Ish

Age at interview: 22
Brief Outline:

Ish had acne between the ages of 13 to 20. He received most of his acne treatment in the United States before moving to the UK. He has tried many different creams and found it frustrating when treatments didn’t work effectively.

Background:

Ish is 22 and a sales advisor. He is single and lives on his own. His ethnic background is White Hungarian.

More about me...

Ish had acne for several years between the ages of 13 and 20. Most of the treatments he tried for his acne were in the United States, although he saw a GP in the UK once when he was 21 because he was worried that the acne might be returning. He finds that his skin is now mostly under control but that he sometimes gets an occasional pimple when he is under a lot of stress. Ish has looked online for information about acne before but says that he would now prefer to speak directly with healthcare professionals. He worries that following advice from the Internet about acne could not only waste time and money on shop-bought treatments but also potentially worsen the skin.

Ish finds that some triggers for flaring up his acne are stress, alcohol and some brands of chocolate. He found that his acne was worst in his later teens and that this may have been linked to stress at secondary school but also because he tended to wear his hair across his face a lot. Ish says that his acne changed a great deal from day to day, sometimes clustered in patches on specific parts of his face and at other times spread across his face. Because Ish’s acne affected mostly his face, he found it difficult to shave when he had raised pimples and he stopped doing so because it would make his skin bleed. Ish enjoyed tanning and spending time on the beach when he lived in the United States and this meant that finding suitable sunscreen products could be time-consuming and a matter of trial-and-error. He finds that his skin gets drier in the UK and that he has to use a moisturiser more frequently to avoid an acne outbreak. 

Ish says that the worst part of his experience with acne was the time-consuming nature of repeatedly going back to doctors and trying new treatments. He became very frustrated with having to return to see dermatologists and using different treatments which often only worked briefly or simply didn’t work at all. He found that some of the treatments gave him side effects and additional problems with his skin, such as making it very dry and prone to cracking. For example, he was prescribed a cream most recently containing benzoyl peroxide which worked well but he had to stop because it made his skin very dry and sensitive to sunlight in addition to bleaching some of his clothes. He recalls that one treatment made his skin very itchy and another cream brought him out in a rash. 

Ish found having acne very embarrassing and says that the impact on his appearance was difficult to cope with because it made him feel self-conscious. For this reason, especially as a teenager, he did not speak to his friends about it and disliked when family members made direct comments about his skin. Ish thinks that it is especially important that healthcare professionals make the effort with young people with acne by being welcoming and open to answering their questions. Ish used to find it uncomfortable having doctors examine his skin at appointments and thinks it’s important that doctors recognise that acne can be embarrassing for young people. He says that young people with acne are unlikely to talk to doctors about aspects of their lifestyle that may be relevant to their condition and treatment unless doctors establish good relationships with them. Ish found that the dermatologists he saw whilst living in the United States were very aware of the emotional impacts that acne can have on body image. For example, his dermatologist gave him a moisturiser to counteract the dry skin from the acne treatment and Ish thinks this helped prevent him from having many scars.

Ish now has a skin care routine which he tries to stick to as much as possible. However, this can be difficult if he is dating someone new, especially because he finds it “embarrassing to introduce that [acne prevention and treatment] into a relationship”. Ish manages his skin well with his routine but he is concerned that it may stop being so effective and require him to change products in the future, as has been the case in the past. He encourages other young people concerned about acne recurrence to visit a healthcare professional as soon as their management routine stops working so effectively.

Ish found shaving difficult with facial acne.

Ish found shaving difficult with facial acne.

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I mean, yeah, especially if you have shave and you have acne, that’s probably the worst combination you could ever have, because your skin, that alone, you know, just when you’re shaving there’s a blade close to your skin which is already taking that hair off, then you’re probably going to end up slicing acne into little pieces and you’re going to bleed more. It does sound disgusting but it’s like, how it is. So, no matter how you look at it, if you shave or something like that, it’s just going to make it worse. 

