When something isn't quite right with your skin, your first port of call is very likely to be your GP, especially if the issue is getting you down, causing you discomfort, or both.
Studies show an increase in skin conditions such as adult acne among women, while the introduction of National Eczema Week and eczema apps, not to mention an influx of #skinpositivity hashtags on Instagram, indicates that more of us are searching for both solidarity and help dealing with our skin bugbears.
While GP appointments are few and far between, talking through our skin problems with a doctor seems like a step in the right direction. So why are more and more of us coming away unsatisfied? Head to any skin support group, Instagram page or Reddit thread and you'll come across the same issue. A handful of individuals even say that they are made to feel as though their skin issues aren't 'severe' enough for treatment or referral and many feel as though they have been 'palmed off' with ineffective lotions and potions. Of course, we all know that NHS services are stretched to their limit. But with new research highlighting the link between skin and mental health issues, surely skin should be taken seriously.
It's no secret that private dermatology appointments are pricey, with London rates often reaching £250 for a 20-minute consultation. So what is the very best way to broach the topic of skin with your doctor in a bid to target the issue head-on? Ahead, the experts weigh in.
Make it the main issue
"Start with the exact thing that is bothering you, however embarrassing, instead of adding it in at the end of your appointment with, 'Oh, just one last thing,'" says Dr Ross Perry, GP and medical director of Cosmedics UK. He advises being brave, laying it all out and keeping it to the point. "If you have photos, show the doctor, as skin issues can wax and wane. Presenting an image of your skin at its worst gives a doctor a good idea of what they’re dealing with and they can then advise accordingly."
Emphasise both the physical and mental symptoms you're experiencing
"Of course, NHS services are stretched," says Dr Nina Bal, aesthetic doctor and founder of facialsculpting.co.uk, "but when your skin is getting you down, seeing your GP really is a good option. Skin conditions such as acne, eczema and psoriasis can lead to low self-esteem, stress and even depression if not treated. Always be truthful about how your skin is making you feel, and if so, talk about the impact your skin condition is having on your mental health."
Dr Perry agrees and suggests being frank about how your skin is making you feel and whether it is affecting your day-to-day life. "It's difficult for a doctor to grasp what it’s like in a five-minute appointment unless you spell it out for them," he says. "As coping with skin issues over a long period of time can affect mental health, it's so important for your GP to have a good understanding."
Ask for a referral
Dr Bal notes that depending on the severity of your skin concern, it can be tricky to obtain a referral from your GP to a specialised skin clinic or dermatologist. Dr Nyla Raja, cosmetic dermatology GP, believes that if you don't ask, you don't get. "You are always able to request for your GP to refer you if you feel they are not able to help. That said, your doctor will always know if your skin is out of their remit and will refer you to a dermatologist if they feel it is appropriate."
If you have been referred, Dr Daniel Atkinson, clinical lead at treated.com says that the wait may depend on where you live, such as availability in your area, and what sort of skin symptoms you have. "Something requiring urgent tests will normally be turned around quickly," he says. "If you have signs of a chronic skin problem like eczema or psoriasis and haven't heard back after referral, the best thing to do is call up the hospital or centre where you've been referred to follow up."
Ask for a second opinion
If your GP has recommended various treatments for a skin problem and none has worked after a while, the best thing to do is to go back and tell them, advises Dr Atkinson. "Some treatments can take several months to show the full benefits, but you can usually tell when something isn't improving after a few weeks," he says. "If you're not satisfied with the opinion your GP has given you, it might be worth contacting your surgery and asking for a different doctor so you can get a second opinion."
The rule of three
"GPs should be fairly happy with most skin conditions so specialist skin advice is really only needed where you need to revisit the GP on 2-3 separate occasions for the same issue," says Dr Perry. "This is especially important if your skin is not improving or it is changing in a way that is worrisome." While frustrating and time-consuming, Dr Perry advises to keep returning. "Your GP will be honest and recognise when a referral is needed."
Search for helpful resources
"Besides your GP, there are other helpful resources, like the British Association of Dermatologists and Psoriasis Association, for example, who might be able to give you some free advice if you're having problems," says Dr Atkinson. The British Skin Foundation is also a useful website for guidance in regard to acne, eczema, psoriasis and a handful of other skin conditions.
Take it to a dermatologist
If you're floating the idea of booking in for a dermatology appointment, private or otherwise, consultant dermatologist Dr Anjali Mahto has shared some insightful tips for making the most out of those 20 minutes. "Regardless of whether your appointment is with an NHS or private consultant dermatologist, the process is going to be extremely similar," she wrote on Instagram.
Think about how long you have suffered with your skin problem
"This will be one of the first things you are likely to be asked," said Dr Mahto. "Is the issue something which has been there for days or weeks or years?"
Be honest about the treatments you've tried
"Write them down or bring them with you," said Dr Mahto. "As dermatologists, it can be tricky for us to know which cream is in the white tube with red writing. We want to know what you have tried already and whether it has helped."
"Many skin conditions come and go and by the time your appointment rolls around, it might be that your skin is in a 'good phase' or the rash you have has temporarily cleared up," said Dr Mahto. "It can be useful to take photographs of the [area] when it is active, particularly if the problem is an intermittent rather than continuous one. Dermatology is a highly visual speciality and it can be hard for us to diagnose a skin problem we can’t see."
Be prepared to answer questions
"While it is important that you have a chance to tell your story, it is equally important that the treating dermatologist also asks you some specific questions about your condition," said Dr Mahto. "This allows us to do some detective work and diagnose your problem as well as come up with a sensible treatment plan tailored to you. The consultation is a two-way interview process."