it was, I suppose [clears throat] I suppose at that age it’s sort of, I ‘spose it is a concern how it affects like socialising and especially when I’d just started a new school and things so. 
Because most young people already knew they had acne, they didn’t need a diagnosis but they did want the doctor to give information and treatments. Abbie thinks it would be good if doctors told the young person about all the different medicines they could prescribe for acne (such as topical gels or antibiotics). People also wanted to know about causes and triggers, especially if they were worried they had done something ‘wrong’. Devan didn’t know a lot about acne before his first appointment and learnt mostly from his doctors.
 

Tom’s brother had told him to stress to the doctor that he had already tried lots of shop-bought things for his acne.

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Tom’s brother had told him to stress to the doctor that he had already tried lots of shop-bought things for his acne.

Age at interview: 15
Sex: Male
Age at diagnosis: 15
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I knew I had spots anyway. And I kind of figured that it would just be sort of like, you know, “Oh, yeah, you’ve got spots. They’re a bit worse than like average and I feel like you should just take this.” And, and the doctor said he wanted to work with me to get rid of them for ever, like so they wouldn’t come back. Which I was quite happy with. So I wasn’t really surprised, cos I kind of figured it out, but like, and I was kind of expecting it.

When you went to see the doctor, could you tell me a bit about that?

He offered me, he spoke to me about how long I’d been trying it and how long I’d been like trying to get rid of it. And my brother had warned me to sort of, even though it had been like two years of trying to get rid of it and sort of it going away and coming back, my brother had warned me that if I wanted to get treatment from the doctor I had to make it out to be very, quite, really bad. Because it was quite bad but it wasn’t like outrageous. So sort of like I just told them what I’d tried mainly and just I kind of, kind of said I’d tried a bit harder than I had, even though I had tried quite hard. But, and he was like, he said it was good to keep trying for the two years or whatever that I had been trying. And he said that that was good and I hadn’t come straight to the doctor. 
People had different responses to seeing GPs about acne. Sarah was offended when her doctors described her spots as “severe” because “implicit in that was them telling me that I had a problem”. Others were hopeful after their first appointment that things might get better and their doctors would help with this. For Marga and Hester, the appointment and getting treatment helped them feel ‘in control’.
 

Naomi wishes her doctors had used the term ‘acne’ earlier.

Naomi wishes her doctors had used the term ‘acne’ earlier.

Age at interview: 22
Sex: Female
Age at diagnosis: 9
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Could I ask you a bit about the very first appointment where you were told that you had acne and what it was like to go to the GP’s at that time?

I don’t really remember [laughs] I mean I, I think, I think they didn’t even really call it acne then because I was so young and they were just like, “Oh, you know, this cream will just help with your skin.” and actually yeah I mean I think, I think like yeah, I mean I knew it was acne I guess but like I think because, I think part of the problem was because everyone was like, “Oh it’s just a teenage thing, you just have bad skin,” and so I remember actually when I went to the dermatologist the most recent time and he said, you know, “This is a disease and we’re going to treat it,” and I just remember that being such a turning point because I’d always just kind of it had always just been like ‘bad skin, a teenage thing’ and then suddenly it was someone who was like really taking it seriously as a disease that was treatable. and I think yeah, so I think like the way people talked about it did really have an impact and I didn’t really realise that until suddenly this dermatologist was saying, you know, speaking about it in that way. and that made me feel like so much better in some ways because even though it was like ‘oh my God, I've got a disease’ it kind of, it made me feel like I was justified in being as upset as I was and that you know, this was a serious problem. But someone was taking it seriously and was going to fix it for me. 

Yeah.

So yeah I kind of wished that someone had said that earlier on really [laughs] because it took a while.
 

Rachael felt upset hearing from her GP that she had acne.

Rachael felt upset hearing from her GP that she had acne.

Age at interview: 18
Sex: Female
Age at diagnosis: 16
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So what did you feel when you were first told that you had acne, what was your response to getting the diagnosis?

I think I was a bit like a bit annoyed and frustrated and a bit like… it's annoying admitting that you’ve like got an actual condition or a problem. Like the word acne just sounds a bit like harsh and a bit, yeah and I felt like some, like you’ve got acne as if… I felt a bit like, I guess disappointed in myself. But, I know it wasn’t my fault exactly but, it's, I know that everyone has bad skin as a teenager but, getting told you’ve got like severe or like moderate like acne, yeah I felt a bit annoyed and a bit insecure about it I think.

Is there sort of a word or words or like a phrase that you'd feel more comfortable, up until that point of just describing your skin as?

I don’t really know; I just knew it was bad but I didn’t want to admit it. And I think it's difficult cos I think, if you give something a word that word will eventually then get the connotations. So, yeah I didn’t like the word acne but I couldn’t think of another one I guess.

What sort of connotations does it have for you?

I think it's kind of maybe like ugliness or like, being ashamed. Like personally, I think that they're sort of connotations – it just sounds quite like an ugly word yeah, in my opinion. 
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