The physical and psychological trauma of acne can be unbearable at times. Some people not only need a doctor but a shoulder to lean on. This is where a good dermatologist comes in.

"Whether your case is moderate or severe, nothing will determine how fast or completely your condition improves as much as a solid, trusting relationship with your doctor. Often this is the crucial 'missing link' in many otherwise sensible treatments for acne," according to Dr. Fredric Haberman of the Albert Einstein College of Medicine in New York City.

Finding a dermatologist is easy, but finding a friend is not. A good dermatologist should play both roles. This is as important as the medicines he prescribes for his patients.

What are the qualities of a good dermatologist? Haberman explains this in Your Skin: A Dermatologist's Guide to A Lifetime of Beauty and Health:

"Ideally your doctor should play the roles of advisor and confidant at the same time. He should educate you about the real causes of acne and dispel myths, reassure you that your pimples are not the result of failing to wash often enough or indulging in the wrong foods or harboring negative thoughts or masturbating. The doctor should also carefully record your acne history, noting such details as how and when the acne began and the patterns it shows (for example, whether you experience flare-ups during certain times of the year or periods of stress), your routine living habits, and any medication you are taking.

"Your doctor should always be sensitive to your doubts and fears regarding the treatment and willing to explain just how his approach will work (preferably with clear written and oral instructions), how long it will take, and what you should expect," Haberman said.

In return, the doctor also expects you to do your part. Friendship, as you know, is not a one-way street. Good friends know the meaning of give and take. You can participate actively in your treatment by telling the doctor all that he needs to know about your condition. For no matter what kind of expert he or she is, that person can't perform miracles if you don't cooperate with him or her.

"What you are responsible for is conscientious cooperation and follow through: disclosing enough accurate details about yourself, observing instructions, and asking questions if directions are unclear. This can help your doctor cure your problem in the safest, most effective way possible," Haberman added.

Admittedly, finding a trustworthy doctor is like finding a needle in a haystack these days especially with so many quacks posing as M.D.s. How do you begin your search?

"A recommendation, particularly from a satisfied relative or friend who had a problem similar to yours and whose judgment you respect, is one place to start. A family doctor is another trustworthy source. If you do not have a personal physician and do not know anyone who has consulted a dermatologist, consult the department chair at a local university or medical center or ask a country medical society or university hospital for a list of names. Do not hesitate to find out a doctor's credentials, whether he did his residency at a reputable medical center, and how many and what kinds of cases and procedures he handles every week," Haberman explained.

"Ask about fees at the outset; many doctors are willing to make adjustments for those whose needs outweigh their ability to pay or to refer you to less expensive but equally competent colleagues. Remember, high price is no guarantee of expert, personal care.

"Once you have narrowed your choices, consult with several physicians before making a final decision. Make sure you recieve satisfactory answers to the following questions. Is the doctor willing to talk about the possible side effects or draw¬backs of your treatment? Can you call him or his office during out-of-hours emergencies? Will he tailor a regimen just for you or does he have one standard treatment for everyone? (Ideally a doctor should consider each patient a new, 'original' case and regard himself as an investigator, ferreting out important clues and conducting a thorough search.) If possible question the doctor's patients. Does the doctor answer their questions adequately, encourage them to voice their fears or doubts? Does he notice and comment favorably when patients' condition improves, giving them the boost they need to continue? Do the patients know the names of the drugs they are taking and the lotions they are using, and how and when they should be used for best results?

"Keep in mind that getting your acne cleared is a two-way proposition. Both sides, doctor and patient, have to contribute to the outcome by being open and cooperative," Haberman concluded.

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