Naomi

Age at interview: 22

Age at diagnosis: 9

Brief Outline:

(Audio or text only clips) Naomi developed acne at the age of 9. She tried different medications before eventually taking Roaccutane (isotretinoin). The treatment cleared her skin but her acne has returned twice since, with the most recent time being treated privately.

Background:

Naomi is 22 years old and a university undergraduate student. She lives in student accommodation. Her ethnicity is White English.

More about me...

Naomi developed acne on her face and back at age 9. Naomi went to her GP about a year later and left the appointment hopeful that the prescribed cream would clear her acne. However, she went on to try various kinds of prescribed creams, antibiotic tablets and the contraceptive pill, none of which helped. Naomi was referred to a dermatologist when she was 15/16 and given a course of Roaccutane (isotretinoin). Her skin stayed clear for several years but the acne returned on her face when she was 19. Her GP prescribed antibiotic tablets and a topical gel but neither made a difference and she was referred again for Roaccutane. Her skin cleared but the acne returned when she changed to a contraceptive implant. Naomi’s experience of seeking acne treatment through her GP and NHS dermatology had been so upsetting that she decided to pay for private treatment. Naomi is grateful that she was able to afford private treatment with inheritance money and although she sometimes feels guilty, she feels it was the right decision because of the profound negative impact acne was having on how she felt about herself. 

Naomi’s experiences with seeking acne treatment have been very frustrating and involved a lot of waiting: for appointments, referrals and trying out so many different products. She feels that this prolonged the length of time that having acne damaged her confidence and impacted on her social life. The treatments themselves could also be upsetting. For example, Naomi found taking Roaccutane quite stressful because it involved a lot of trips to doctors for blood tests, compulsory pregnancy tests and to collect the next month’s supply. She also experienced side effects such as very dry skin and she found that her acne would become worse on the treatment before it started to get better. 

Naomi thinks it can be difficult to have acne as a young person because this is a formative time when appearances matter a lot. Acne affected her self-esteem and it knocked her confidence further when various treatments didn’t work. She found it hard to open up to people about how badly her skin was affecting her, including to doctors. Naomi didn’t feel confident telling the doctors that she would like stronger or different medications, and they did not tend to offer other options. A turning point was when the dermatologist for the third course of Roaccutane described acne as a “disease” and reassured Naomi that it could be treated. Previously, Naomi had felt that many of the doctors had dismissed her acne as “just a teenage thing”, despite the fact that it had started for her at an early age, lasted for many years and returned again in her early 20’s. Naomi encourages other young people with acne to feel more confident and be insistent when talking to doctors.

Naomi didn’t like to do hobbies (like swimming) which got her face wet because her make-up would come off.

If you go swimming, like if you’re wearing make-up obviously it’s going to come off. So I think that did kind of bother me like I never really wanted to get my face wet because like I’d be kind of exposed as it were. But like but we didn’t really often do that kind of thing. But yeah it was definitely something I thought about. And like on holidays as well like we, we sometimes went on like ‘cos I really like horse riding so like sometimes we’d go like riding or something and then like, you know, you want to like splash your face ‘cos its really hot, like you’re in holiday, but like I’d never really want to and then [laughs]. So yeah I think, I think yeah it did kind of affect my behaviour but probably not my clothing so much because there was nothing I could do.

Naomi was upset by others giving incorrect and unwanted advice about acne causes and triggers.

I think I never really had a lot of faith in what just stuff from the shop would do because, you know even pills and creams weren’t doing anything so I mean like what was a face wash going to do. But I think I think like I kind of, because I was so desperate to do something that might help you know, I was so rigorous and I’d be like washing my face like two or three times a day just trying to do something that would make it better and like people used to say, “Oh, you know, you know, you should, you need to drink more water, like that will obviously help.” So I was drinking so much water and like [laughs] I’d be at school with like a bottle of water and just like emptying it and then going and refilling it because I was just so desperate to like kind of, I don't know, I think I thought like maybe it would just wash it out of me or something.

And then one person one time said to my mum, you know, “Oh, it’s the fruit and vegetables, she’s obviously just not having enough fruit and veg.” And so I’d just eat so much fruit because I thought it might help and like nothing made any difference. So, yeah it was crazy. And like you know, one, one person said, “Dairy products are really bad,” so then I just had this massive thing about cheese and like I couldn’t eat cheese because I thought it would make it worse and like it didn’t make any difference, so [laughs]. 

