Caregivers Concern About Impact Of Severe Acne On Teens

Over 90% of parents of teenagers with severe acne who took part in a recent survey sponsored by Sun Pharmaceuticals Industries in conjunction with the American Acne and Rosacea Society (AARS) said they were “very concerned” about the harmful impact of the skin disease on the physical, mental and social well-being of their teenager.1 They also expressed their concerns about the effects on their whole family and the lifelong physical scarring.

The catalyst for the online survey, which was conducted from October 29 to November 5, 2020, by Regina Corso Consulting of Sun Pharma, AARS and Hilary Baldwin, MD. “As dermatologists, we know [what our patients go through], but we never collectively looked at the impact it had on their parents, ”Baldwin said. Dermatology Time® and Contemporary Pediatrics®.

Over 90% of parents of teenagers with severe acne who took part in a recent survey sponsored by Sun Pharmaceuticals Industries in conjunction with the American Acne and Rosacea Society (AARS) said they were “very concerned” about the harmful impact of the skin disease on the physical, mental and social well-being of their teenager.1 They also expressed their concerns about the effects on their whole family and the lifelong physical scarring.

The catalyst for the online survey, which was conducted from October 29 to November 5, 2020, by Regina Corso Consulting of Sun Pharma, AARS and Hilary Baldwin, MD. “As dermatologists, we know [what our patients go through], but we never collectively looked at the impact it had on their parents, ”Baldwin said. Dermatology Time® and Contemporary Pediatrics®.

Hilary Baldwin, MD

“Children don’t live in a bubble and their parents take care of them every day and [going through it] right next to them, ”said Baldwin, medical director of the Acne Treatment and Research Center in Brooklyn, New York, and former president of AARS. “So with this survey, we wanted to make sure we better understand how parents feel about their teens with severe acne. “

The poll questions were informed by what Baldwin and his colleagues hear in their practices, such as teens who want to come home from school due to bullying, don’t want to have their picture taken, or quit the sports they love it because physical contact with other players will result in lumps on their chest or backs bursting and dripping blood on their uniforms. Wrestlers and swimmers told Baldwin they dropped out of the programs because of embarrassment when they took off their shirts. This has sometimes resulted in the postponement or loss of college scholarships.

“These are major changes,” she said. “Parents are hurting, some maybe as much as their children, and it’s time for people to recognize that. “

While there weren’t many surprises for Baldwin among survey respondents (n = 250), she was interested to see 55% of parents delaying dermatologist visits and starting more aggressive medications earlier. . The message must get out: Effective and early therapy is paramount for a positive outcome, Baldwin said. One result showed that 23% to 26% of parents allowed their teenagers with severe acne to use over-the-counter medications exclusively and 8% did not give them any medication.

“A lot of people think over-the-counter medications are good enough for severe acne. Once these products fail, parents are likely to turn to a dermatologist,” Baldwin said. “The biggest hurdle is? is not seeking care, but seeking appropriate care. Some parents struggle with the use of effective drugs. They want natural products, but these products just aren’t going to cut the mustard with lumpy or cystic acne.

She advised working with parents to allow their teens to use their favorite medications for “a little while,” but advised patients and their families that these products may not give optimal results. “Plan each step in advance,” she says. “Think about how these parents make decisions. Are they the hands? Helicopter parents? Did they drag their kids out kicking and screaming or did the teens instigate the visit to the office? Just keep in mind [that] you have to go fast. The longer it takes for people to get good aggressive therapy, the more likely they are to get physical and psychological scars.

Adherence is another issue, “more often than not non-compliance is based on forgetting,” noted Baldwin, however, sometimes there is a problem of control between parents who want their child to take medication and the child feeling under pressure and, in turn, not adhering.

In some cases, non-adherence may result from side effects of more potent drugs. “We have many new toys that are an improvement over the choices we had before,” said Baldwin. “New formulations for topical and oral medications as well as new active ingredients have improved tolerance. “

“At each visit, non-conforming behavior should be assessed, but it is important that providers and parents are not accusing. The script should recognize that teens forget, that they are tired, that they don’t want to get up early, that they don’t like the smell or the taste of the medicine, or maybe they have problems. unwanted effects, ”Baldwin said. . “Then discuss ways to improve this. “

Based on first-hand experience with his own teens who suffered from severe acne, Baldwin recommended combining taking the drug with some daily activity. “My kids probably wouldn’t be happy at all if they heard me share this, but I stuck the tube of medicine to the handle of the refrigerator door,” she said. “The first thing my kids did when they got home from school was walk to the refrigerator, and the rule was they didn’t open the refrigerator door until they applied their medicine. Place the medicine between the salt and pepper shakers on the table or near their toothbrush. Throw samples in their gym bags or jacket pockets, anything that improves their ability to remember to use it.