Was that a concern for you when you sort of first started shaving, if you had acne at that time?

Yeah, I just wouldn’t shave. 

Yeah. 

To be honest like, it comes to that point where you experience it once or twice and you know, you’re using an aftershave but you’re still using prescribed creams on your face that just like combines, and it’s either one or the other basically. So you shouldn’t really combine chemicals to begin with. So that’s just going to make it worse. 

Ish is careful about cosmetic and body care products he uses.

Ish is careful about cosmetic and body care products he uses.

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Yeah, if you put something on, for example fake tan, you have to put moisturising on. You, so you’re not alone trying to look for something that helps your acne. You’re going to go to try to find other products that won’t make it worse. So if you’re tanning or anything like that, you’re going to have to start finding products that will work good with your skin every single time. So, that’s a little bit hassle and a lot of money we’re talking about. I mean just the tanning lotion, if you buy one, it’s about like, thirty, forty pounds. They’re expensive. So it becomes a little bit expensive hobby in the end. Yeah

Like trial and error because you just have to….

Exactly, ’cos something will make you break out a 100 percent, you know, and most of the time, out of ten products, it’s nine products that will make you break out and most of the time, it’s the last product that actually works. 

Topical treatments made Ish’s skin dry, adding to his image worries.

Topical treatments made Ish’s skin dry, adding to his image worries.

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It was embarrassing having acne, I’m guessing during that age. And then just, I don’t know, it was just really bad as you always had it in the most awkward place that you could think of, like in the middle of your forehead, or like, you know, somewhere where people can actually really notice it. So that made things worse. And just like, I don’t even know, it as just like that phase was like, you’re going to go to the doctor, you’re going to get something and if it’s something that dries your skin out you’re not only going to have face your acne problems, you’re going to have to face other problems now because your whole skin is turning red or like is drying out and you’re like, you know, you just put your hand next to it and like a bunch of dead skin just falls off.

Ish describes some of the side effects and impracticalities of topical treatments he’s tried.

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Ish describes some of the side effects and impracticalities of topical treatments he’s tried.

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I think I just only remembered the last one I had cos that one had benzoyl peroxide in it. But with that one, I remember the problem was that it tended to make my skin really dry after a while, so you had to stop the treatment. But that was the best one that was working for me. So it really wasn’t, so I did it like for a month or two and then my skin got really dry. Then I stopped for a month and then it like came back. So you’re just repeating it over and over and over again. You’re not really getting a definite cure. So that’s, yeah, that’s annoying.

It bleaches fabrics. So I mean I had a white pillow so it didn’t really affect that part. But my clothes here, over here all the way on the collar here it bleached it. And also makes your skin very sensitive to sunlight and where I’m from it’s like the tanning beds are everything. So if you’re tanning or going to the beach or something like that, basically your face is going to burn and it’s going to make it worse. So that was a little bit downer.

Do you remember any other side effects from any other treatments for acne?

I remember one of them made my skin itch and one of them gave me rashes. So, it just made it a little bit worse, yeah.

Now Ish is in his 20’s, he finds it easier to talk about his acne than when he first got it at the age of 12.

Now Ish is in his 20’s, he finds it easier to talk about his acne than when he first got it at the age of 12.

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I mean to be honest, especially during that age I don’t think anyone’s going to talk to it, talk about it. That’s why it’s so important, as I said like, finding the right doctors who make you feel welcome and open about this subject ’cos you’re not really going to start talking to your friends about these kinds of things during that age. It just makes you feel awkward a little bit and you’re embarrassed about it. I mean later on like, I know it’s a cliché but when you grow up a little bit more you have more experience, you will know that your friends went through it and it’s a little bit easier to talk about it. And it’s like, “Yeah, I used this and I used that and it worked perfectly, you know.” It’s more of an open subject. But when you’re twelve, thirteen, fourteen, it’s like you’re not going to talk about it. You have enough stress on you as it is fitting into a social group at school and everything. You don’t want to be known as the person, “Oh, yeah that’s the kid with the worst acne in the school, you know and he evens talks about it.” So you don’t, you try to avoid that [laughs].

