Marga

Age at interview: 24

Age at diagnosis: 18

Brief Outline:

Marga developed acne around the age of 18/19. She has tried oral contraceptives, oral antibiotics, topical creams, shop-bought products and ‘natural’ remedies. At times, acne has had an impact on her emotionally by lowering her confidence and self-esteem.

Background:

Marga is 24 years old and a postgraduate student. Her ethnicity is White British.

More about me...

Marga developed acne on her face around the age of 18/19. She tried a number of shop-bought face washes before visiting a GP about a year and a half later. Her GP thought that her acne may be caused by a hormonal imbalance and so prescribed the contraceptive pill, Yasmin. She was also given adapelene topical cream but this dried her skin out so much that she couldn’t use make-up. She was then prescribed antibiotics for her acne and found that Lymecycline worked very well. After finishing the course, she managed her skin well with benzoyl peroxide cream. However, after a few months, her acne started to return. She felt especially bad at this time because she was in her mid-20s and acne is so often associated with being a teenager. Marga was put back on Lymecycline but this did not help much. She is currently taking another antibiotic, erythromycin, which is working well but she is concerned about what will happen when she stops taking it. Marga has noticed that a number of things can make her skin worse. This includes dairy, sugary foods and alcohol. She also finds that stress can cause problems for her skin and can result in having both eczema and acne.

Acne has a big impact on Marga’s confidence and self-esteem. Going to the GP and getting medicines are one way she tries “taking back the control” over her skin. Make-up is a kind of “safety net” for Marga in that it can help her feel more confident about her appearance. However, she recognises that it can become a pressure and the desire not to have to rely on make-up was one of the motivations for seeing a doctor about acne. She worries that acne might undermine her perceived competence and responsibility when giving conference presentations or when working with adolescents, for example. Marga’s GPs have not directly asked her about the emotion impacts of acne, but she feels they take her more seriously when she offers this information herself. Marga has had some bouts of depression for which she was prescribed anti-depressant medication; she decided not to take these tablets though because she was already taking oral contraceptives and antibiotics for her acne. Marga has also tried various home ‘natural’ remedies; she feels more inclined to try these because she thinks that they are less likely to have side effects than prescribed medicines. 

Marga has looked for information about acne online and she has also spoken to some friends and family members about their experiences. She enjoys having the opportunity to be open about having acne because she thinks that it’s usually quite a “taboo” topic. Talking about acne with other people has not always been a positive experience for Marga though; she has heard blasé comments sometimes which suggest that she, or something she is doing such as wearing make-up, is at fault. Marga’s advice to other young people living with acne is to be open to trying different treatments, both medical and otherwise (such as cutting out dairy as she has). She says that it’s also important to do things to boost your confidence and not to let acne stop you from doing the things you want to. She would like for doctors to take it seriously when patients come to them with acne and to ask about their emotional health because acne can impact across all aspects of their lives. 

Marga thought she had grown out of acne, but it came back at age 24.

Yeah. I think it was like, it was definitely at the end of school or beginning of university, I can't remember exactly, but it was definitely 18, 19 when I started to get sort of regular spots. You know, I didn’t have anything up until then really, so I guess it frustrated me a little bit because I thought I had passed that; that I'd been lucky to not have any spots really. And I guess I was frustrated because I felt like I'm not supposed to have it. I'm not-, it's when-, you have spots when you're a teenager. And I guess that when I-, sort of end of last year those sorts of thoughts definitely came back. I thought, ‘ah, I'm 24’, you know, ‘I'm an adult.' Another thing is I work in a school and I work around-, often I work around a lot of sort of adolescent children. I felt like, I often felt like it was almost affecting my profess-, my being professional cos I felt like, you know, I've got spots, I look like the kids now and I'm meant to like be in charge of these kids.

But I didn’t really-, I probably only voiced that to my parents but I guess you do have those questions, questions to yourself like ‘why do I have these spots, like I'm meant to be spot-free’ and I guess you feel like it's affecting your-, I guess your age and your maturity in a way, like your  perceived maturity and ability to look after these children.

Marga finds it annoying when other people imply acne can be easily ‘fixed’.

Or things like, for example, they’ll be like, “Oh if you do this that'll be fine,” or, you know, “It'll be fine in the summer when you get in the sun.” And obviously the sun has-, does make spots better but it doesn’t make them go away. So, I guess it's also that sort of blaséness being like, “Oh if you do this it'll be fine,” and like no, it won't be, [laughs] like if I do that it – they’ll still be there. So I guess for other people who don’t actually-, aren't actually experiencing or aren't in that situation at the time, having the spots I guess it's not-, it's easier for them to make the blasé comments about it. And – as if, I guess it makes you think as if it's like you're doing something wrong and that’s the reason you have spots. I guess it's that sort of blaming in a way.

