Essential Primary Care by Blythe Andrew; Buchan Jessica; & Jessica Buchan

Author:Blythe, Andrew; Buchan, Jessica; & Jessica Buchan [Blythe, Andrew & Buchan, Jessica]
Language: eng
Format: epub
Publisher: John Wiley & Sons, Incorporated
Published: 2016-05-16T00:00:00+00:00

Case study 21.2

Kirsty is a 16-year-old student who has come to see the GP about her acne, which started about 2 years ago. She’s tried various over-the-counter treatments (which contain BPO), but nothing seems to have made much difference. As a result, she’s started using make-up to cover it up. It’s started to get her down: she’s in the final year of her GCSEs and really wants to have better-looking skin by the end-of-year ball in a month’s time.

What should the GP do?

Identify and address ideas or concerns about lifestyle and diet. Acne is not linked with poor facial hygiene – the central discolouration in blackheads is oxidised melanin, not dirt! Diet is not related to acne, but smoking is associated with increased severity.

Ask if she is taking any regular medication. Acne can also be caused or exacerbated by drugs, such as corticosteroids, lithium and phenytoin.

Enquire sensitively about how has it is affected her (socially and emotionally). People with acne commonly lack confidence and have a poor self-image.

Ask if she is in/about to start a sexual relationship. If so, is she using or does she need contraception? Some hormonal contraceptives may worsen or help improve acne.

Examine all acne-prone areas, including her back, and document the physical severity in her medical records (see Table 21.3). The GP may need to ask her to remove her make-up in order to examine her face.

Table 21.3 Assessment of acne severity.

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