So yeah, I think it really kind of like took over my mind. I mean it was just horrible.

Naomi’s acne returned when she tried the implant (hormonal contraceptive). She had recently stopped taking isotretinoin (Roaccutane) and so didn’t want the contraceptive pill.

And what about when sort of before you went on the third treatment of Roaccutane (isotretinoin), when it resurfaced, when you had the implant?

Yeah, yeah that was really awful because I’d only sort of a few months before I finished the previous one and I didn’t want to be taking a pill anymore every day because having taken so much medication all my life I just, I thought, you know, I want to be able to get up in the morning and not have to remember to take a pill, not that I forgot but I just, for me it was just another form of medication and I didn’t want that anymore. And so, you know, I went to the GP and they said, you know, “Try this implant” and initially I thought ‘oh well, I’d rather have a coil because they don’t have hormones in’ and like . But when I went to the like sexual health clinic place they were like, “Oh, don’t worry, like we can, we can just put this implant in, it’s really easy and it’s like much less painful than a coil.” and, you know, “If you have any problems, we can just take it out and it’ll be fine” and I think I should have stuck to my guns and said, “No,” but I was like, “Yeah, you know, I might as well.” And so they put it in and within a couple of weeks my skin was just ruined and so I, I was like well maybe I should just wait a bit ‘cos it might improve but it just didn’t get better. So I went back to the clinic place and said, “Please just take this out, I don’t want it here.” and obviously that whole process like took time as well because I had to wait to see if it improved then I had to phone and make an appointment and they didn’t have one for like four weeks. And yeah so then I had that taken out and then I was hoping that that would make things better but it just never really, like I waited for a few months and nothing happened and that was when I was just, I was so upset I just thought like ‘I just want to go private because I can’t face waiting again’.

Naomi thinks there are several factors which might explain why her acne clears up whilst on holiday.

My mum always used to think that when we went on holiday it got a bit better and I think, I think that wasn’t, I mean maybe it was a combination of factors but I think partly, maybe partly the sun but also I think like ‘cos on like beach holidays and you’re swimming in the sea and like maybe the salt, I don’t know. but like yeah I think when I was younger maybe slightly better on holiday but maybe also that was maybe it was also a stress thing because I was away from school and like my peer group and the pressure of, you know, worrying about other, ‘cos I didn’t, I didn’t worry as much about what my family saw so maybe I was more relaxed on holiday and that kind of helped it but . But there was never anything I could pinpoint that then I could have done. ‘Cos if it, if it was the salt water then I, if I’d known that then I could have, I don’t know, used that and fixed it but, or if it was the sun, you know, I could have gone out in the garden all the time [laughs]. But yeah because I never really knew what it was and it was probably a combination of things yeah I never really knew. 

Naomi wishes her doctors had used the term ‘acne’ earlier.

Could I ask you a bit about the very first appointment where you were told that you had acne and what it was like to go to the GP’s at that time?

I don’t really remember [laughs] I mean I, I think, I think they didn’t even really call it acne then because I was so young and they were just like, “Oh, you know, this cream will just help with your skin.” and actually yeah I mean I think, I think like yeah, I mean I knew it was acne I guess but like I think because, I think part of the problem was because everyone was like, “Oh it’s just a teenage thing, you just have bad skin,” and so I remember actually when I went to the dermatologist the most recent time and he said, you know, “This is a disease and we’re going to treat it,” and I just remember that being such a turning point because I’d always just kind of it had always just been like ‘bad skin, a teenage thing’ and then suddenly it was someone who was like really taking it seriously as a disease that was treatable. and I think yeah, so I think like the way people talked about it did really have an impact and I didn’t really realise that until suddenly this dermatologist was saying, you know, speaking about it in that way. and that made me feel like so much better in some ways because even though it was like ‘oh my God, I've got a disease’ it kind of, it made me feel like I was justified in being as upset as I was and that you know, this was a serious problem. But someone was taking it seriously and was going to fix it for me. 

Yeah.

So yeah I kind of wished that someone had said that earlier on really [laughs] because it took a while.