And it's not, it's not that easy, it's not, it's not as simple as that, you know, if I stop touching my face then my spots will go away [laughs].

Doesn’t really work like that I don’t think, so yeah.

Marga takes the combined pill to help with her acne. Although there is no clear link between diet and acne, she thinks dairy is a dietary trigger of hers and wonders about hormonal links to this.

Did they talk about things like causes and triggers and the sort of medical side of it?

Yes, they went through the fact that it was probably hormonal which is why I was on the Yasmin, and yeah, they basically went sort of outlined the fact that my hormones are probably up and down, and things like that and they said eventually it will level out – which I guess gave me confidence because I knew that this isn't forever, and like it's just because my hormones are quite fluctuating at the moment. Interestingly though, I've-, basically I've given up dairy. This is, they, the doctors didn’t mention anything like this, but I heard from a friend that dairy can actually be a trigger of acne. I've given it up probably about two-, two and a half years now. I still eat it from time to time, so I'll still eat cheese on pizza for example but I switched to soya milk; I don’t drink milk. And that’s been amazing as well for my skin, which is obviously something that the doctor hasn’t really mentioned to me at all. But my skin has got so-, also I've noticed a significant improvement for example when I went off the Lymecycline and had that about six month period, nine month period where I wasn’t on anything apart from the benzoyl peroxide. Even before that, actually before I went on Lymecycline I also had given up dairy and it really, really helped. Because I notice when I now then have cheese I'll, you know, maybe like two or three days in a row, I'll-, I can guarantee that I'll get a few spots which is, you know, I haven’t really mentioned that to my doctor; I don’t know whether I feel a bit stupid saying it because they’ve never mentioned to me that food can be a trigger. So that’s, yeah, that’s another thing that dietary that I've changed as well which I feel like as well helps with that control element cos I feel like, you know, I know that that’s bad for my skin; I wonder whether it's the cow hormones or something in the, in the milk. 

Marga thinks the interaction of stress, eczema and diet might impact her acne.

So, I get eczema when I'm stressed, and often sometimes when you have dry skin or eczema, like on your skin, on your face, I think it can pro-, you can get more spots because of that cos I think it like, the dry skin cells and like clog up your pores I think. I don’t know whether that’s true but-. I sometimes I feel like when I get stressed I get ac-, more spots and dry skin, so I don’t know whether that’s got a relationship to it.

But definitely I get spots when I'm stressed.

Like if I'm, I don’t know, if I've got an exam or if I've got like something due in. Another thing actually is interesting – so when I've, this year when I've been quite depressed I've eaten a lot. I've comfort, comfort eaten, so a lot of high sugar, a lot of sort of refined carbs which sort of like really high in sugar. I've like-, I've eaten a lot of that for when I've like not been feeling great, and that gives me spots which is interesting cos I have like a massive sug-,like I have loads and loads of sugar in my system.

And that gets, definitely gets expressed in my skin which is interesting. Like, if I eat like loads and loads of chocolate or like I guess when I've been feeling down I crave unhealthy food, and that definitely, definitely expresses itself in my skin.

Which might be one of the reasons why I've had this bout of acne. I-, sort of after around, like the end of this-, last year, the start of this year, it might have actually a massive link actually thinking about it.

Marga disagrees that make-up triggers her acne and instead highlights how it helps her feel more confident.

So, I guess the issue about make-up is often people will say, “You have spots because of the make-up you're wearing,” and that, “If you wear less make-up then the spots will go away.” But from my experience it definitely hasn’t been that. I've had spots regardless of whether I've worn make-up or not. And I think that’s sort of-, it's interesting because make-up has become such, like such a safety net for me, of being able to have more confidence when you have spots. But on the other hand people then assume that, you know, make-up's actually the cause of spots rather than something that’s helped to mask it. 

So, I guess it's that sort of people maybe judging why you have spots or trying to put reasoning as to why you have spots when I’ve spent years and years and years trying to work out why I have spots [laughs]. 

Marga sometimes has to wait for other family members before she can do her skin care routine, including applying topical treatments.

So, living here I have a sink in my room so that’s absolutely fine. I do go home quite a lot, and I share a bathroom with my mum and my brother. And sometimes I guess me and my mum probably get ready for bed generally around the same time so I'll have to -, we either share the bathroom-, because there's only one sink and I often like, like the whole sink to myself partly because I like [gestures splashing face with water] probably make a bit of a mess around the sink [laughs] and have to clean it up. Then I'll probably come back if she's in there or something, or she'll come back or whatever. So I guess, you know, and sometimes, “Ah, you’re in the bathroom again,” or whatever to my mum or something. So, I wouldn’t say it's a massive problem but I guess when you're sharing you have to compromise a lot more than obviously if you have your own sink so.