For Ish, acne has affected his social life a lot and when it is bad he doesn’t want to go out.

For Ish, acne has affected his social life a lot and when it is bad he doesn’t want to go out.

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Did it sort of impact on your social life?

I think it does impact on it a lot. When you do have really bad acne, ’cos with acne it’s not always the same. So one morning you wake up and you’re going to have twenty of them and that’s the day when you’re like supposed to go somewhere with your friends. And you’re just like, ‘Okay, I’m not going to go anywhere. I can’t even be bothered about it.’ ’Cos you just feel, you know self-conscious about it. So it does impact on it a lot, I think. I mean school you can’t really avoid but, you know, on your free time you try to avoid it if you’re having one of those days where your acne gets worse. 

So it has been the case because of acne and the way you’ve felt about it, you’ve avoided going out?

Yeah, I mean there has been, there has been where, if it’s been bad or something, then I’d rather just not go out because it’s like, ‘Oh, God, I’m not going to show my face today.’ So, yeah.

When Ish forgets to do his routine it has a big impact on his skin. He finds it stressful having to use several products on his skin every night and sometimes doesn’t have the energy to do it.

When Ish forgets to do his routine it has a big impact on his skin. He finds it stressful having to use several products on his skin every night and sometimes doesn’t have the energy to do it.

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But now it’s just having that daily routine when you go up you actually have to use that face wash. Then you have to make sure it hydrates it. Then you come home, then you’re going to use a tonic to make sure, you know it smoothes everything out. Take the dirt of. Then you can also hydrate it again. Also wash it. So that daily routine is just a little bit stressful to me and when you forget it, it just makes everything worse because you forget it one day or one night, it just messes up the whole thing and you’re going to have to basically restart it again. So, yeah, just that routine of it, like, cleaning your face and you’re using three or four different types of products so that’s like, you know, if you’re tired, you don’t really have energy to do it. But if you don’t do it then your skin does suffer in the end. 

For Ish, being told bluntly about his acne and trying many home remedies was not good for his self-esteem.

For Ish, being told bluntly about his acne and trying many home remedies was not good for his self-esteem.

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I feel like sometimes parents tend to make it worse because the parents are like, well they are your parents. They try to help you with everything. But they tend to come across a little bit harder, “Oh, you have that pimple right there. You can put this on it and it will go away.” You know, trying those home remedies all the time and stuff like that. So they’re not really helping. They’re making it worse. I mean, they’re destroying your self-esteem a little bit. So it’s just like, back off a little bit. Don’t be that harsh and that blunt. There’s a level of like, since it’s a taboo in like every day social life, just ‘cos you’re my parent doesn’t really give you the right to be attacking about it. So, yeah.

Did you sort of feel able to voice that to your parents at all, if they did make comments like that?

I wouldn’t really say anything to them, for example, it’s just like, ‘Oh, God, why did you have to mention it.’ You know, what I mean, but it’s like they’re your parents. So they’re trying to help you and they’re trying to do the best for you, no matter what. But it’s like, ‘Yeah, don’t talk to me. I know it’s there.’ 

Ish felt that in a relationship you “always want to show your best side” and it would be “embarrassing” having to do his morning skin routine if he had just started dating someone.

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Ish felt that in a relationship you “always want to show your best side” and it would be “embarrassing” having to do his morning skin routine if he had just started dating someone.

