Reaching out to, engaging with, and supporting people with skin conditions can be sensitive matters. But success can make a huge difference to patients’ lives, as Victoria Goldman explains

Skin disease can have far-reaching emotional implications. But all too often its impact is underestimated, according to Dr Bav Shergill, spokesperson for the British Skin Foundation (BSF) and a consultant dermatologist at Brighton and Sussex University Hospitals NHS Trust.

The BSF is currently conducting a survey into the impact that acne has on UK sufferers. The charity is keen to uncover the scale of the issue and whether those living with the condition, regardless of age or sex, could benefit from more advice, support and guidance than is currently available.

Pharmacists stock a wide range of skincare treatments. Yet a recent survey for the Australian moisturising skincare brand QV Skincare found that only 27 per cent of people with a skin condition visit a pharmacist for advice, indicating that they are not aware of the support available. It is surprising to see so many people bypassing pharmacists, says Stephanie Young, of QV Skincare.

“Pharmacists are trained professionals and are an important part of the healthcare industry,” she says. “People can get advice on common skin complaints and will often get the treatment they need straight away.”

The customer needs reassurance that there are excellent treatments available

Ash Soni, Royal Pharmaceutical Society president, says that pharmacists may be more suited to offering skincare advice than GPs. “Pharmacists see four times the number of those who visit their GP,” he says. “Generally, unless people are coming to collect a prescription, we see them when they are well or feel they don’t think they need to see a doctor. This is particularly relevant to those with skin problems, including eczema, as they commonly feel that it’s not a ‘real’ medical problem. This means that they will come to a pharmacy for advice, particularly if they’ve used general moisturisers.”

According to Jerome Lemaire, UK marketing director at Reckitt Benckiser (RB), pharmacists can help customers with layout and merchandising measures. “Make it easy for customers to find skincare products,” he says. “Help open up discussions by signposting product ranges with posters and displays in the window and in-store. If customers spend time considering their purchase, comparing products or appear to be having difficulty in choosing the right product for them, pharmacists could offer advice about the different product formats, which can be included as part of a skincare routine.”

Professional advice

Armen Mirzoian, director and co-founder of new British skincare brand Cloud 9 Skin Solutions, says customers look to the pharmacy for professional advice in which they can have confidence. “A point of differentiation for pharmacy over other retailers, including some supermarkets, is that customers can take advantage of a private consultation with a pharmacist to discuss conditions and the most appropriate treatment,” he says. “As a new brand, support from local pharmacists is really important for us. This kind of endorsement will give new customers the confidence to try our range of products, tackling cellulite, dry damaged skin, varicose veins, acne and scars.”

Many people are embarrassed by highly visible skin conditions. Rebecca Bennett, health professional relationship consultant at Johnson & Johnson, manufacturer of Neutrogena T/Gel, says that the private consultation room should be made available to all customers, regardless of their skin problem or its severity. “Having dandruff or psoriasis on the scalp is a common complaint,” she says. “The customer needs reassurance that there are excellent treatments available that can help them manage the condition, and early and regular treatment can really make a difference.”

As part of a consultation, pharmacists can advise customers to seek a proper diagnosis if the cause of their symptoms isn’t clear. This is particularly important in the case of eczema and psoriasis, as the symptoms of these two conditions can be very similar. Over-the- counter treatments, such as new Dermalex Repair Scalp Psoriasis, can be used in mild to moderate cases of psoriasis, but the condition needs to be diagnosed first.

RB recently extended its Clearasil Ultra brand with the addition of a new range of Clearasil Ultra 5 in 1 products. “The skincare aisle can be confusing for teenagers, given the number of brands available and the variety of claims promoted by the different products,” says Mr Lemaire. “Make the shop teen-friendly by making the skincare aisle easily accessible. Provide skincare leaflets and perhaps offer consultations, so you can discuss a personalised treatment plan. There is also a link between stress and spot outbreaks, so become familiar with the school year and understand when teenagers in your area will have major exams that may cause problems for their skin.”

Although boys suffer from acne and spot-prone skin, many products are targeted at the female market. Alan Taylor, director at Eve Taylor, says that Teen-skinactives’ products for both acne-prone oily skin and dry dehydrated skin are aimed at boys as well as girls. “Ingredients in Teen-skinactives are much gentler on the skin than chemical alternatives and are much less likely to cause adverse reactions or further problems,” he says. “A lot of teenagers (both girls and boys) are now more socially aware of what is out there through the internet and Twitter, etc. They now have the opportunity to look for themselves and feel that they want products that are suitable and don’t create further problems.”

Adults can experience acne, too, with around five per cent of women and one per cent of men affected. According to a new survey commissioned by Eau Thermale Avène, only 33 per cent of adult women suffering from acne consult their pharmacist for advice. “The acne experienced may not be that severe, but for women who have never experienced acne as a teenager, a few spots can be seen as a disaster,” says Imane Mahlous, product manager at Pierre Fabre Dermo-Cosmetique. “Over-the-counter products are available for a wide variety of skin conditions and are highly effective. However, depending on the skin condition, some consumers can find these harsh on their skin.”

Eczema approaches

Emollients are essential in the daily management of dry skin conditions. Last November, GlaxoSmithKline extended its range of products for babies and children, with the launch of new Oilatum Daily Junior Shampoo, Head to Toe Wash and Bath Foam. GSK recommends pharmacists and pharmacy assistants offer their customers appropriate support and advice and that they recommend how much, how often and how to apply emollients. Emollients are the mainstay of treatment, even when eczema is clear.

Mr Soni says that one of the biggest challenges with eczema management is persuading people to use enough moisturiser. “My philosophy is for adults to apply a moisturiser every time they wash their hands or think about it, or feel their skin feels dry,” he says. “For children, the cream should be applied in the same way, including when they or their parents think about it or when the skin feels dry. For babies, I recommend applying creams every time their nappy is changed or their parents feel their skin looks or feels dry. Also, I remind them to make sure they use a moisturising bath additive or shower gel that contains no fragrance.”

Pharmacists should select products that don’t contain fragrance or potential irritants such as lanolin, says Mr Soni. “As lots of these products are used on young children and babies, they must be non-irritant to this sensitive skin type,” he says. “An ideal product in this armoury would be Cetraben, as it meets both these criteria and also is easy to apply and aesthetically pleasing. Also the range includes a bath additive, which helps in maintaining moisture.”

Parents often look for natural products that are readily available from health stores. Meghna Patel, director of Mahi Naturals (UK distributor for Hope’s Relief, a new natural pharmacy skincare brand), says pharmacies should therefore stock natural alternatives. “Overall, customers are very savvy when reading ingredient lists, and are wary of those that contain SLS, parabens, petrochemicals, artificial colours and fragrances,” she says. “Mums are especially picky when selecting skincare for babies and children, and want to be sure products are not only effective but also gentle and safe for delicate skin.”