Money and costs with acne

The financial cost of having acne was not a big concern for most people we spoke to. However, having to treat and cover up acne for years did have financial impacts for some. Costs associated with having acne included:

  • prescription costs for those who had to pay
  • cost of shop bought products (including face washes, moisturisers and makeup)
  • private clinic appointment fees and treatments
  • travel costs for attending medical appointments and treatments

Marga explains why having acne can be expensive.

Age at interview 24

Gender Female

Age at diagnosis 18

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It is so expensive. Like I’ve spent so much money in the, over the past few years; particularly prescriptions are really expensive. And particularly, for example if you’re on a new pill, a new acne pill, and they’ll trial it for a month and say, Come back in a month, and, you know, if you haven’t had any side-effects we will prescribe you for another, for another three months, or something like that. And, but if they just gave me three, three months then it’s like one set of prescriptions. So, I’ve spent a lot of money on prescriptions; I mean I don’t know how many but, you know, a lot. And I’ve spent a lot of money on expensive make-up particularly in the last few years. And also sort of high street remedies where you think ‘well, I haven’t tried that before,’ and they’re often like 20, 15, 20 quid and you think ‘well, you know if it’s, if it’s that amount of money you think well it could actually work,’ and you’re willing to give it a go. Like you’re willing to think ‘well, you know if it makes my skin better it’s worth the money. Often it hasn’t really worked in terms of the high street stuff. And even like the prescriptions are, you know, [laughs] half of them don’t really work anyway, just depending on your skin type and stuff like that. So, financially yeah, it’s actually really quite expensive.

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Most people had financial help from parents or grandparents to cover the costs associated with treating and covering up acne. Others paid these costs for themselves.

Before she went to her GP for help with her acne Molly bought skincare products from her pocket money but found it was not sustainable.

Age at interview 20

Gender Female

Age at diagnosis 11

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I think I was kind of, I bought a lot of over the counter like, I dunno, Neutrogena whatever, stuff like that which if I was to advise anybody it would be that a lot of that stuff is really expensive and the like the amount you need cos, cos obviously even with that stuff it’s, you can’t have a short term solution generally. So being able to afford to buy those things again and again and again I find that I couldn’t sustain that. Like I was like 11 years old, I maybe got like a pound a week, so that was kind of impossible.

And so those would have been like the branded ones like

Yeah.

Clearasil and Neutrogena and stuff?

I feel like they probably work for milder acne and like a few spots or whatever but I nev-, I didn’t find them very helpful. But that, but that was potentially because I couldn’t afford to sustain them, like had I been able to afford, cos some of them are like £14 for a small bottle, had I been able to afford to have that over, and also you can get through those bottle in like two weeks, three weeks or something. I’m not sure what the impact would have been, but that’s a difficult method to sustain so I would always say go to a doctor if you can just like purely financially it’s a lot more like, it’s a lot easier to afford and potentially even it’s free.

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Prescription costs

Prescriptions costs were not a problem for everyone. Prescriptions for under-16s and for 16–18 year olds in full-time education are free and when people did have to pay for prescriptions, their parents often helped. Hester’s friend told her about the HC2 form, which allows people over 16 on a low income to get help with prescription costs.

For those who paid for their prescriptions, the costs of treating acne could be significant. This was a worry for some given that there was no guarantee a prescribed cream or medication would work, and they could go through a lengthy and costly process of trying out different treatments. People had different opinions about whether the cost of paying for treatments was justifiable.

Although Harriet’s mother paid for her isotretinoin treatment, she thinks it was quite expensive and if she had had to pay herself it would have been something she would have had to think about.

Age at interview 21

Gender Female

Age at diagnosis 12

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It was never too much of an issue for me, but I know, well, to start with when I was getting my medication it was free. But then it’s now sort of however many pounds to get things for a prescription. So that wasn’t ever too bad because it wasn’t that expensive. But then I think with the Roaccutane (isotretinoin), it was about £50 or something for a month’s supply. Which was quite expensive. And luckily I was still living, living with my parents and they were happy to pay that. But I could understand that if you were sort of self-sufficient and financing yourself, it would have to be an actual consideration whether you wanted to take them or not. I mean thankfully for me I could just be like, Yes, I want these and my mum would just be like, Okay, yes darling. Have some money. [laughs]. But, yeah, if it was now, you, I mean it would probably be an investment that I would make, but it would be one that you’d actually have to think about rather than something you can just take for granted.

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Molly pays for her prescriptions now but thinks you get a good amount of product for what you pay. She thinks paying for prescription creams has made her more likely to stop a treatment that wasn’t giving results.