Naomi saw GPs about her acne for many years.

The GP’s were generally like really nice about it but I think like through my teenage years in particular they, they perhaps weren’t, weren’t as like quick to, to do something about it because, you know, everyone has that attitude like ‘oh it’s just a teenage thing, it’s a phase’ and like, not that they didn’t take it seriously but I think they would, they just kept being like, “Oh, you know, just wait and see, just like wait a few more months,” and like every time I waited it just, it was longer that I was having to, you know, feel so awful about myself and so I think that was quite frustrating. and so then often it like, you know, it would, it wouldn’t be until I went and was like really upset and emotional that they’d actually do something about it and you know, say like, “Oh, well, this obviously isn't working. Let’s move onto something else.” And like, I think that was like frustrating because I just kind of felt like they weren’t they didn’t really understand.

Naomi didn’t feel confident enough to ask her GP to try something else, even though the treatments didn’t seem to be working.

Usually the decision was ‘do I carry on with what I'm doing now or do I kind of go up to the next level?’ And I think usually I would be the one pushing to try something stronger because nothing was working and I was frustrated but I think often I think my, my lack of confidence in going to all these appointments kind of meant that when I, particularly with the GP ‘cos I’d be going because I’d run out of whatever I was taking and so then they’d say, “Okay well shall I just prescribe some more?” And I’d kind of be wanting to try something else because it wasn’t working but like didn’t have the confidence to say, “No, I don't want more of this. I want something that’s gonna work” and so I’d just say, “Yeah, okay, I’ll have more.” and I think, yeah that was part of the problem because I guess I did have a choice and I could have said, “No, this isn’t working for me. Can you give me something else?” but yeah. Also I just wanted to, I always wanted to leave so I’d just be like, “Yep, fine, I’ll take a prescription and go.” yeah but that meant that there were times when I was just on the same thing for so long and it wasn’t working and I’d go and get more and it still wasn’t working so that’s quite frustrating. 

Naomi saw a dermatologist privately when her acne returned, having previously had a long treatment process through the NHS route.

I mean the first time I went I didn’t really know what to expect and like I knew that it was just going to be a kind of stronger version of medication and that was why I was in a hospital rather than the GP, but like I didn’t really understand what was going on. and yeah but then the second time obviously, I’d, it had come back and the GP had made me try some other stuff that I’d had before but it had never worked and of course it didn’t work. and so I was kind of frustrated and just really upset that something that I thought was over had just kind of come back. and the fact that I was like going back to this hospital and like I didn’t want to have to go through that again but I knew I was going to. and then yeah the third time was possibly even the worst because I felt like it was my fault and, and because I was having to go privately so I felt guilty about the fact that I was like spending all this money on something that most people would just say was like a vanity thing and like, you know, “Why, why don’t you just wait and go to the NHS doctor?” And like even though no-one ever said that to me – it felt, it felt so bad because it felt so like selfish. But and I remember I went in and, you know, you have to like sign a form to say that it’s like to say that you’ll pay for the appointment and I just remember they kept saying like , “So you're a private patient?” and I was like, “Yeah, I’ve come here privately,” and then they were like , “So do you have insurance?” and I was like, “No, I don’t have insurance, I’m paying for this privately.” and then they were, they were like, “You know you have to pay for this?” and I was like, “Yes. Just let me get-,” and I was just like crying and like, “Please, just let me-, I just really, really want to see the dermatologist.” and yeah so that just felt really awful and like obviously every time I went to see every time I started the Roaccutane (isotretinoin) like the second and third time, it felt like, it felt good in that I was finally doing something that I knew would work because it had always worked for me but it was also really emotional because it felt like a huge step back and like ‘oh I’m back where I was before’ and you know, back to square one, all this kind of stuff. That’s like just really emotional [laughs].

Naomi felt anxious about her medical appointments and didn’t feel her doctors were interested in hearing about the emotional impacts of acne.

