Q&A: Acne affects physical, mental well-being of young people
Acne can affect the physical and emotional well-being of adolescents and cause physical and emotional scars that can last a lifetime.
Healio spoke with Julie C. Harper, MD, of Dermatology and Skin Care Center of Birmingham, Alabama, about how acne can affect young people and how to best address it with patients and their parents.
How can acne affect a young person’s life?
Acne can have a great impact on a young person’s life. Acne has been linked to depression, anxiety and social withdrawal. Unfortunately, the impact of acne can outlast the acne itself. Sometimes this long-term impact is visible in the form of scars, but sometimes the impact is invisible with ongoing psychosocial sequelae.
What are some of the biggest misconceptions about acne?
There are many misconceptions about acne. One is that the acne sufferer is doing something to cause them to have acne, and if they would just “change their behavior,” the acne would go away, for example, changing skin care habits or changing the way they eat. However, acne is not caused by “dirt” on the skin, and it is not caused by people who are neglecting their skin care routine. Additionally, while eating a well-balanced diet is a good recommendation for all of us, diet alone is not the cause of acne.
What are some of the main questions you receive regarding acne?
Many of my patients ask, “Why me? What am I doing that is causing me to have acne?” This is evidence that misconceptions about the causes of acne are pervasive. I explain that acne is caused by hormones, oil, plugging of the follicle, bacteria and inflammation. Those causative factors can be targeted by many of our acne treatments. It is important to see a dermatologist if your acne is bothering you and stop trying to fix it by yourself.
How do you educate young people about acne treatments?
This is an important part of treating acne effectively. Topical retinoids are a cornerstone of treating any acne, but there is a “right” way to use topical retinoids. I recommend Aklief Cream 0.005% (trifarotene, Galderma), a next-generation topical retinoid that is FDA approved to treat acne in those 9 years of age and older. I can prescribe Aklief Cream for acne on the face and on the back, chest or shoulders. It takes one pump of Aklief Cream to cover the face and two pumps to treat the trunk.
I tell my patients that there are three things that everyone does wrong. No. 1, they use too much medicine. No. 2, they spot treat. Not only do we want to improve the acne that is present at the time, but we want to prevent the development of new acne. Therefore, it is important to treat the entire affected area. No. 3, they give up too soon. It is important that acne patients be patient patients. It can take several months to see the full impact of prescription acne treatments.
How do you discuss options with parents?
I try to discuss options with patients first, regardless of age, then with parents. The patient is the one who has to use the medications, and they should have a say in the treatment approach that we pick. Of course, parents have to give their consent, but I prefer to keep my focus on the patient during the entire visit.
How do you discuss psychological issues that can come with acne?
Ask! How does your acne bother you? Is it embarrassing to you? Does it affect the activities you participate in? Does it affect what you wear? Answers to those questions also give us a goal to shoot for as the acne improves.