Age at interview 20

Gender Female

Age at diagnosis 11

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The prescription charges are like £8.20 and the, the doctors I found are very willing to give you like quite a, a good amount for that. So like enough to last me like two or three months maybe so that’s, in that sense that’s very affordable I think. But yeah, I did have it free for a long time and it’s definitely made me more, even though it’s not a massive expenditure at all, it’s made me more aware of like really being in control of thecos if I’m paying for it like directly, being in control of what I have and if I don’t think something’s working, like I didn’t think this cream was working and I didn’t see the point in paying for it which maybe when I wasn’t paying for it, I was just like well we’ll carry on and we’ll see’ I think it made me a bit more maybe critical of, of like treatments now that I am paying for it. But I mean I think doctors that I’ve had have generally been quite good in like giving a, a substantial amount, I’m sure there’s limits on what they can give you but like a substantial amount for the prescription charge.

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A few people who got their prescriptions free or whose parents paid felt guilty about the costs associated with treating their acne on the NHS. They felt socially it wasn’t seen as a serious problem. When Naomi was on her third round of isotretinoin someone told her that the treatment cost the NHS thousands of pounds and she felt guilty about using taxpayers’ money on clearing up her skin.

Shop-bought skincare and makeup products

While basic routines with soap, water and moisturiser didn’t have to be expensive, most people had tried a wide variety of over the counter skincare products to treat their acne.

Skincare products (face washes, masks, cleansers, toners, moisturisers, sun creams) can vary in price. Although they were considered ‘not cheap’, some people were happy to pay if the product worked well and didn’t need to be bought too often. However, there are expensive products on the market and people could spend considerable amounts of money on a single product that worked for them. Fatima, Sarah, Alexandra and Emma and Becky use special skincare products that cost a lot per bottle but seem to work well with their skin. Quite a lot of the young people we spoke to wore make-up to cover their acne and some found the more expensive brands were better suited to their skin. Others, like Nina and Hester, had tried expensive branded concealers that didn’t work for their skin.

Alexandra uses expensive brands and feels they make a big difference to her skin.

Age at interview 22

Gender Female

Age at diagnosis 13

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The skin products that I use now, so Clinique, I use two special lotions one for the night and one just for shower gel.

And it really, it’s really nice, it really works. Makes me feel very OK about my skin so that’s why I use it. And it’s around, each product is around £30 as well.

And then yeah. This the-, Garnier spot they have a special one with charcoal in it, a scrub for my back. I think I use that twice a week at the moment, just because I’m so used to scrubbing my back to keep the skin quite thin I don’t want it to get thick again, because then I’m afraid that might, the bigger spots will return. So it would, yeah, it would take, that takes me into 10, £10 each bottle every time and I use it every two times a week so that’s, yeah, I think all in all out of the things I spend most money on is, it’s the skin, for me, yeah, skin for me and shoes.

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Deborah talks about the cost of make-up.

Age at interview 25

Gender Female

Age at diagnosis 12

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I think there definitely is a financial [laugh] aspect to it, especially when you’re going through products or you’re having to buy more expensive things. But I think that comes with anything, especially being, being a woman and having make-up all the time, that’s quite a big financial aspect as well. So I don’t see it being that much of a drain. But I’m lucky enough to be in a position for it not to be. While I was a student I wasn’t buying as many of the products because I didn’t have the money around for it, but it was – it was less, it was bothering me less if I had acne through university cos you can be more relaxed, and you’re not expected to be as, as professional all of the time. So yeah, there definitely is an impact. I found it quite difficult through uni to afford some of them, but it didn’t matter as much if I couldn’t. Whereas now, it’s nice to have them around.

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A few people mentioned ways in which they tried to save money but still get good quality products, such as finding cheaper products with the same core ingredients or buying branded products when they were on sale. Ish and Hester think trying out different products was a waste of money and that it’s better to get professional help.

Fatima uses a 6 step skincare regime prescribed by a private clinic in her home country but swaps their sun block and face wash for a cheaper brand.

Age at interview 21

Gender Female

Age at diagnosis 12

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I use another brand cos I mean like sun block they… The first time I went there they also offered me like the facial wash but yeah I don’t use their facial wash cos I just feel like the sun block and facial wash I really like can buy it at a cheaper price like in the supermarket or something. I mean like yeah I don’t really have the use of all the products of that clinic. Yeah. So yeah I just use my own brand.

Ok

[uh huh]

So you feel like those are the things that aren’t quite so important to follow?

No I just feel like I don’t have to pay the price for those stuff. I mean like sun block. I mean I know what sun block is. I know what facial but for the rest I’m not too sure about it. Like what components there are and then I really need to like. I’m not too confident if I use another product but like face wash and sun block they are just like face wash and sun block [laugh].

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Yi collects samples of new products whenever she buys skincare products.

Age at interview 23

Gender Female

Age at diagnosis 14

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I think the facial mask is more pricey, it’s like £14 for a pot, but it lasts for like two months or three months. And for the cleanser and the toner they are about £10 and, so is the moisturiser, yeah, not like as pricey as the mask, yeah.

