Acne Treatment by A Doctor
‘Acne treatment by a doctor’ refers to any regime for the treatment of acne administered whilst under the care of a person who is medically qualified. The extent of medical involvement in acne treatment varies enormously, from acne sufferers who consult their general practitioner once as a matter of courtesy, to those who require specialist treatment by a dermatologist, which may continue for years.
Who Should Consult a Doctor?
Adolescent acne, by far the commonest type of teenage acne, is a self-limiting condition. 'Self-limiting' means that, however severe the condition, it will resolve over time without treatment or medical intervention. In the case of adolescent acne, natural resolution of the condition may take any period from a few months to many years. Acne treatments are used both to speed up the rate at which the condition resolves and to prevent the development of severe acne or cystic acne, either of which can cause permanent acne scarring. Teenage acne sufferers with mild or moderately severe adolescent acne have a choice between consulting a doctor or managing the condition themselves. Teenagers with severe acne, or acne with atypical features, should consult a doctor as a matter of course. This results in a situation whereby the majority of all teenage acne sufferers manage their acne without the involvement of a doctor, using either a conservative acne treatment regime or over-the-counter acne medication.
Which Doctors Treat Acne?
Of the teenage acne sufferers who consult a doctor regarding treatment for acne, nearly all will be seen and treated by a community-based General Practitioner, although a small percentage will be referred to see a dermatologist as a hospital outpatient. It is rare for an acne sufferer to need treatment as an inpatient on a dermatology ward Referral to see a dermatologist is usual in cases of persistent or severe acne, where complications have arisen, or if there is doubt as to a diagnosis of adolescent acne. It is, however, incredibly rare for acne sufferers to require treatment as a hospital inpatient on a dermatology ward. In the United Kingdom, more teenage acne sufferers are admitted to psychiatric wards because they have developed acne dysmorphia than are admitted to dermatology wards to be treated for one of the really horrendous types of acne - keloid acne, acne conglobata or severe cystic acne.
Advantages of Doctors Treating Acne
For many teenagers, the decision whether or not to consult a doctor about acne will be influenced by previous experiences of visiting their General Practitioner. However, there are certain advantages to a doctor delivering acne care :
- Doctors have the experience to make a confident, if not always correct, diagnosis as to the clinical type of acne. A doctor can also make an assessment of the severity of the acne, monitor its state over a period of time and recognise any complications which arise.
- Some teenagers find it reassuring to consult a doctor about their acne, although many teen acne sufferers find that they can manage their own acne treatment quite happily following an initial medical consultation.
- The cost of purchasing over-the-counter acne medication can be considerable, whereas in the UK medication prescribed by a doctor is provided free of charge or at a subsidised cost. People under the age of 16, in full time education, living in low-income households or satisfying other specific criteria do not have to pay for prescription acne medication, or indeed any prescribed medicines.
- General practitioners provide access to prescription-only medication, which includes the oral antibiotics used to treat cases of severe acne and oral contraceptives which are an effective acne treatment for young women.
Disadvantages of Doctors Treating Acne
Teenager are not adults, but neither should they be treated as a children - a situation which leaves some doctors at a loss when dealing with teenage acne sufferers. It's perhaps understandable that the main disadvantages associated with doctors treating acne arise not from the treatment itself, but from problems relating to the doctor-patient relationship.
- Teenagers can feel disempowered if they have to hand over control of their acne management to a doctor, particularly if they are not given the opportunity to have a say in important decisions relating to their treatment.
- Some doctors are not good communicators, particularly when it comes to communicating with teenage patients, and a situation can all too easily arise in which the doctor-patient relationship breaks down completely.
- There is a tendency for doctors to prescribe medication for acne. There is a subconscious assumption that an acne sufferer who consults a doctor will feel 'short changed' if some tangible form of acne treatment is not offered. Doctors may also feel that it is both quicker and easier to prescribe acne medication than to explain the rationale behind conservative acne treatment.
- Doctors tend not to be supportive of patients who want to use alternative treatments for acne, although this stance is probably quite understandable when one considers the issue of medical ethics and malpractice insurance.