Marga doesn’t want to take lots of pills every day so she decided not to take antidepressants as well as antibiotics.

So, I went through a little bit of depression at the start of this year, and I've sort of often been prone to like sort of anxiety and stuff like that. But I went through a little bit of a bout of depression at the beginning of this year, and they offered me , they offered me anti-depressants, and I mean they, they prescribed it to me and I just didn’t want to take it, to take them really. So, cos I prob-, generally cos I felt like I'd, I was taking these erythromycin, I was taking it two twice a day, so I was already taking four pills for that; I was already taking the pill every day, and I was like, 'well’, you know, ‘I don’t want to completely medicating myself’ like a-, that’s probably one of the reasons actually because, you know, that’s already five pills in one day, and this one you had to take twice a day, so after-, one-, I think both after meals and it was just completely complicated I thought. And I guess I was concerned that I was completely just medicating my body and I didn’t like the idea of taking anti-depressants partly because I know people who've got addicted to it and saying that they can't act-, they're finding it difficult to get off them.

So I didn’t want to do that. But they basically said that my self-esteem, for example, that was linked to problems with my skin as well. They said it would get better if I went on these but obviously it was totally my decision and I decided not to.

Lymecycline cleared up Marga’s acne and, when it returned, erythromycin worked well.

So then they, they put me on a, a pill , sort of an acne pill on and off for a long time but I can't remember what it was called now. They put me on some pills, some acne pills, but [sigh], so my acne problems basically were really carried on for a long, long time until I got to maybe two years ago where they stuck me on maybe, I think they stuck me on Lymecycline, maybe that’s a year and a half-, about a year and a half ago they stuck me on Lymecycline and that worked really, really well. And I, like all my spots went and I had real faith in it and it worked really, really well, so I was on that about, for about six to nine months I think. And then they told me to go off it, and then, so then I went, I went travelling for a bit and my skin was fine – like I had a spot here or there – but it was absolutely no problem at all. Had benzoyl peroxide alongside that and that’s rea-, I really like that; I think that’s really good, it's always been really good for my skin actually. But then I came back and I actually, it was the start of this year I think may-, it could have been maybe a change of scenery or something; I'm not quite sure whether it was stress, I'm not sure, but my skin got quite bad from probably about October time till about February. My skin was just as-, just got bad again and I was, you know, I'd turned 24 and I was just really stressed out about it because I thought , you know, I'm 24, this is the sort of thing that typically you associate with teenagers, with adolescence, and I guess it just got me down quite a lot. So that wasn’t really that fun. And like every-, you know, round my, sort of round my mouth I had lots of spots and like sort of here [points to cheeks], and so then I went back to the doctors and they put me on Lymecycline again. I think that’s around Christmas time and it just didn’t work so I was a bit frustrated about that because it had once worked really, really well. So they stuck me on erythromycin and I've been on that for about five months now I think. For-, I think I'm due to finish end of August, beginning of September, which I will have been on it for about six months by that point. And I really, really like it; like my skin's improved so much like, you know, I haven’t really got anything-, haven’t got any spots anymore and my scars are like pretty much gone now. 

Marga’s on the pill for her acne. She’s noticed that GPs keep asking her about switching to another contraceptive.

The fact that I'm on this Yasmin (contraceptive pill) sort of suggests that they said, “Well, it might be that your hor-” The first thing they stuck me on before they stuck me on any topical skin stuff or on pills was Yasmin. They said, “It could be the fact that you’ve got a hormone imbalance and the cycle-,” and they asked me at the time, “Do you get worse spots around the time of your period?” And I said, “Oh, I think so.” So they stuck me on that. I don’t think it makes that much difference to me really. Maybe like a few but . I mean I definitely think the Yasmin helps. 

Mm

Interestingly however, I don’t know whether this is relevant, they always try and take me off it at the doctors. They say, “Have you considered any other contraceptions?” and I know it's because of they’re expensive [laughs]. And they-, every single time I go to the doctors and I ask for a re-prescription, or they notice that I'm on Yasmin, they’ll say, “Have you considered other forms of contraception?” or “Would-,” you know, “Would you consider going off this pill?” And then I say, “Well it's actually for my-, I'm partly doing it because of my skin,” and then they say, “OK, fair enough.”

But it's every-, honestly, every single GP.

That’s very interesting.

Yeah. And it actually started to annoy me because as I really considered last time to say, “Look, I don’t-, can you put on my notes I don’t want to go on off, go off it because I get asked every time.” I might do that next time they ask [laughs] but.

Do they say why that they're asking?

No, but I think I've made an assumption that it's about cost. Because it's every single GP and I-, something sounds a little bit suspicious there, I don’t know.

