Chapter 33: Care of the Adult with a Dermatological Condition

Samantha is 21 years old and has arrived at the day unit for a colonoscopy to investigate abdominal discomfort and changes to bowel function. You have been asked to complete the nursing admissions documentation and prepare Samantha for the procedure. During your assessment you note that she is relatively fit and healthy and she comments that she enjoys swimming but has not been for a few months due to her acne. You observe Samantha’s appearance, that she is wearing heavy makeup and allows her hair to fall across her face and seems self-conscious about exposing her skin. It is clear to see that she has both whiteheads and blackheads on her face and neck and these are accompanied by some inflammation.

Although Samantha has attended the day unit for a non-related investigation your holistic approach to her care needs to include addressing her acne. While a full dermatological assessment can be lengthy and may be impractical at this time there is the opportunity to offer some support.

Questions

  • What questions could you ask Samantha to help assess her acne?
  • How could you advise Samantha with self-managing her acne?
  • Which sources of evidence could you access to ensure best practice?

Answers

  • These questions can help assess the extent and impact of the condition
  • Is there a family history
  • How long has Samantha had acne
  • Is the presentation now, normal, less severe or more severe
  • Are there trigger factors such as stress, exercise or menses
  • How does the acne affect her social life and relationships
  • There is some practical advice that can help Samantha care for her skin
  • Keep her hair off her face
  • Acne does not mean poor hygiene and is not related to being dirty.
  • Wash with a mild soap or oil free cleanser. Do not scrub the skin as this can make the acne worse
  • Use cosmetics that are oil free or ‘non-comedogenic’ to help reduce blackheads and whiteheads.
  • Do not pick the spots as this may leave scarring
  • Speak with the local pharmacist who can advise on ‘over-the-counter’ preparations.
  • Understand that treatments may take at least 2 months before improvement can be seen so use the preparations correctly and complete the treatment.
  • As a student you will not know, or be expected to know all the answers. You do need to know how to access best evidence and also be able to direct Samantha to more experienced help.