To keep adolescent patients and their parents on the same page, Baldwin recommended that, ideally, dermatologists allow 30 minutes to 1 hour for another acne visit. Talk about what acne is, why they have it, when it will get better or worse, what medications we generally have, what we are going to use for them, anticipated side effects and expectations of. improvement, ”she said.

She stressed the importance of tailoring the treatment plan to the patient’s preferences and lifestyle. “We need to learn a lot about our patients on that first visit, starting with how much acne bothers them. I ask on a scale of 1 to 10 – 1 being “What acne?” and 10 being, “Get that thing off my face now” just to find out what they’re going to do, “she said. “Someone who’s 10 will do whatever I ask him to do, I could throw him 6 drugs, and they’ll use all 6, while someone who’s 2 won’t use anything.”

Other relevant questions include whether the patient is a morning or evening, how hectic his mornings are, whether the equipment he wears for sports has headbands, chin straps, or objects that rub on his feet. shoulders, what time he comes home, and when they shower.

While it is vital to discuss the emotional and quality of life impact of this skin condition, Baldwin advised to postpone this discussion. “On the first visit, the teenager doesn’t know me from Adam and doesn’t trust me. This is not a time when he or she is likely to open up, ”she said.

On the second or third visit, she suggested an open statement such as: “This [severe acne] must make you very angry. She cautioned against pushing teenage patients to share their feelings if they don’t want to. “It is often helpful to ask the parent to leave the room, especially with adolescent male patients,” she said. “Try to schedule a time, perhaps via telehealth, to have a separate one-on-one with the parent to let them offload.”

Open ended questions about how patients deal with acne or if they are being bullied can facilitate the conversation. “Dermatologists don’t have a lot of time with each patient,” Baldwin said. “But we need to take the time to ask questions and listen to the responses of adolescent patients with severe acne or their parents.”

Baldwin also advised bringing in a trained therapist for referrals: “Sometimes the floodgates open and I don’t have the time or the expertise to close them,” she said. “Patients frequently refuse to see a therapist because of the stigma they perceive to be ‘crazy’. I explain to them that they are going through an extremely difficult time and that the benchmark is just to give them someone to talk to.

The survey found that 78% of parents surveyed felt they had in-depth conversations with their teens about the emotional side of acne. It was not his experience, according to Baldwin.

“I have twin daughters, who both had acne, both of whom needed isotretinoin, and what I learned was that it was really hard to know when to talk and what. say, “she said. “No matter what I said, it was the wrong thing and it resulted in an argument. This often happened at breakfast and they left for school on a bad note. I learned not to say anything, which was not easy. I learned to tell them about their acne in a quiet and peaceful time, maybe on the weekends when no one was mad at anyone.

“Another lesson was to tell them about their acne in a calm and quiet time, maybe on the weekend when no one was mad at anyone,” Baldwin said. “It also helped to have small snippets of conversation, to just leave a comment [such as], ‘Are you satisfied with your medications? Is there anything I can do to change them? ‘ I tried not to bring my teenage experience into the conversation because they didn’t appreciate me telling them how I was dealing with acne at their age. I ended up saying to them, “Talk to me if you want or I’ll help you find someone else to talk to.” You know I’m here and I’ll do whatever it takes. So leave him alone.

This article was originally published by Dermatology Times.

Disclosure

Baldwin is a paid consultant for Sun Pharma.

The references

1. Parents are very worried about the effects of severe acne on their teenage children, a new survey reports. Sun Pharmaceuticals in collaboration with the American Acne and Rosacea Society. Press release. Sun Pharma. April 7, 2021. Accessed May 13, 2021. https://www.sunpharmaderm.com/pdf/Sun_Pharma_Acne_Survey_Press_Release.pdf

2. Parents: Your teenager’s severe acne affects the whole family. Sun Pharma. Accessed May 11, 2021. https://www.sunpharmaderm.com/pdf/Sun_Pharma_Acne_Survey_Infographic.pdf


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