There are literally hundreds of ways that acne can be treated and many reasons for apparent failure of a product. To confidently recommend appropriate treatment, will depend upon answers to the following:



What does their acne look like to you?

Acne is a visual disease and most commonly occurs on the face, although the back, neck, chest and shoulders may also be affected. You need to look for:

- Blackheads/Whiteheads - Non inflamed acne

- Yellow and/or red spots - Inflamed acne

- Or combination of both; Scarring and Excessively Greasy Skin

These will give you the clues to both how long they may have had acne (scarring and red marks left from recent spots), and what type of acne they have, as well as how severe it is. Depending upon answers to the above, you can recommend treatments as per the 'acne treatments' section.

How does their acne affect them?

Some people will apparently be unbothered by a case of bad, inflamed acne and might appear to be genuinely unconcerned about treating it. Others can appear to be distraught over a few spots and might take up a lot of your time and ask many questions. What will often help put that person's acne into perspective is to ask them how it affects them, not how you might think it affects them - the two could be different!

How long have they had acne?

Some people will rush to their doctor, insisting upon strong treatments or referral to a dermatologist at the first signs of acne, whilst others may sit out their acne and literally wait to 'grow out of it'. Acne lasts an average of eight years and therefore should be treated as soon as it first appears.

What treatments have already been tried?

Some people claim to have tried 'everything on the market'. This is almost impossible, for it depends upon which market they are referring to. Usually they will be talking about self-medication; treatments bought off the shelf designed to help with 'problem skin types'. It is likely that these products have been used and, if, after a couple of weeks, there is no improvement, they will consider the product 'useless' and it will be resigned to the back of the cupboard.

You will need to get an accurate idea of what they have already used to be able to assess what treatments should be used next.

- Self Medication: Products that can freely purchased off the shelf. These may claim to help 'problem skin', 'oily skin types', 'spot prone skin'. There will usually be a couple of ingredients that have an antibacterial, soothing or drying effect on the skin.

- Pharmacy or over the counter products: These will usually contain ingredients proven to help control acne such as benzoyl peroxide or salicylic acid. These products commonly cause localised irritation to the skin, which may often be the reason for stopping treatment suddenly.

- Prescription treatments: With a combination of over 100 prescription acne products available it is rare that all treatment options would have been exhausted. Once you understand how different treatments work, it will enable you to give helpful advice to your patients. Acne treatments are covered later in this module.

CONTINUED IN PART 4