Advice to medical professionals helping young people with acne
• be aware that although acne is a physical condition, it affects many people emotionally and psychologically.
Quite a few people said it was important for doctors to appreciate this and show understanding about how it impacts on their self-esteem and mood. A few people felt the teenage years are often a particularly difficult time with increased importance put on appearance, meaning acne can have big emotional impacts. Even if you don’t think their acne is severe or anything to be worried about, it may have a huge impact on their confidence, self-esteem and social life. Harriet says teenagers are “often quite self-conscious” and so doctors need to “tread carefully”. Sarah remembers feeling “quite offended” when she got a letter saying her acne was ‘severe’. • understand that it may have taken a long time for the young person to visit a medical professional about their acne.
Many of the young people we talked to had initially tried to manage their acne without seeing a doctor and it could be years before they decided to see a medical professional about it. Seeing a doctor can feel like a big step. Rebecca found it “quite daunting” going for the appointment with her GP. Many said they wanted their GPs to refer them to dermatologists when initial treatments hadn’t worked. Some were concerned about the potential waiting times to see a dermatologist, especially if they felt their acne had already lasted longer than expected. • recognise that young people with acne will have different expectations of the type of advice and help they want. Some will want to know lots about acne and be involved in decisions about treatments, but others won’t.
Some people said it was important for doctors to get a clear idea at the start what each person’s priorities were. For some people, it is important to find out why they have acne and to know what they could do to prevent or manage it. Having a doctor explain a little about the causes and triggers of acne can be helpful. As Harriet said, knowing about the hormonal causes of acne could “reassure them that it’s not because [they’re] doing something wrong”. For those who were interested in self-help, getting advice about diet and changing bedding/towels regularly was welcome information. Others were more interested in their doctor taking the lead in finding a solution. Abbie thinks many teenagers just want their acne “gone”, and aren’t interested in “the whole specifics”. • be open about treatment options
For some, it wasn’t just important for doctors to recommend or prescribe a product but to discuss the benefits and side effects/risks of treatment options as well as advice about prevention. It could be frustrating if a doctor was prescribing one cream after another without considering the individual’s situation. People valued knowing that their doctor had put thought into the treatment options presented to them. Molly felt it was important that GPs be honest with young people that there isn’t a “miracle cure” for acne. A few people who had taken isotretinoin and benefited from it felt it should be offered earlier and that the worst side effects shouldn’t be over stated. • make time to talk through the emotional impact of acne as well as the physical side and treatment options.
As Naomi explains, “I want[ed] to talk about the fact that this is destroying my self-confidence and really ruining my life”. Some people feel it would be helpful if doctors gave encouragement and enquired about how acne was affecting people’s self-esteem and mental health. Only a few people mentioned doctors asking them about mood and this was usually in the context of them taking isotretinoin, for which depression and feeling suicidal is a possible side effect.