It is a common question doctors ask acne patients – “How is your life being affected?” It’s a way of revealing the very real – but hidden – impact of the condition.
To raise awareness, dermatologists with the Acne and Rosacea Society of Canada share anecdotes illustrating the impact acne has had on their patients’ lives.
(Acne, teens and self-confidence)
“One patient in particular stands out in my mind. She was in her early teen years and came in for our meet and greet appointment with her head down, eyes cast to the floor and her hair styled forward, covering her forehead and cheeks. She was soft spoken and did not make eye-contact.
Her acne was mild-to-moderate on physical exam and very treatable but I understood that there was nothing mild about it to her. I provided encouragement, a prescription, written instructions and asked her to return to see me for follow-up in 3-4 months. At the follow-up appointment, the positive change in her demeanor was remarkable: her head was held high, her hair in a ponytail pulled off of her face, and there was lots of eye contact and a quiet confidence in her communication.”
(Personal experience with acne)
“I know from my personal experience with acne that having even a single inflammatory papule, pustule or cyst makes me feel very self-conscious, sometimes to the point that I dreaded social situations. Fortunately, these lesions are now few and far between due to the availability of safe and effective acne treatments. Patients should be encouraged to seek treatment. Everyone deserves to feel good in their skin.”
(Use of makeup to hide acne)
“I have patients in my practice who would never consider leaving the house without make-up because of their acne or acne scars. Patients often explain their hesitation in removing their make-up in the exam room. It means potentially leaving the clinic without make-up, or re-applying before they leave, which patients often do. This has been very helpful for me in understanding how they feel having their bare skin viewed by others. For some it is simply inconceivable.”
(Acne is often dismissed)
“Patients with acne often feel like their condition is dismissed. Commonly, when I meet a new patient with acne one of the first things they tell me is ‘today is a good day, it gets much worse’ as if they have to convince me that their condition is ‘bad enough’ to warrant treatment. Any patient with acne deserves treatment and they shouldn’t have to feel like they must fight for it.”
(Acne and bullying)
“No matter when it arises, it often has a profound impact on quality of life. I have treated teens with acne who are being bullied and teased at school, and as a consequence refuse to go.”
(Acne in adulthood)
“Adults with acne have told me that they believe that their breakouts are impeding their career advancement by making them look “too young” or not their best. Women with acne in their 40s express frustration about still getting blemishes and at the same time starting to see signs of skin aging.”
(Hiding acne scars with beard)
“For patients who do not wear make-up, there are fewer options for covering up the marks that they do not want to see or have seen by others. One of my middle-aged male patients has had a full beard since his early 20s because of his strong desire to conceal the acne scars that mark his cheeks and chin. He has “never felt that shaving was an option” for him and had accepted this as his reality although he explained it felt restricting.”
(Lasting effects of acne scarring)
“My patient had driven 5 hours to see me from his home Pittsburgh, Pennsylvania. Severe acne as a teen left him with multiple large atrophic facial scars. Now in his early 30’s, he’d come to see me because he’d heard of a new filler used for treating acne scars available in Canada but not yet in the United States of America. His acne had become dormant decades ago but his scars were tormenting him.”
(Impact of acne scarring)
“My acne patients have expressed feelings of depression, anxiety, frustration, shame, and low self-esteem. These feelings do not always dissipate with the resolution of the acne lesions especially when the acne clears but the scars remain. I have had patients come into my practice to explore treatment options decades after their struggle with acne as the remaining acne scars ‘are affecting how I feel’.”
Test your acne knowledge. You may be surprised at some of the answers…