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Independent pharmacies are in a strong position to offer advice on the management of dry skin conditions  

Less than half of pharmacists make accurate skin condition diagnoses and only 26 per cent offer effective treatments. We consider how to improve care for patients with dry skin

The British Association of Dermatologists launched Skin Support in July, a Department of Health-funded website providing psychological support for people with skin conditions. Skin conditions are the most common reason for people to consult their GP, and it’s not just for help with the physical symptoms.

In April, a report by the King’s Fund, commissioned by the BAD, revealed that the visibility and chronic nature of many non life-threatening skin diseases such as eczema, acne and psoriasis are not being addressed. Yet these conditions can have a profound impact on the psychological wellbeing of a patient and their quality of life. In the UK, psoriasis alone is linked to 300 suicide attempts annually.

With stress being a common trigger of skin disease flare-ups, psychological and self-help approaches can be a crucial aspect of the management programme. “Skin diseases can have a devastating impact on people’s mental and emotional wellbeing, and the benefits of support on both mental health and physical symptoms are well known in medical circles,” says Dr David Eedy, president of the BAD.

“However, few dermatology departments have access to local liaison psychiatrists and their associated services, so self-help can be a vital tool for patients. The problem is that finding self-help materials can be difficult – patients don’t know where to look and resources are available across so many different websites. The beauty of the Skin Support website is that it brings together lots of content in one easy to navigate place, and it tailors the materials to people’s individual skin disease and any physical impairment this may involve.”

Primary care services

Every year, 13 million GP appointments are made for skin conditions, many of which can be managed in primary care. According to research on behalf of Cetraben at the end of 2014, 57 per cent of people have been to see a GP about their skin and 24 per cent have seen a pharmacist. More than a third of people have tried four or more treatments before their current one, and 42 per cent decided on their current treatment after it was recommended by a healthcare professional.

Yet the King’s Fund report revealed that only 49 per cent of pharmacists make accurate skin condition diagnoses and only 26 per cent offer effective treatments. “Independent pharmacies are in a strong position to offer advice on the management of dry skin conditions,” says Dr Kerryn Greive PhD, scientific affairs manager at QV Skincare. “By playing a greater role in this, independent pharmacies would not only relieve the pressure on GPs, but they would also become more profitable. There are issues with compliance, which relate back to a lack of understanding of the nature of dry skin conditions and the directions for treatment – the strategy for overcoming this should be to invest in additional training.”

One of the biggest obstacles for independent pharmacies is that they are operating in an extremely competitive marketplace and many are struggling to compete against the large chains. “The expert advice and support that independent pharmacies can offer people with dry skin conditions would be welcome, but more people need to know that it’s there,” says Dr Greive. “The more that independent pharmacies can do to highlight the services they offer, alongside their points of difference (personal care and convenience), the better.”

Jerome Lemaire, RB marketing director, agrees that pharmacists’ key advantage over the grocery channel is their knowledge and expertise. “The lower amount of traffic can be turned into a plus, because it means that the pharmacist has time to offer valuable advice,” he says. “For a customer this is a one-to-one opportunity where they can discuss their skin issues and receive in-depth knowledge and advice. Since skincare and skin problems are very personal and sensitive subjects, the pharmacist can make the purchase easier by recommending the correct product.”

Treatment choices

Emollients are the mainstay of dry skin management, even when the skin is clear. GSK recommends that pharmacists and pharmacy assistants offer their customers appropriate support and advice and that they recommend how much, how often and how to apply emollients. It often takes trial and error to find the right emollient for an individual – the most suitable product is the one they like the most and will therefore use regularly.

Tina James, sales and marketing manager for Hope’s Relief UK, says that customers value expert advice and opinion, so pharmacy staff should keep up to date with the latest skincare offerings to be able to select the most appropriate product. “In community pharmacy, pharmacists and their staff should be able to advise on alternative natural products for the treatment of dry skin, particularly eczema, dermatitis and psoriasis,” she says. “Pharmacists will know that there are an increasing number of customers looking for safe alternatives to steroid and petroleum-based products for eczema that are safe for long term use.”

Various new product ranges for dry skin conditions have been launched in pharmacy in recent months. Purepotions Skincare product range for dry and itchy skin conditions, for example, is now available in independent pharmacies, Purple Orchid Pharma launched Loyon in July, a gentle and effective keratolytic treatment for psoriasis. Loyon is clinically proven to be as effective as salicylic acid at removing psoriasis plaques, without the negative effects. Loyon contains a fast spreading combination of emollients and dimethicones, which act to protect and moisturise the skin.

According to Mr Lemaire, pharmacists need to make it easy for customers to find skincare products and should devote more space to the medicated skin category. “Help open up discussions by signposting product ranges with posters and displays in the window and in-store,” he says. “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 that can be included as part of a skincare routine. If the customer expands on what they are looking for, or which skin problem they want to address, the pharmacist can advise about the different product formats and what would be most suitable for the customer’s skin type.”

Expanding market

Dry skin is typically grouped with eczema and psoriasis, but not all customers with dry skin need medicated products. In Spring this year, LloydsPharmacy launched its first dermo-cosmetic skincare line. The affordable, everyday skincare range, which is free from chemicals and packed full of natural ingredients, contains a unique anti-waterloss complex – HydraMatrix. According to LloydsPharmacy, one in six women in the UK describes their skin as dry, with 52 per cent of consumers admitting to using a facial moisturiser to treat dry skin.

“This three-in-one complex works cleverly with the skin’s natural processes, and with its accessible price point it’s a great everyday range for people looking for a hydrating formula,” says Joanne Carey, LloydsPharmacy’s skin health expert. “In addition to products, in-store skincare advisors can offer a free skin analysis to find out level of hydration, elasticity and pH levels in selected stores.”

According to RB research, around 33 per cent of consumers are looking for a cleansing range that keeps skin hydrated. RB’s popular Clearasil Daily Clear range has undergone a brand redevelopment with the introduction of four new Clearasil Daily Clear Hydra-Blast products with effective but non-drying action. The formulas prevent the skin from over drying, but ensure deep cleansing to help deal with daily blemish breakouts.

O’Keeffe’s Working Hands hand cream provides welcome relief to those that work with their hands on a daily basis. “The hands are one of the most used body parts,” says Simon Damp, European sales director for O’Keeffe’s Company UK. “Cracked and dry skin can result in serious and painful problems developing that could limit simple tasks that you carry out on a day-to-day basis like driving and writing. Maintaining healthy hands is essential to ensure you keep active.”

Pharma Nord’s Omega 7 sea buckthorn oil capsules work from within to help combat dry skin. According to Dr David Mantle, medical adviser at Pharma Nord, the fatty acids and antioxidants present in the capsules help to maintain the structure and function of the skin and protect against free radical damage.