And the serum also like twenty, £20, I think. I’m not so sure. I also try some new products for some samples, I don’t, like to compare if it is better or if it’s stuck, yeah.

Where did you find out about the samples to try?

Oh, I just when I buy something it will come with some samples and sometimes I go shopping at some store and they will get a lot of samples out of there, if you actually buy something.

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Tom finds that branded creams only work for a bit so you have to keep buying more.

Age at interview 15

Gender Male

Age at diagnosis 15

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I don’t know if this is just me and my theory. But I seem to find that the branded ones work really well to start with but then they start, your spots start to coming back a lot. As in, I figure it’s so that you keep buying it. But that’s just my theory and that’s just probably me being paranoid about it. But I always like, when I first got like the branded ones it had been a lot more like, Oh, my skin’s looking really good. Oh, I should keep using this. Then the spots would start coming back a lot more. And then it would be like, Oh, I need to keep buying this. And I was like, Oh, it seems a bit suspicious sort of thing.

So yeah I don’t know. So in patches they get really good and in patches they go bad. So today’s like quite good I think, not bad. And at the moment it’s just getting better, it’s not really getting worse, because of the GP and stuff. So that’s good.

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Paying for private care

A few people had gone to private dermatology clinics for treatment. Some people paid for treatment to avoid long delays of months or more to see a dermatologist on the NHS. Abbie’s grandfather paid for her to see a dermatologist privately, which meant she was seen more quickly and got medicines only a dermatologist could prescribe. Alexandra paid for weekly and then monthly treatments at a private clinic in her home country. Fatima went to a clinic in her home country and, although she thought they seemed focused on making money, found their products worked well for her.

Naomi used her savings and money she inherited to pay to see a dermatologist privately and thinks it was worth it.

Age at interview 22

Gender Female

Age at diagnosis 9

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Yeah, yeah, well I think yeah, that’s the only real expense I think. I mean I’ve had to pay for prescriptions obviously but that wasn’t that much. But then yeah when I went privately I decided that I wanted to do it and, I mean I’m really lucky that I could afford it and yeah I just used savings that I had and also my granny died last year and she had like left me quite a lot of money and so I kind of, I didn’t feel that it was something that I should feel bad about spending that money on. Because, for me, like you know, the first, I think the first appointment was £200 and then the subsequent ones were £150 each so like it was a lot of money, especially like I’m a student, it’s not like I have a job but for me like there wasn’t anything that was more justifiable spending the money on than my skin because it was the thing that had the biggest impact on how I felt. And so yeah and, and in a way like because I was sort of saying to myself, you know, this is the money that has come from my granny so that’s okay and I knew that she would have wanted that’ so I didn’t feel bad about using that money. And also, you know, of all the things we spend money on I think our health is like the most important thing and our sanity so yeah, I guess I kind of justify it to myself. But I was lucky I was in that position because I’m sure there are lots of people who would want to you know, not have to wait months and months for an appointment through the NHS but aren’t able to do that and I’m just, I’m really glad I did because it, yeah it made a big difference to me.

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Hester saw a doctor privately but then saw him through the NHS to save money. This allowed her to get isotretinoin on the NHS, which was considerably cheaper.

Age at interview 21

Gender Female

Age at diagnosis 15

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When I came back I couldn’t get an appointment with the doctors on the NHS for quite a while. And because it was scarring so badly, my Dad actually paid for me to go privately. And that was a lot of money. I had two private appointments and each were about £300. So it’s a significant amount of money. And I think had my Dad not paid for that, I don’t- I think a lot of people couldn’t have afforded to do that. And actually it was when I spoke to one of the doctors and he laid out the costs of Roaccutane (isotretinoin) treatment privately and was like, It’s going to be about two grand. So [laugh] then, but he worked partly private and partly NHS, so then he then saw me again on the NHS. And so I actually did get the Roaccutane treatment for- not for free cos prescription charges, but effectively. Yeah. Effectively for free compared to two grand. So it’s, yeah. I think the amount of money I probably spent as well on like buying quite good foundations and things like that, and a lot of make-up.

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Travel costs

Travel costs were not an issue for most people, but some treatments required regular trips to the GP or dermatologist for check-ups and travel costs could mount up.

For Devan the biggest cost of having acne has been getting into the city to see his doctors.

Age at interview 18

Gender Male

Age at diagnosis 13

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It’s purely just for me getting into [city name] where, where the GP, where the dermatology is.

That’s purely, the, one of the biggest sort of financial costs that I’m faced with. But thankfully I’ve found the [home to hospital transport service], it’s only £10 to get there, so it’s not too bad, but, as it would be to take the normal bus.

But that is really the biggest cost, because thankfully I don’t’ have to pay for my prescriptions yet.

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