So there was never any time to explore the emotional side of the of the condition or, or really like talk about the impact it had on my life because they were always just interested in the medical perspective and I guess like that was what I was looking for from them, I just wanted then to fix it. But like yeah I could never really have explained how much it meant to me and yeah I think that was quite, quite kind of almost hurtful just because, for them, I was just like five minutes of their time just writing out a prescription and yet for me that appointment meant so much and like I’d be worrying about it for days beforehand. And like I’d usually be crying before I even got to the appointment because just like going into the dermatology unit of a hospital was just like so emotional for me and like and then like having to wait for so long. And yeah at one time it was like an hour and a half but usually it wasn’t as bad as that. but yeah and you’d have this like appointment and I would have been like thinking about it for ages and thinking about what I was going to say and all this kind of stuff and I’d get there and my mind would just be completely blank and all I could do was just sit and cry and like answer questions and it was just miserable [laughs]. and in fact like when I, so, the last course of Roaccutane (isotretinoin) I had three appointments with the consultant and like the first one was just a complete mess, I just cried through the whole thing and then the second one I was doing really well and I hadn’t cried until I sat down in the chair and he turned to me and he just said, “How are you doing?” and I just broke [laughs]. Because I think like the first couple of months of the treatment are always kind of the worst because everything feels like it’s getting worse because obviously it has to get worse before it gets better, and all that kind of thing. and then the third one I managed to get through without crying but it was just like, you know, and it felt like such a waste of an appointment because I had so many things that I kind of wanted to say about like how it affected me. But they never asked so, you know, yeah, we never really talked about that. And they’d always try and like make small talk [laughs] he’d be like, “Oh, so what are you doing at university?” and it’s like I don't want to talk about this, I want to talk about the fact that this is like destroying my self-confidence and like really ruining my life and I just want you to fix it [laughs].

Naomi talks about dry skin as a side effect.

Every time I had it I started on a lower dose, I think you start with like half the quantity and then after like a month or two you move up to the full dose. and so I think that kind of like eased it in without like too many side effects straight away but like, yeah just like horribly dry skin [laughs] and like your lips just peeling all over the place [laughs]. and, I mean I don’t, I mean they do say that like it can affect your mood, but I mean I think I was quite upset about the whole process anyway so I don’t think it was necessarily the pills that were making it worse. But yeah I mean I guess I didn't have any of the really, really awful side effects that you read about on the packet which are quite daunting, you know, you read it and it's like, “Oh I could get jaundice,” or whatever but . Yeah I mean I guess it wasn’t that bad but it’s just like, you know, it does make your skin worse before it gets better and that’s, that’s always quite hard to go through and yeah but you just have to use tons of moisturiser and loads of Vaseline [laughs] and then, and then it improves, but yeah.

It was frustrating for Naomi when people trivialised her acne as ‘just some spots”. She had acne from the age of 9.

What about the transition from primary school to secondary school for you?

I think, yeah, in some ways like it was more accepted there because like yeah it was more common and you’re at an age where yeah like people just think that that’s quite normal. But in some ways I found that quite frustrating because people would, if anyone ever talked about it they’d be like, “Oh, you know, you’ve just got some spots – like big deal.” whereas for me it, it was like a massive deal and like I just felt like no-one ever understood because you know, I’d had it so long already and it had such a huge impact on me and yeah I just felt like people were dismissive and wouldn't take me seriously and yeah I think that was quite upsetting as well. and I remember like when I, because obviously I was taking this like medication and stuff and, you know, so like my friends knew and you know, I think they just sort of thought, you know, “Why are you making such a big deal of it? Like it’s a phase, like it will go.” 

I mean for me like I look at pictures of me then and I just think ‘that looks disgusting’ and I think that, that was part of the problem as well because I thought I looked disgusting so I thought everyone else must have thought that as well. And like I definitely told my, one of my closest friends that one time and she was just like, “Well you know nobody thinks that.” But it didn’t matter that nobody thought that, it was the fact that I felt like that. And like, you know, I see people with bad skin sometimes now and I just feel really sorry for them because I know what that’s like but maybe it doesn’t even affect them as much, maybe they don’t even care but like if for me it was just like a really big deal.

Reflecting back on a summer job, Naomi compares her school environment to her work environment. She thinks teenagers put more emphasis on appearance, whereas adults are more “accepting”.

I worked over the summer between like my years at university for my mum’s architectural practice, I was just like doing some sort of admin and that kind of thing but I felt like, and my skin was never that bad during that time but. Yeah, I mean, well it was last summer because that was when I’d just had the implant put in so that was kind of stressful but in some ways that wasn’t as bad really because they were, well my sort of colleagues but I think that’s less damaging to your self-confidence than your peer group. 

