Psychological effects of skin condition on young women and how a physician can help the patient

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Hans van der Slikke, MD: “It’s September of 2001, and we’re in Paris at the 2nd Controversies in Gynecology and Obstetrics Conference. Next to me is Sanderyn van der Doef - hello, Sanderyn.”

Sanderyn van der Doef, MD: “Hello.”

Hans van der Slikke, MD: “Sanderyn is a psychologist who works in the Netherlands and Highland, and she did research about the influence of skin conditions in young women. You did a presentation about this topic this morning, could you explain for our audience what the importance of your research is?”

Sanderyn van der Doef, MD: “What we saw in this study was that we as adults don’t realize how much the influence of a skin condition in a young girl is for her self image and her quality of life at that moment. Young girls between fifteen and twenty years old are developing their identity and because of that they feel very insecure on who they are and how they look. When their skin is not in perfect condition, then they feel very, very upset about it. Just one pimple can make them very upset, and this is why we did that study. It was done with 307 young girls in four different places in Holland.”

Hans van der Slikke, MD: “How did you recruit these girls?”

Sanderyn van der Doef, MD: “We asked them in the streets if they wanted to join us for a short interview about their skin.”

Hans van der Slikke, MD: “They were on the street so they didn’t stay at home because of their skin condition.”

Sanderyn van der Doef, MD: “That’s true, but maybe this was the first time they went on the street to go out. We asked them to tell us what kind of skin they had and they could choose between three types of skin. At the same time the interviewer made an assessment of their skin type, and independent of each other they chose almost the same type of skin. Most of the girls we interviewed had a skin type of 2 or 3 and that means that it was oily skin with a few or more than a few pimples. We also asked them how they felt about their skin and many of them had very negative feelings about themselves. In the eyes of the interviewer, they only had just a few pimples, not more than three or four at a time and it didn’t look like much to an adult or the interviewer but they felt very negative about it. We also asked them where they went for advice to treat their skin. What we saw was that most of the girls didn’t go to a doctor at all. They didn’t go to any healthcare worker at all, not a doctor, not their GP, nor a dermatologist and most of the girls didn’t do anything but took care of their skin on their own. Some of them went to their mother or went to friends to ask for advice. Because it was such a surprise that they didn’t go to a doctor, we also did a study with physicians or GP’s in Holland and we also asked them what they thought about seborrhea. Seborrhea is a skin condition where the skin is oily; they have greasy hair, and some pimples but not much. We saw in that study that most of the physicians didn’t think seborrhea was a medical condition. They thought, especially in mild cases, it wasn’t a medical condition; it’s not something to be treated by a GP, it is the responsibility of the patients. Only in very severe cases where there was acne they were motivated to treat it. This means that girls don’t go to the doctor for advice and it means that nothing will happen to help them because they probably know that a doctor doesn’t do much for that skin condition when it is mild in the eyes of the doctor. As a psychologist, I see that it has a tremendous effect on their lifestyle and their self image.”

Hans van der Slikke, MD: “But you told me that most of the girls had Type 2 or 3 so does this mean that you advise almost all girls to go to the doctor?”

Sanderyn van der Doef, MD: “First of all, we have to make doctors aware of the fact that it’s such an important issue for young girls and, secondly, we have to make doctors aware of the fact that they have to help these girls. Don’t send them away and tell them things like it will be over in a few years and your skin condition isn’t severe. Try to help them, and there must be ways in which a doctor can help them. The way I help them is to talk with them and let them be aware of the fact that there are other important things in life but a doctor can help them also but first you have to make the doctor aware of this situation.”

Hans van der Slikke, MD: “I think most of the time the girls will be there for another reason and then ask - by the way is there anything I can do about my skin?”

Sanderyn van der Doef, MD: “Yes, that’s absolutely true. Most of the girls don’t dare go with that question to a doctor. They feel ashamed of it but this is another reason why it’s so important to make doctors aware of the serious situation of how girls feel about their skin.”

Hans van der Slikke, MD: “On the other hand, you could argue that maybe this is not especially a task for the doctor but a task for, let’s say, general education in schools and indeed this is a case for mothers.”

Sanderyn van der Doef, MD: “To do what?”

Hans van der Slikke, MD: “To advise them that it will go away.”

Sanderyn van der Doef, MD: “No, I don’t think this is good advice to tell them because in this case teenagers think they are not taken seriously if you tell them it will go away. Everyone has this period in his or her life and they have a real problem. They feel it as a real problem so you have to help them, and I think a doctor can help them. This is why, I should think, even mothers and schoolteachers should educate teenagers about the fact that even one pimple on your face can make you very upset, and we know that. It’s not that you have to accept that situation, you can go to a doctor that can help you so we have to educate the teenagers, the mothers, the teachers, but also the doctors about this situation.”

Hans van der Slikke, MD: “Thank you very much, Sanderyn. You taught us today that the skin is a mirror of your self.”

Sanderyn van der Doef, MD: “Yes, that’s true.”

Hans van der Slikke, MD: “Thank you very much.”