The general practitioner is visited by a young man aged 15 years and his mother. The young man seems very uncomfortable and his mother concerned. The mother leans forward to explain the story. The GP encourages the young man to speak and suggests that it might be helpful for the mother to leave the room. The young man decides that he would like to be alone with his GP, and he reassures his mother that he will speak about the problem that they have come about. His mother rather anxiously leaves the room.
The patient explains that he has had mild acne for 2–3 years, but recently he has noticed more spots on his face and a few spots on his shoulders. He is not looking forward to summer when he will be wearing swimming trunks and wanting to do without a T-shirt. He also tells the GP that he is very keen on one of the young women in his class at school. She also seems interested in him but he feels self-conscious about his acne and this has got in the way of his developing their friendship. He is embarrassed that he should feel this way as his father has told him that it is only acne and that he will grow out of it. His mother is more understanding as she had acne when she was young and still has some pockmarks on her face. She has told him that it did make her very miserable and she never got treatment as there was none on offer at that time. He has not tried anything for his spots, except for over-the-counter medi- cines, which have not helped. He is worried that his acne is there because he does not wash enough or because he eats fatty food and likes chocolate. He is a healthy person and enjoys football and goes to the gym. He does shower daily and washes his face morning and evening.