Molly, aged 20, has had acne since she was 11. She eventually went to a GP for help at age 14 and tried various prescribed treatments. These methods were unsuccessful and she wants to ask for a referral to a dermatologist for Roaccutane (isotretinoin).
Molly’s acne started when she was 11 years old. Her skin became progressively worse before she visited a GP when she was 14. She has visited various local GPs for treatment in the last nine years. Her triggers for acne include changes in water type/quality (such as hard or soft water in different places) and stress. She also thinks that diet may play a role in exacerbating her acne.
Molly initially tried prescribed antibiotic creams and tablets. She felt more comfortable using the creams compared to the long courses of antibiotic tablets. She had some side effects, such as dry and flaky skin, but found that both of these were manageable. She was unable to take the contraceptive pill due to family health risk factors. Molly also tried at-home remedies such as lemon juice and toothpaste, but she found that they burned and were not effective. She avoids wearing make-up on her face and has cut out dairy from her diet to see if it will improve her skin. After much deliberation, she is starting to consider trying Roaccutane (isotretinoin). She was against this medication in the past because she read about the possible side effects (e.g. depression) and did not want to jump straight into what is considered a last resort prescription. However, after 9 years of visiting local GPs with no effective treatment for her acne, she feels ready to ask for a dermatologist referral for Roaccutane. She has sought out information about the side effects and plans to take the medication over the summer so her parents can monitor her.
Molly has had some negative experiences during GP consultations, primarily when GPs have been insensitive in discussing her acne. She describes the process of finding a good GP as trial and error. Molly believes that GPs often think that acne is not a legitimate reason for seeking help and that they see it as just a natural part of puberty. However, Molly feels that coming to the consultation with a lot of knowledge about acne and treatment options has made GPs take her more seriously. Nowadays, she feels like she has more control over her treatment decisions. Molly appreciates that her GPs have told her that acne treatment is not a miracle overnight cure, giving her a realistic set of expectations for treatment. Molly has sought information online and finds the acne forums especially helpful. She believes that the wide variety of opinions and experiences shared on forums are useful in creating a full understanding of acne management. However, she believes more information is needed on the ways in which acne can be a symptom of another condition (e.g. polycystic ovary syndrome/PCOS).
Molly feels much better about her acne now, although she still has her bad days. Her advice to other young people with acne is to take control of their treatment and ask a GP for what they want (e.g. specific medication). Her advice to healthcare professionals is to remember that acne can be a sensitive issue for young people. However, she also thinks it’s important that doctors be honest about the severity of the acne and help the patient to be realistic about the estimated length of treatment.