Bruises, cuts, grazes, scars and minor burns – pharmacists are in the frontline when it comes to wound care and can advise on and encourage the right patient self-care.

While there is no treatment to eradicate scarring and striae completely, pharmacists can discuss self-care steps with patients to minimise bleeding, infections and wound dehiscence.

Pharmacy training expert Steve Riley says that pharmacists are generally not very well informed about scarring and stretch mark management. He explains: “It is not an area extensively covered by our core education and some would not readily associate it with the key activity of supporting the safe supply and effective use of medicines. However, pharmacists are taking on and delivering more clinically focused roles and there is a need, particularly in the community setting, to support self-care, health promotion and wellbeing.”

Stretch marks
Pharmacists can suggest preventative measures, such as using sunscreen to help a scar pigment settle, or advising on a healthier regime to avoid the rapid weight gain and loss that can cause stretch marks.

Steve Riley adds: “As pharmacists, we are one of the healthcare professionals most likely to have regular contact with patients concerned about scars or stretch marks. As we supply the products used to support the management of scars and stretch marks, we are ideally placed to give self-care guidance.”

Bio-Oil is a well-known treatment to help improve the appearance of scarring, uneven skin and striae. But the brand also offers behind the scenes training and support for pharmacists in this area. It also offers free guides in their resource centre at www.biooilprofessional. co.uk, including a training module written by a dermatology specialist nurse (www.bio-oilprofessional.co.uk/ primary-care-training) to support healthcare professionals in scar management.

Science of Skin’s Solution for Scars cream was created by two cosmetic surgeons to help heal common skin ailments and reduce the appearance of scars and stretch marks. The results of a clinical trial released on 31 January 2017 now suggests that the active ingredient, epigallocatechin-3- gallate (EGCG), can reduce the redness and thickness of skin in under two weeks (A Double-Blind Randomised Controlled Trial Demonstrates for the First Time Evidence for the Role of Topical Epigallocatechin-3-Gallate in Reducing Angiogenesis, Inflammation and Skin Thickness in Human Skin Scarring: A Non-Invasive, Morphological and Immunohistochemical Study).

Scar issues Science of Skin’s co-founder and cosmetic surgeon, Douglas McGeorge, explains: “Solution for Scars is an ideal product to stock in a pharmacy because of its versatility in helping with a variety of common skin ailments.

"Developed and proven to reduce scar thickness and redness, this new medicine cupboard staple helps to soothe and calm red and irritated skin, such as burns, cuts and grazes, chicken pox and acne scarring, as well as helping to reduce the appearance of surgical scars, stretch marks and sporting scars. Packaged in a handy, travel sized bottle, it is a must when it comes to emergency skincare. After years of research and the understanding of the extraordinary ingredient EGCG, Solution for Scars is a trusted, scientifically and clinically proven solution to help change the destiny of scars.”

The household licensed medicine Sudocrem Antiseptic Healing Cream is wellknown as a nappy rash cream, but it can also double up as a treatment to soothe cuts, grazes and minor burns. Its water repellent base creates a barrier over sore skin that can help reduce infection.

This month, Sudocrem is being promoted by an educational campaign called Play More, which encourages outdoor play for preschool children who are prone to cuts and grazes. As a part of this initiative, 10 nurseries across the UK have been awarded with a grant for play equipment to help improve their outdoor space.

Youki’s wound healing products have seen some recent developments too. In April 2016, the brand launched its Bio-Cell Spray and Skin Repair Cream in two smaller 12ml sizes for minor injuries and first aid use. The products work by creating a permeable membrane over the wound that allows oxygen to reach the site and maintain it at body temperature. Youki has been registered as a Class 1 Medical Device with the MHRA since 2002 and has been granted a CE mark.

Dr Sujata Jolly from Clinogen Ltd, who developed the Youki products, says that they are an effective first port of call for first aid, minor burns and common skin complaints, including eczema, dermatitis and psoriasis. Dr Jolly says: “Unlike traditional dressings, such as plasters, Youki helps to heal open wounds much more quickly and reduces the likelihood of scarring. For cuts, grazes and open wounds, Youki Bio-Cell Spray is easy to use, as all that’s needed is a quick spray onto the affected area – no secondary dressing is needed as Youki forms its own protective covering. Once the wound has healed, Youki Skin Repair Cream can be used to nourish and strengthen the skin and minimise scarring.”

Bruises and swelling
Pharmacists may want to add Nelsons Arnicare arnica cream and gel to their shelves to treat pain, bruising and swelling, as the brand will be promoted in a ‘below the line’ campaign in the run up to summer. Arnicare brand manager, George Lellis says it is important that all pharmacy staff are well educated on common conditions causing aching legs and feet and should have a clear bruise cream category. He says: “There should be a clear and prominent category in store for aches and pains. If there are relevant leaflets on aching legs and feet that customers might find useful, make sure these are easily visible. Staff should also know where the relevant products are in store to ensure a smooth customer purchasing experience”.

The wound care category is often associated with first aid products, but injuries and discomforts can also occur after birth in the vulva, labia, perineum and anus areas. Multi-Gyn Compresses are a natural remedy for the intensive care of these external intimate areas. The small pads contain 2QR-complex, a natural bio-adhesive gel derived from the Aloe vera plant. They come in boxes containing 12 sealed packs.

The compresses are useful for women who have had an episiotomy, or if the perineum has been torn or stretched during delivery. They can also soothe haemorrhoids, anal fissures and inflammation caused by incontinence, frictions caused by sanitary pads and sexual activity and reactions to soap and detergents.

Online marketing manager and pharmacist from the distributor Purple Orchid Pharma Lana Orton says: “If a mum-to-be is buying supplies for her birth bag, the role of a pharmacist should be to recommend all the ‘must-haves’, including Multi-Gyn Compresses. However, if a partner comes into a pharmacy to buy medical supplies after the baby is born, it is difficult to discuss the sensitive issue with them. We have noticed that the compresses are sold much better when they are close to breastfeeding products, especially breast pumps and nipple creams.”

Beating bacteria
Comvita Wound Gel contains medical grade manuka honey, which according to recent research, is an active ingredient that has valuable antibacterial properties. Manuka honey has been the focus of clinical studies and past research has shown that it is effective at breaking up biofilms and preventing bacterial growth. Such findings have led to the development of medical-grade manuka honey wound and skincare products. The most recent study, conducted at the University of Southampton and published online in the Journal of Clinical Pathology in September 2016, reveals that manuka honey can prevent the formation of biofilms). These communities of bacteria and microorganisms form in moist environments and are harder to treat with antibiotics as the bacteria is covered in a sticky coating.

The research specifically examined the effect of manuka honey on bacteria associated with urinary tract infections during urinary catheter use. When manuka honey was added to bacterial communities, the biofilm was reduced. Comvita’s Manuka Honey UMF15+ was used in this study (the study was not funded or organised by Comvita).