Acne

Repeat visits to medical professionals and referrals for acne

Repeat visits to medical professionals

Most people saw their doctors about acne more than once. This might be because they needed a repeat prescription, treatments hadn’t worked or had caused unpleasant side effects, or acne came back after clearing up for a while. Molly stressed it’s important to know that treatments can take a while to work and her doctors explained that the medicines weren’t “overnight cures”. People didn’t always see the same doctor – including because they had moved address (such as going to university) or out of choice (if they felt the doctor hadn’t been helpful).
Lots of people tried several different prescribed acne treatments. Tom remembers his GP giving him a choice between a topical gel and antibiotic tablets. Rachael tried three different types of antibiotics but began to feel “hopeless” when these didn’t work and made her feel sick as a side effect. Some people said they would have liked something (e.g. a leaflet) about other young people’s experiences on various acne medications. Rachael didn’t know anyone else who had taken isotretinoin (e.g. Roaccutane) and said she would’ve liked statistics on the chances of having side effects too.

Many people felt fed up about trying each medication for a block of time, usually a few months. Chris’ treatments went up in strength (“I felt like they were giving me better things each time”) but only kept his acne “at bay” rather than clearing it. It can also be expensive trying different acne treatments if the person pays for prescriptions or opted for private medical care, and with travel to medical appointments (see also ‘finances’). Some people thought it was good though that their doctors gave them weaker treatments first rather than skipping to stronger medicines with worse side effects. Sometimes the early treatments worked well and there was no need for others.
Referrals (e.g. to dermatologists or for mental health support)

Going back to the doctor over and over again without any improvement can be frustrating. If the medicines prescribed by GPs (like topical treatments and antibiotics ) didn’t work, some people were referred to dermatologists (who can prescribe isotretinoin). Not everyone we talked to had seen a dermatologist – sometimes they were happy with seeing GPs or using shop-bought products. Other times, people had asked for a dermatology appointment sooner but their GPs were reluctant to make the referral. This felt unfair and like the doctor didn’t understand the emotional impacts acne can have. Some people opted to pay to see a dermatologist privately in the hope of their acne clearing quicker.
There can be a wait before a dermatology referral ‘comes through’ – Chris said “don’t be shocked if you get like a three week or even a month sort of waiting list” and Naomi’s wait was over two months. Some people also found it hard to get follow-up appointments at suitable times. Rachael had to miss school to make the dermatology appointments but says her teachers understood.

Most people went to a general dermatology clinic, but some had been to ones specially run for children and young people. Devan and Emma had been worried about seeing a dermatologist for the first time, but found them “really nice”. Will and Hester said their dermatologists answered questions in more depth than GPs had. Ish thinks it’s important doctors are friendly to young patients so they can “open up” about things which might be affecting their acne. Some dermatologists examined the person’s skin and, as for Emma, took photographs to compare changes at the next appointment.
If treatments from the dermatologist had been successful in clearing up acne, the person was ‘discharged’ (meaning the appointments stopped). Emma remembers talking about being discharged from dermatology at her appointments and reassured she could come back if her acne returned.
Another kind of referral is for mental health and self-esteem support. Not many people had asked for (or been offered) professional help with emotional impacts from acne though. Marga was offered anti-depressants but didn’t want to take more tablets in addition to antibiotics for her acne.
It was usually the young person’s parents who encouraged them to see a doctor and sometimes family members came to appointments too. Others preferred to go to appointments alone but often talked to their parents about how their acne was and treatment options. Chris wanted to be “independent in that sense” as he felt “it’s my skin condition, like, I’m old enough to book a doctor’s appointment and go get this sorted out”.

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