By Natalie Alcoba
Madian Taleb had a tumultuous relationship with his skin for most of his childhood. Allergic reactions to certain fruit prompted regular visits to the dermatologist for the third-year mechanical engineering student. But his tolerance reached a boiling point when he was 15 years old and woke up one day to large, red, pusy pimples on his face and upper body.
“I didn’t go to school for two days,” recalls Taleb, 22, as he absently rubs his hand across his now-clear cheeks. So he visited several dermatologists until one of them prescribed pills and medicated cream that cleared up his skin. Since then, Taleb has been virtually worry free of skin problems and has maintained his baby-soft skin with a daily cleansing routine.
Sarah Comper and her friend Julia Yusupova have similar cleaning practices. Comper has regular morning and nighttime appointments with Spectrogel, while Yusupova prefers an apricot scrub to exfoliate her skin. But Comper remembers a time when she felt like the whole world was looking at the pimples on her face. The 19[year-old started taking medication when she was 14 years old to control her breakouts, although in hindsight she says she probably didn’t need to. “You see it worse than everybody else,” says the business management student. “I just wanted [the pimples] to go away.”
For Richard Fernandes the answer to his pimple problems came in learning skincare management.
Fernandes used to wrack his brain for creative ways to clear up his skin while he attended Wilfred Laurier University. “I used to think ‘is there a needle I can use to zap them?’” He tried over-the-counter products readily available at pharmacies, but nothing gave him the results he wanted.
Then, about seven years ago he met a doctor who was starting an acne clinic and his outlook became a lot clearer.
As a patient and employee of the Yorkville SkinCare Clinic (he’s the managing director), Fernandes has learned all he can about skin care.
“Acne is not just pimples on the face,” says Dr. Allan Somersall, founder of the clinic. “Acne is a whole lot of other things related to self-image and self-confidence and projection of self.” Keeping that in mind, Somersall started his clinic, based in Yorkville, with the goal of addressing the social, psychological and emotional factors that come with the skin disorder, in addition to the medical ones. That means providing a caring environment where patients feel comfortable seeking advice from doctors and nurses who can educate them on their skin condition.
“If somebody comes in to see us and there’s one big zit on their face, we treat that zit as if they’re sick, sick emotionally,” he says. “Because they feel when they leave home in the morning that everybody is going to look at them and is going to think they’re ugly, something’s wrong with them, so they’re destroyed by a simple thing on their face,” says Somersall, a physician and research chemist. He says that on the whole, acne is treated as a trivial illness within the medical profession since there are no life-threatening implications. “We treat it seriously because it has serious implications to the person’s psyche.”
Those implications can vary, from someone who has been minimally affected by a few pimples, to someone who is suicidal.
“This is the crucial stage of life where identity and persona and image are so important, and here’s acne staring you in the face. Every time these people look in the mirror they have all these emotional problems to deal with,” says Somersall.
Fernandes has heard many stories about acne coping tactics; girls growing their bangs long to cover up pimples on their forehead, people standing in a corner at bars, some even choosing a venue for its dark and more flattering light. “If people saw them in the dark, they felt closer to what other people look like,” he says. But he has encouraging stories to tell too, some with fairy-tale endings of previously single students landing a date after understanding the cause of their skin problems.
Somersall says he has hundreds of patients from Ryerson and expects that number to rise with next year’s double cohort, since first-year students will be a year younger and more prone to acne.
“We’re anticipating it’s going to be a substantial increase in patient flow” because of all the younger students, says Fernandes.
Alison Burnett, Ryerson’s health promotions nurse, says acne-related complaints are among the most common patient issues at the school’s health clinic. Depending on the severity of the skin condition, she says on-campus doctors will try to treat the pimples with topical cream, then with medication, such as birth control if the patient is female. Students requesting stronger medication, such as Accutane, are referred to outside dermatologists. Through education and support, doctors will provide counselling to students who suffer from the emotional and psychological effects of acne or refer them to the university’s counselling centre. “It can affect an individual’s self-esteem,” says Burnett.
For potential patients, the steps up to the Yorkville Skin Care clinic on the third floor of a discreet brown building in the heart of trendy Yorkville can be intimidating. So, that first visit is one focused on making them comfortable in their own skin. A physician sits down with them for a half an hour consultation to address their skin condition, explain why and how acne is caused and try to put the severity of it into perspective. And since most people usually come in thinking the worst, they leave with a positive outlook and a better understanding of what is happening to their skin.
“A lot of it has to do with information, with education and with understanding,” says Somersall who has often been thanked by his patients for being the first person to actually explain the medical reasons behind acne.
Fernandes says many over the counter products, such as Clearasil or Proactiv, are appealing to the lack of education about acne. “I’m not saying Proactiv doesn’t work,” he says, just that you can get medications prescribed from an acne clinic without spending so much money.”
During that first trip to the office, a new relationship is formed between the doctor and patient, requiring return visits every four, six or even eight weeks. Each time, a doctor assesses the skin and makes decisions according to current problems. It’s important to remember, Somersall says, that the skin is alive and always changing. What may have been helpful a month ago may not be the right medicine now.
“We have to literally adapt our management depending on how the skin is behaving,” he says.
And contradictory to the common perception that taking care of acne is a short-term job, Somersall says many patients have been going to his clinic for more than five years.
“We think of this just like dental care. You need skin care,” says Somersall. “If you’re acne-prone, then your skin care is urgent and is consistent … This is war. If you don’t mount a response, the acne will get you.”