I don’t, I mean there have been odd days where I’ve felt really embarrassed about my skin but, well I mean there have been odd days and I would generally make sure that I wore make-up if I were going out to see people. If I were going out to the library I’d, I just don’t care but if I am actually seeing somebody then I would make sure I wore make-up. But while there have been odd days where it’s gotten me down they really have been odd days. I wondered when I say this kind of thing if I am protesting too much and actually it is terribly important to me and I’m just not allowing myself to acknowledge it but I, it’s just not really something that I’ve noticed myself worrying about that much. I don’t feel like it’s affected my friendships or my social life or my relationships. And obviously, given the choice, I would rather not have acne but given that this is the situation I am in, I’d rather just get on with my life and not worry about it that much.

I think when I was at school, I was, I was quite romantically unsuccessful at school. And I know this sounds bizarre but I was very embarrassed about being un-, not very romantically successful but I never remember blaming the acne on it. I remember thinking that, I remember blaming my hair which was quite bushy at the time and I remember worrying that everyone thought that I was a nerd or a geek and just not very interesting and I remember worrying about not being cool enough and not wanting to go drinking and not being funny and not being a good dancer but I don’t actually remember [laughs] worrying about acne too much. I mean maybe I’m just forgetting it. And I did, I did worry about the rash. And yeah when I got to university it just didn’t really

Well so I mean when my ulcerative colitis flared up, I, it was really physically limiting my life. I was having to, it never really got to the stage where I had to plan my day around the condition but I was constantly having to kind of rush off to the loo at odd opportunities and I did feel embarrassed about that and I did feel embarrassed. I did feel the need to kind of make excuses for myself. And also it, aside from just meaning that I had to run to the loo all the time, I got exhausted, it affected my performance in my work. Acne’s never done anything like that to me. It’s, it doesn’t make me tired, it doesn’t impede my concentration.

And I guess I just feel like I’ve always been of the opinion that it’s only really a problem if you make it into too much of a problem. And I am aware that, I say this knowing that obviously people notice it and obviously even if only on a subconscious level people probably do make judgements based on it. But given the other battles I’ve had to fight, it’s not really seemed like the most important one.

I’ve never really felt the need to look for more, well, support networks for acne online. So I’ve avoided that and honestly every time, you know, every so often when I am feeling particularly blue I have looked for those kind of websites and they just made me feel worse because you get all of these people talking about how acne has ruined their lives and how they don’t feel that they can go out. And you’re, Oh god, I went out yesterday, does that mean I should be really embarrassed about going out?’ [Laugh] As I said earlier I have used sources like acne forums to check out potential products, though again as I’ve said, I would be, I am wary of taking those sources of advice too seriously. Partly because of the risk that companies may be employing people to, you know, pollinate them. Partly also just because you get very little information: a) how well informed a lot of the posters are but; b) how, what their, how their skin condition compares to yours and it could be a very different situation. And you don’t get a sense of that online. So when I’ve been doing research, the sources I have trusted most have been those run by the public sector in some capacity. Or academic sources. Though that is, that’s the literature I’d look at now. It’s not a literature I would have looked at when I was younger and trying to work it out how to deal with my skin.

Moving away from university and not, and having a break in your healthcare and having to register with a new GP and not having an ongoing relationship with the GP has undoubtedly made it harder and has I think been a reason why I have not sought as much medical advice as I might have. It’s taken me a while to work out how to navigate the NHS and it would be a lot easier if I’d been based in one place the whole time.

Could you say a bit more about that process of learning how to navigate NHS healthcare?

Yeah. I think when I was in contact with dermatologists I’d get very frustrated at the length of waiting time to get an appointment and appointments being rearranged and that kind of thing. And I never really followed up on it because acne didn’t feel like a particularly urgent problem. When I was dealing with ulcerative colitis which was an urgent problem, I had to develop a, I had to be more assertive, I had to say, No, I need an appointment sooner than this. But it’s difficult to say that with acne because it’s not, you know, it’s not really making you ill in the same way that a gastro-intestinal problem is for example.

