Peter Lapsley: Acne on the web

Peter Lapsley It is good to be able to report good news from time to time, and this week brought with it some very good news indeed – the launch in London on Tuesday 29 March of The Acne Academy, a web-based resource both for health professionals and for people with acne. That may sound inconsequential to those who have not had acne or seen its effects at first hand. To those who have, it is an important and exciting development.

Acne is amongst the most misunderstood and frequently dismissed as “trivial” of all medical conditions. Because it is so commonplace, everyone knows someone who has it or has had it, and it is widely supposed to have little impact on the quality of people’s lives. Recently, two separate organisations – the think tank, Demos, and the Proprietary Association of Great Britain (PAGB), which represents companies providing over the counter treatments – have classified acne as a “minor ailment,” which it is not.

At the launch of the Acne Academy, Dr Eva Ritvo, a psychiatrist from Mount Sinai in the United States, and media doctor, Dr Hilary Jones, catalogued the findings of a rigorous recent [February 2011] survey of 506 adolescents and 1,001 parents’ perceptions of acne. The findings were unequivocal and showed remarkable disparity between teenagers’ views and those of their parents.

Of the teenagers surveyed, 91 percent said their appearance was of greatest importance to them and that they saw acne as the most difficult condition to have during puberty. Over a third of them believed that adolescents with acne were likely to be bullied at school. Half saw acne as a leading cause of low self-esteem and self-confidence. And 89 percent of teenagers said they would be prepared to stay off Facebook or not go on a date for a year if only they could be rid of their acne for good.

In contrast, parents believed body changes to be the most difficult aspect of puberty. Of those surveyed, 50 percent did not talk to their teenagers about their acne because they thought it was normal and that they “would grow out of it.” And over 70 percent had never encouraged their teenagers to seek medical advice, saying they didn’t think the acne was serious enough. It can scarcely be a coincidence that precisely the same proportion of teenagers had never sought medical advice about their acne – usually an eminently treatable condition for which there is a wide range of treatments, few if any of those sold over the counter being of proven efficacy.

Amongst both teenagers and parents, it was evident that there is widespread ignorance about the long term implications of leaving acne untreated, such as scarring, and about available treatments.

There has been considerable coverage in the media recently of the consequences for charities with national or local government contracts whose grants are being reduced as a result of national belt-tightening. I am sympathetic. But what of those healthcare charities with no government contracts, which rely for their success – indeed, for their survival – on their members’ subscriptions and on donations from the public? Many of them do excellent work, catering for people with unglamorous or even “repellent” conditions which attract very little public sympathy and support. Most are struggling to survive; some have gone under in the recession. One such was the Acne Support Group.

Set up and run by Alison Bowser, an immensely imaginative and energetic woman who had been through the acne mill herself, the Acne Support Group provided a high quality service of support and impartial, evidence based advice to people with the condition. Last year, the Group’s fragile funding base collapsed and Alison was compelled to close it down, leaving people with acne with no patient driven support.

That is why the launch of the Acne Academy is so welcome. Well run websites offer cost effective means of providing information. The Academy has been developed by a team of leading UK health professionals including consultant dermatologists, a GP with a special interest in dermatology, a dermatology nurse specialist and a pharmacist, all of whom have volunteered their time to offer an outstanding online resource primarily for patients but also for health professionals. The information it provides is balanced and practical, covers all aspects of acne and the wide range of treatments available for it, and signposts reliable sources of help.

The Academy also demonstrates how positive the results can be when health professionals and the pharmaceutical industry pull together in patients’ interests. It is transparently funded by unrestricted educational grants from six pharmaceutical companies and yet the information it offers is clearly completely objective and impartial.

Peter Lapsley is patient editor of the BMJ. He was chief executive of the Skin Care Campaign for ten years until March 2007, is an honorary member of the British Association of Dermatologists, an honorary member and chairman of Trustees of the Primary Care Dermatology Society, and chairman of the Oversight Committee for the All Party Parliamentary Group on Skin.