With GPs less likely to prescribe skincare products, community pharmacists are best placed for patients to seek advice and treatment, opening up new profit potential. Sarah Welsh explains...
As the largest organ in the human body it’s vital that skin is well looked after. From rosacea to eczema and everything in between, community pharmacists are well placed to offer advice on a number of medical skin conditions that can be managed and treated at home.
With the NHS considering cutting prescriptions of medicated skincare products, such as emollients, community pharmacists need to be prepared for increased numbers of patients requesting over the counter remedies.
“Visiting a local community pharmacist is a much more convenient option than making a GP appointment or paying to see a dermatologist,” says Amish Patel, managing director of Hodgson Pharmacy.
“It’s important to stock a range of products which customers can use to treat their conditions in their own home without the need to visit the GP. Stock the well-known brands that patients will recognise, such as E45 and Aveeno, and make sure there’s always someone trained on hand to offer guidance.”
Eczema is a skin condition that between 10-20% of children and 5-7% of adults suffer from in the UK and community pharmacists can play a key role in assessing and treating patients.
“Emollients are absolutely key and helping to find a product that suits an individual, as well as educating people on appropriate quantities is essential,” says Dr Emma Wedgeworth, consultant dermatologist and British Skin Foundation spokesperson.
“Mild topical steroids such as 1% hydrocortisone are available over the counter and explaining these are safe if used appropriately and how to use them can make a huge difference.”
Although it may seem obvious, educating patients about the basics is essential. Advise patients to avoid foaming washes and bubble baths which can strip the skins natural pH barrier and moisturise frequently with non-fragranced medical emollients to retain moisture lost and help to reduce inflammation.
Psoriasis is an immune-mediated inflammatory disease (IMID) which, according to the British Skin Foundation, approximately 1% of the population suffer from. If a patient visits their local pharmacy with symptoms it’s highly likely that they aren’t the only one in their family.
In fact, the British Skin Foundation has found that 30% of people who have psoriasis also have relatives with the same condition.
“Psoriasis can occur on any area of the body, including the scalp, hands, feet and genitals, although different types tend to occur on different areas,” explains Urmston.
“Psoriasis affects men and women equally and can occur at any age, although there seem to be two peaks: from the late teens to early thirties, and between the ages of around 50 and 60.”
There is plenty of advice that pharmacists can offer to help sufferers, starting once again with emollients for the body and tar-based shampoos with salicylic acid for the scalp. Stressing the importance of patients developing good moisturising regimes that are not only effective, but that realistically fits in with their lifestyle is essential.
If over-the-counter treatments aren’t working then it may be time for patients to move onto prescribed treatments.
“Community pharmacists are perfectly placed to provide good information and support to people with psoriasis who may have queries about their treatments, from topicals right through to systemic and biologic drugs,” points out Urmston.
“This can sometimes be as simple as reminding patients of the importance of reading the information leaflet that comes with their treatment.”
According to the Psoriasis Association, lack of communication and management of expectations can contribute to people with psoriasis feeling ‘fobbed off’ with topical treatments which they feel are ineffective. Community pharmacists can offer patients reassurance by explaining the different treatment options and encouraging them to be patient when waiting for results.
“There is a lot of strong evidence that lifestyle can affect psoriasis,” explains Wedgeworth. “Maintaining a healthy weight, not smoking and reducing alcohol intake may actually help improve psoriasis control.”
Arming patients with this knowledge will help them to make better, more informed lifestyle choices which could have a positive impact on their skin condition in the future.
Rosacea, which often starts with facial redness and flushing, is a common condition which most often affects people between the ages of 30-60. Globally, it’s thought that 5% of the population are affected by rosacea.
In addition to recommending topical products for patients to use it’s also important to highlight the lifestyle factors that can aggravate this chronic inflammatory condition such as spicy foods and alcohol.
“Rosacea skin is often very sensitive so advise patients to avoid harsh scrubs, acid toners or other such products,” says Wedgeworth.
“Recommend the use of un-fragranced gentle skin care and broad spectrum UV protection daily. Also advise the patient to avoid steroid creams on the face because this can make things worse.”
It’s vital that community pharmacists and their staff keep up-to-date with the latest information and advice so they can reliably inform patients seeking information and guidance.
“Staff training is vitally important,” says Patel. “Most members of my staff have carried out Alphega training. They work through a monthly training work book online which covers skincare, including eczema, psoriasis and rosacea, so they can talk to patience with confidence.”
Many manufacturers also offer training so it’s well worth community pharmacists and their teams taking advantage of these resources available as it gives them a more in-depth knowledge of the products they sell.
“We offer free walk in and booked consultations for all skins conditions,” says Patel. “The beauty of the pharmacy is that I am trained and I can offer more value products which can help relieve symptoms and not break the bank.”
Offering patients literature that they can take away and read at home is a good idea, particularly for those short on time. The Psoriasis Association for example has a range of information leaflets available, which are aimed at patients living with the condition, that cover everything from explaining what psoriasis is to the various treatments available.
Community pharmacists may soon see increased numbers of patients requesting over the counter treatments for skin conditions, so it’s important they have the knowledge and products to help. Although prescriptions for skin medications may decrease, community pharmacists can make up any lost profits by offering patients in-depth understanding and education about skin conditions as well as selling a range of quality and value products.
In today’s digital age patients may prefer to access further online help and services about their skin complaints, so community pharmacists should point them in the direction of reliable resources including the British Skin Foundation, British Association of Dermatologists, National Eczema Society and the University of Nottingham Centre for Evidence Based Dermatology.
The Psoriasis Association’s website contains plenty of good quality information about psoriasis, psoriatic arthritis and different treatment options. The website also offers users up-to-date news on newly available treatments, as well as any issues with existing treatments. It also provides suffers with the opportunity to read the stories about other people living with the condition and forums where they can share their own experiences, discuss treatments, tips and hacks for managing their psoriasis.
The Psoriasis Association also has a dedicated website for teenagers and young adults who are living with psoriasis, which can be found at https://www.psoteen.org.uk/
For support with the psychological impact of psoriasis the Look Deeper website, www.seepsoriasislookdeeper.co.uk, raises awareness of the affect this condition can have on a person’s life, mental health and emotional wellbeing.
The British Skin Foundation runs monthly online clinics on topics including psoriasis, eczema and rosacea. Log on here for more information www.talkhealthpartnership.com/online_clinics
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