I think the worst thing was at school and yeah the work environment was kind of not as bad for me because it didn't really matter what I looked like, that didn’t, well it mattered to me but like I felt like they weren’t really gonna judge me for that because they were older and like I was doing them a favour by going in and doing this work for them. Whereas with your peer group I think it’s just much more traumatic and you feel like it matters a lot more what you look like. and also I think just being around like teenagers who care about that kind of thing was more stressful whereas I feel with adults they’re more accepting and less judgemental. so yeah, yeah I think that’s not as bad.

For Naomi the stress of not knowing how best to deal with her acne kept her awake at night.

Has it ever affected anything like sleeping patterns, getting to sleep or staying asleep?

Well yeah, I think so actually because obviously when I was like going to sleep that would be when I would be like thinking about it. And like I’d often get quite upset. So yeah I think so. I think like stopping me getting to sleep – yeah not, not staying asleep that was, that would be fine but yeah often like I’d just be lying awake thinking about it, feeling miserable. And particularly [clears throat] particularly when I had the implant and then that made it worse and like that let me up a lot because I felt like it was my fault. Because I felt like I'd been kind of talked into having it and I'd kind of been, I felt a bit misled because obviously they’d said, “Oh, like don’t worry, like if it’s a problem we’ll just take it out and it will go back to normal.” But I felt like I should have said, “No,” that it wasn’t worth the risk and so I, yeah that was particularly kind of yeah, frustrating for me because I felt responsible. And like the whole time before I’d never really felt like I had any control over like what made it better or worse and then suddenly it was like, it had become a lot worse and it was sort of my fault. And yeah so that was quite frustrating.

And that definitely kept me up [laughs]. And then also all the times that I kind of lay awake wondering what to do about it and like yeah. So yeah, yeah I think it did affect my sleep [laughs].

It was “liberating” for Naomi when she wore make-up during sixth form.

Yeah so well because we weren’t, obviously we weren’t allowed to wear it at school in secondary school until well like sixth form they didn’t really mind so much so yeah I think I must, yeah I was in like the first year of sixth form when I started wearing foundation and it just, arr, that was so liberating and even though my skin was a bit better them because I’d had the first course of Roaccutane (isotretinoin) and it had helped but like my skin wasn’t always perfect and obviously it was, I think it was still kind of like recovering from you know, the sort of the treatment and stuff. So it definitely, like it didn’t look perfect all the time. And so like the fact that I could just like cover it all up and like, yeah, and just look like everyone else does, that was really nice. and, and obviously then like later on when I had to go back for more treatment I like when I went with my mum, the dermatologist said like, “Well so, you know, what’s it like?” and she said, “Well I don’t really know because Naomi always wears make-up so I don’t see it.” [laughs] and like, yeah then, oh then obviously people would say, “Well, you know, if you didn’t wear make-up then of course you wouldn't have bad skin,” and I just felt like they just didn’t understand [laughs]. 

Naomi was “a bit upset” that her mother didn’t come with her to follow-up appointments.

Well I mean cos my mum was kind of the one sort of dealing with it as it were when I was younger but yeah we never really talked about it and I think, you know, maybe that’s just part of our relationship and the fact that, you know we, we don’t really talk about stuff like that and for her like it was just the kind of thing that every so often she’d be like, “It’s still not any better is it, let’s go again.” and yeah so I never felt like I really opened up to her about how much it was affecting me. 

Would you tend to go to appointments with the GP and the dermatologist just on your own or would you take a family member or friend?

Well when I think, yeah so initially I went with my mum when I was like really young and then and yeah she came with me to the dermatologist like the first time round and then the second time round, she came for the first appointment and then was like, “Oh, well you don’t need me,” and I was like a bit upset about that because I felt like I did, but never mind. and then this time in [university city], my boyfriend came with me and he’s a medical student so that was just kind of reassuring as well because you know, he was there but. 

Naomi wasn’t looking for a relationship when she was in school. Now she is in university she does have a boyfriend who is very supportive.

Has acne ever had an impact on potential relationships?