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I mean there is a feeling of waking up in the morning and having your own routine that you’re used to, is a lot better, especially if you don’t know someone that long. I mean, if it’s a friend for five or six years that I’ve known them, it’s fine, you know, if they see it. But if it’s someone that I just recently met or you’re dating someone on top of everything, it’s kind of embarrassing to introduce that into a relationship, as in like “Yeah, I’m just going to have to get up thirty minutes before because I have to do all of these things, you know like, washing your face, hydrating it, tonic, everything that needs to go on it. And I don’t know it just feels like they’re judging you on some level. As in like, “Oh, what would happen if they wouldn’t do that?” You know what I mean, they have a weird idea, like, ‘Are you going to turn into Shrek or something?’

It’s uncomfortable, to be honest. I mean, if you’re going to go on a first date or anything like that, you’re going to have acne. You’re going to try and do everything to hide it. No matter how we look at it. No matter what’s going on, who’s, how comfortable you are in your skin, for all I care, you can be Beyoncé and like, you know, be amazingly gorgeous, but if you have acne, you’re going to try and hide it, no matter what. So just having that in your life still to this day is frustrating, I guess. So in relationships, you’re going to try to show the best side of you, especially in the first few months or the first year. Then you don’t want them to see you having an acne, I mean you’re coming in contact with a person very, very close. So that’s going to be like, ‘Oh, God, what if they see it. They’re going to be grossed out or something like that.’ 

And what about for you, if you met somebody who had acne themselves?

It’s really hard not to, see that’s the bad, really bad part about it, you see I used to have acne and I know what worked for me and when you had acne and you kind of see someone and you’re interested in them, yeah and you do tend to accept them. But you really want to be like, “Oh, I tried this and you could try it too. Maybe it works for you.” ’Cos you’re not really able to say that to a person ’cos then they’re going to be offended. That’s like, ‘Oh, so you don’t like me this way or you think I’m ugly?’ You know what I mean, so it’s just like that kind of affects the whole thing. So you can’t even give advice to them. So that’s a little bit annoying. But you wouldn’t want it happening to you. So I wouldn’t want my partner to be like, “Yeah, you have a huge pimple on your forehead and I used to do this and it went away.” You know, so it’s a little bit weird that it’s a taboo on top of everything. So it’s such a daily thing but it’s still a taboo, no matter how we look at it. Like, no-one is willing to talk about it that much. You can Google it. You’ll see the weird commercials with Demi Lovato having whatever it’s called, her skin care these days. You know, she’s going to be talking about it but come on you’re a celebrity. I mean, if I had that much money, I would look like, my skin would be perfect too every day. But you know what I mean, it’s just like as an average every day person, an average person, we’re not going to be talking about it. It’s a taboo for everyone, in a relationship, in friends, everything. Most of the time we don’t talk about it. It’s still embarrassing.

For Ish, attending a support group would have been “awkward”.

For Ish, attending a support group would have been “awkward”.

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To be honest with that, not really. There wasn’t really anything like that I’m guessing or I don’t know, I don’t think I was interested in counselling groups about it. Probably, I have no idea if they even had that option. So, I don’t really know. 

So, you wouldn’t have liked it or you would have liked it?

I think during that time, I wouldn’t have liked it. At that time I wouldn’t have liked it all probably. So, yeah, I think I would have thought it was embarrassing. So now I don’t really care. If someone says there is a website, I will probably check it out. And if I do know something that works, I will probably post it because I don’t really care nowadays.

But that time, it would have been awkward. Probably would have been embarrassing. 

Ish thinks it’s important for doctors to be “understanding” about how acne affects a young person’s life.

Ish thinks it’s important for doctors to be “understanding” about how acne affects a young person’s life.

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Yeah. Exactly, as in like, people, especially with skin care, since it’s something, to be honest it’s the first thing other people notice about us, our skin and everything, our facial features. It’s like, I don’t even know, they are so understanding about it that this will affect your life, and we’re here to help you throughout that whole process and they’re, I don’t know, it just feels like they thrive to be, you know, bring the best out of yourself. So they’re not going to be like, “Yeah, this isn’t going to leave you a scar or anything like that.” They’re not guaranteeing anything, but your still feeling welcome there and you know that they’re trying their best to help you.