Mm, yeah

But then when I say that I'm on it for my skin and they say, “OK fair enough.”

Marga and her friend made a home remedy with aspirin to put on her spots.

I think when you have acne you are literally willing to give absolutely everything a go. For example, I put, for quite a while [laughs] I put asp-, I got a pestle and mortar and put, got aspirin tablets and then made it into like a paste and then stuck it on my spots, and stuff like that. 

So, I've often been willing to try lots of different things and this will actually really, really-, I noticed it completely, and now I swear about; I wouldn’t drink milk again. Which is interesting.

Where did you hear about the aspirin paste?

[Laughs] It was also through a friend. He, he just said he used it for his skin and he was at my-, I was at his house one time and basically he put-, he like made a paste for me, I stuck it on my skin for about two hours or something, and like I felt like the redness had gone down, and the next day I did it again and-. I mean I don’t [laughs], I don’t know how useful it is but I did feel like the redness went down.

So, I did that for about maybe like a couple of weeks after [laughs], after that and then I sort of forgot about it. But, yeah, it's interesting how you're willing to definitely improvise [laughs].

Marga thinks herbal and home remedies are less likely to have side effects than conventional medicine treatments.

I mean for the yeast one I really don’t think it made any difference; I think I was just eating yeast. So… [laughs]. I don’t think it had any side effects. I think, I guess the ones that are sort of more natural ones, say like, you know, the yeast and the cutting out wheat and the cutting out dairy, I guess you have more faith that they might not have side effects cos they seem more natural, like natural based, whereas for the antibiotics you're always a little bit worried what's in them because they're not as-, I don’t know, they don’t really feel as natural cos you're taking a pill and you feel like you're sort of medicating yourself.

So, I guess we’re always-, we’re more willing to try the more sort of homeopathic remedy, or the more natural remedies cos we didn’t really think it-, if it didn’t work it didn’t work and it's not going to be bad for us if it doesn’t work sort of thing.

Marga, who is 24, works with adolescents in a school. She is self-conscious of her acne and worries it affects how others see her.

I guess it frustrated me a little bit because I thought I had passed that; that I'd been lucky to not have any spots really. And I guess I was frustrated because I felt like I'm not supposed to have it. I'm not-, it's when-, you have spots when you're a teenager. And I guess that when I-, sort of end of last year those sorts of thoughts definitely came back. I thought, ‘ah, I'm 24’, you know, ‘I'm an adult.' Another thing is I work in a school and I work around-, often I work around a lot of sort of adolescent children. I felt like , I often felt like it was almost affecting my profess-, my being professional cos I felt like, you know, I've got spots, I look like the kids now and I'm meant to like be in charge of these kids.

But I didn’t really-, I probably only voiced that to my parents but I guess you do have those questions, questions to yourself like ‘why do I have these spots, like I'm meant to be spot-free’ and I guess you feel like it's affecting your-, I guess your age and your maturity in a way, like your perceived maturity and ability to look after these children.

The children never said anything, it was probably all in my head, but I guess when I was trying to for example deal with kids who are not that-, pretty close in age. So, I'm 24, they would be like 17, 18 and they had, you know, some of them often maybe-. I mean kids at that age do look completely varied in age. So there was some that did look a lot, a lot mature than that and they had, you know, didn’t have any spots, and you think, 'gosh’, you know ‘they don’t have any spots so they could probably get away with being my age.'

So, I guess you felt like, in your head, ‘oh’ - I don’t know whether it would affect my ability to do my job but you did feel like - you didn’t feel as legitimate at being your role in a sense as being sort of that position of responsibility.

Marga explains why having acne can be expensive.

It is so expensive. Like I've spent so much money in the, over the past few years; particularly prescriptions are really expensive. And particularly, for example if you're on a new pill, a new acne pill, and they’ll trial it for a month and say, “Come back in a month, and, you know, if you haven’t had any side-effects we will prescribe you for another, for another three months,” or something like that. And, but if they just gave me three, three months then it's like one set of prescriptions. So, I've spent a lot of money on prescriptions; I mean I don’t know how many but, you know, a lot. And I've spent a lot of money on expensive make-up – particularly in the last few years. And also sort of high street remedies where you think 'well, I haven’t tried that before,' and they're often like 20, 15, 20 quid and you think 'well, you know if it's, if it's that amount of money you think well it could actually work,' and you're willing to give it a go. Like you're willing to think 'well, you know if it makes my skin better it's worth the money.' Often it hasn’t really worked in terms of the high street stuff. And even like the prescriptions are, you know, [laughs] half of them don’t really work anyway, just depending on your skin type and stuff like that. So, financially – yeah, it's actually really quite expensive.