I don’t know, I mean I, I wasn't in a relationship or even looking for one at school and then by the time I got to university I had I’d been through the first lot of Roaccutane (isotretinoin) and my skin was sort of like pretty good to start with and then I met my boyfriend and then it wasn’t until a little later that I had the second and third course of Roaccutane and he was very supportive throughout the whole way. So yeah I do, I don’t think it would really, I mean I don’t know maybe at school if I’d been more confident about myself I would have, I don’t know [laughs]. But I don’t think I was really in the right like frame of mind and I wasn’t really interested so I don’t, I don’t think so, but I don’t know it’s hard to tell.

Yeah. Was that, when you say not in the frame of mind for potential relationships - was that generally or do you think that was related to acne?

I mean I think generally because my, I, yeah I wasn’t really looking. But like also I think if I'd thought about it I didn’t really think that anyone would be interested… I don’t know [laughs]. It was probably part of that but , you know I was also busy with like all my academic stuff and like my friends. So I don’t think it would have been like the only factor but it probably did have some-, well it certainly had an effect on what I thought other people would think when they saw me so I just thought that no-one would find me attractive anyway so it didn't really matter but yeah.

When Naomi was in primary school, no one else had acne. A cream she was prescribed didn’t work and she couldn’t cover her acne up.

Yeah well I mean that was just, the first person was just one of my, my parents’ friends who was a GP and you know, he, he just saw me and prescribed this like cream. And I just remember like the first, the first time I was like really happy because I was like, “Oh, this is brilliant, like I’ve got this cream and it’s going to get rid of it and then I can just like move on”. And especially when you're at primary school and like no-one else has skin problems and like you can’t, you can’t wear make-up or anything to cover it up because like that's just not acceptable. and so I just remember being really happy because I thought like that would be it and then obviously like there was the disappointment because that didn’t work. And then it just kept going.

And because you said you were in primary school when you first started to get acne.

Yeah.

Could you tell me a bit about what it was like for you at that age, being amongst peers you said also didn’t have acne?

Yeah I think I think that was, that was one of the like, yeah I mean it was, not, I wouldn’t say the worst time but it was quite a hard time to have it because, yeah, no-one else, well I mean maybe people, people did have it a bit but like I wasn’t aware of it ‘cos I was just so consumed by how bad mine was. and you know, one time my mum gave me like some like, you know, cover-up stuff to put on it and I just remember like someone in school being like, “What’s that orange stuff on your face?” Because like children don’t understand that you can’t ask questions about things like that and so then I just like never used it again.

Reflecting back on a summer job, Naomi compares her school environment to her work environment. She thinks teenagers put more emphasis on appearance, whereas adults are more “accepting”.

I worked over the summer between like my years at university for my mum’s architectural practice, I was just like doing some sort of admin and that kind of thing but I felt like, and my skin was never that bad during that time but... Yeah, I mean, well it was last summer because that was when I’d just had the implant put in so that was kind of stressful but in some ways that wasn’t as, as bad really because they were, well my sort of colleagues but I think that’s less damaging to your self-confidence than your peer group. I think the worst thing was at school and yeah the work environment was kind of not as bad for me because it didn't really matter what I looked like, that didn’t, well it mattered to me but like I felt like they weren’t really gonna judge me for that because they were older and like I was doing them a favour by going in and doing this work for them. Whereas with your peer group I think it’s just much more traumatic and you feel like it matters a lot more what you look like. and also I think just being around like teenagers who care about that kind of thing was more stressful whereas I feel with adults they’re more accepting and less judgemental. so yeah, yeah I think that’s not as bad.

Naomi used her savings and money she inherited to pay to see a dermatologist privately and thinks it was worth it.