I’ve been on a number of different pills. All of them have made me quite volatile. The first one I was on which was Dianette, which was kind of prescribed particularly because of the high oestrogen levels in the hope that that would help my acne. That gave me really bad mouth ulcers which is not listed as a side effect of Dianette but they stopped the minute I stopped taking it and I can’t think of anything else that would have caused that to happen. I think all of them also made me gain weight which, I mean, Im aware that this is very silly because I could stand to gain a bit of weight but I did not like it. And in general I just found that I was happier off them than on them, in spite of the impact they had on my skin, and without fail every contraceptive pill I’ve been on has improved my skin.

So for you, it was sort of weighing up the side effects against the improvement in your acne at that point?

Yeah.

I can’t really remember when I was diagnosed with acne. I think it was in Lower Sixth in secondary school. When I was younger than that, more kind of Year 10/11, beginning of Lower 6th, I also had this very nasty kind of red rash. We, it was variously diagnosed as eczema, dermatitis. We never got a kind of clear idea of what it was or how to treat it. It would be kind of around my eyes and around my neck and just generally looked very red and unsightly and that just disappeared by the time I got into 6th Form. What didn’t disappear was the acne and that just kind of remained throughout 6th Form and also throughout my time at university up to the present. Although it has certainly gotten better than it was while I was an undergraduate when I think it was particularly bad.

So the rash and the acne came at the same sort of time for you?

A similar time and then one disappeared and the other didn’t. If I’d had the choice honestly I’m really glad that the rash disappeared cos the rash was very difficult to cover up and [pause, thump/door closing in corridor] that really upset me, the rash the acne, a lot less.

And could you tell me a bit about going to the doctor’s for both the rash but maybe acne as well?

For both the rash and the acne. Going to the doctors was, so we, for quite a while I think I tried to deal with it, you know, just by putting on creams and whatever with my mum’s help. And eventually we went to the doctor and got referred to a dermatologist who tried to treat both conditions but what happened? I went on antibiotics which didn’t really do much. I went on the pill, I think it might actually have been the pill that cleared the rash up. The problem was that the, there was a very long waiting list to see a dermatologist and when I moved away from home for university, the appointments got quite disrupted and in the end especially as none of the treatments they were advising for me seemed to be doing that much good with the exception of the pill which I went, eventually went off because I found I wasn’t agreeing with it in other ways. The treatments didn’t seem to be doing that much good and so I just ended up not actively organising any more dermatologist appointments and I’ve not been to a dermatologist now for about two years.

Every so often I’ve had a few spots on my back and a few on my chest but nowhere near as many as I’ve had on my face. And right now I’m not actually sure but I think I’m, I probably don’t have any on my chest and my back.

Do the different locations have any sort of significance for you in terms of the way you feel about it?

Now that is an interesting question because I do remember once considering wearing a backless dress and deciding not to because of acne I had on my back which is interesting because why would that be more of a problem? Is it that it’s a lot harder to cover it up with makeup? I mean I guess I could have had a friend to help me but it’s not really to ask, you want to ask of your friend. It could also be because I’ve got a kind of a faint birth mark on my back but I definitely remember it being the acne that was the problem. Is it because it somehow seems acceptable to have acne on your face and not on your back? That could be it. I remember my housemate last year, she had had acne and had taken a course of I think it was a steroid cream that had cleared it up. And kind of going on and on about how she had bacne’ and how much she hated it. I think that kind of created a bit of a stigma about back acne that for some reason I don’t feel about face acne.

And was the occasion with the dress was that since you had that housemate or was that a previous experience?

I think it was since I had that housemate, I think she was a bad influence on me [laughs]. It’s not something I think of very much but this is primarily I guess because I don’t expose my back that often.