Yeah, yeah, well I think yeah, that’s the only real expense I think. I mean I've had to pay for prescriptions obviously but that wasn’t that much. But then yeah when I went privately I decided that I wanted to do it and, I mean I'm really lucky that I could afford it and yeah I just used savings that I had and also my granny died last year and she had like left me quite a lot of money and so I kind of, I didn’t feel that it was something that I should feel bad about spending that money on. Because, for me, like you know, the first, I think the first appointment was £200 and then the subsequent ones were £150 each so like it was a lot of money, especially like I’m a student, it’s not like I have a job but for me like there wasn’t anything that was more justifiable spending the money on than my skin because it was the thing that had the biggest impact on how I felt. And so yeah and, and in a way like because I was sort of saying to myself, you know, ‘this is the money that has come from my granny so that’s okay and I knew that she would have wanted that’ so I didn’t feel bad about using that money. And also, you know, of all the things we spend money on I think our health is like the most important thing and our sanity so yeah, I guess I kind of justify it to myself. But I was lucky I was in that position because I’m sure there are lots of people who would want to you know, not have to wait months and months for an appointment through the NHS but aren’t able to do that and I’m just, I’m really glad I did because it, yeah it made a big difference to me.

Naomi wishes she had been more “insistent” with her GP on finding a product that suited her instead of continuing with products that weren’t working.

I just wish I’d been more kind of insistent with like the GP’s and like because I felt like I couldn’t not make demands but I felt like, because no-one else is really taking it that seriously that I should, I was stupid for worrying about it and like feeling so bad, but really like the impact it was having on my life – like I should have been more demanding really and when they kept being like, “Oh, just try this like, we won’t bother like escalating your medication,” I should have been like, “Well no, like none of these things are working for me.” and I think, you know, all the times they said, “Oh just try another three months,” I think I should have just been like, you know, “I’ve been on this before,” or, “I've been on this for a long time now and nothings working,” and I think I should have kind of taken control of it myself a bit more because I think I was too passive. And like part of that was just I was like too emotional about it and like not prepared to sort of stand up for you know, my own choices but yeah I just like I would say ‘be insistent’ because even if people think it’s just a phase or you know, “It’s just your skin,” like, you know – if it has a huge impact on you then it is really important and the longer it drags on, the more damaging it is on your, your mood and your social situation and like that, that just isn’t worth waiting for.

Naomi thinks doctors should have checked to see if her medications were working.

Just like kind of they never really checked whether stuff was making a difference and like there were times when I’d just sort of ran out of medication or whatever and just thought what's the point of going back cos they’ll just give me more of this stuff and it’s not going to make any difference. So then I’d just not go and then just wait until I felt so bad that I had to go and make another appointment. And they never sort of like checked up on me to see like whether it was working and I just felt like it was never, never enough progress. So yeah, I think just kind of like taking it really seriously and like not wasting loads of time [laughs]. Cos I felt, I felt like I did just waste a lot of time being upset and unhappy about it and that could have been quicker and less painful [laughs]. 

Naomi thinks medical professionals should take the emotional side of acne more seriously. Her dermatologist never took time to talk through the emotional impact her acne was having.

I just think that the most important thing would be like taking it seriously. Well I mean not that they didn’t take it seriously but just being so sensitive to the fact that it’s like, it’s such a big thing and like yeah maybe it is just a phase but like the most damaging thing is saying that to someone or implying it or just yeah just suggesting that its, it’s something that you need to get over and like. I think yeah, so treating it like a, like a disease like something that you can fix is just like, I think yeah that was really important for me and... And yeah just, I think like being sensitive to the emotional side of it because I think, I don’t know, like you don’t want to make comparisons but like people with other diseases like, you know, cancer or diabetes like obviously it has a massive impact on their life but having something so obvious on your face and particularly in such like a formative time of your life has a huge impact. And I think I never really felt like the medical professionals really understood that and maybe that was my fault for not saying anything but like yeah. Sometimes I just thought like ‘do you not realise how bad this is?’ 

And you just, you’d be seen so quickly and they’d just ask, “Is this working? Have you had any side effects? Go and do a pregnancy test. Pick up the prescription.” and yeah so there was never any time to explore the emotional side of the of the condition or, or really like talk about the impact it had on my life because they were always just interested in the medical perspective and I guess like that was what I was looking for from them, I just wanted then to fix it. But like yeah I could never really have explained how much it meant to me and yeah I think that was quite, quite kind of almost hurtful just because, for them, I was just like five minutes of their time just writing out a prescription and yet for me that appointment meant so much and like I’d be worrying about it for days beforehand. And like I’d usually be crying before I even got to the appointment because just like going into the dermatology unit of a hospital was just like so emotional for me and like and then like having to wait for so long. And yeah at one time it was like an hour and a half but usually it wasn’t as bad as that.