Understanding the problem 

Atopic eczema is the most common type of eczema. It can come and go, and sometimes customers will experience periods of flare-ups, where the condition worsens. The frequency and severity of such periods vary, and people will often need support with how to manage the condition effectively throughout their lives, although childhood eczema can improve with age.

Having dry skin or eczema can have a significant impact on a person’s quality of life, as well as on their psychosocial wellbeing. Children may be affected by bullying, poor sleep quality, low self-esteem and absence from school, and adults can be equally as affected.

Being able to empathise with customers and reassure them about regular use of emollients, as well as recommending the most suitable products for their needs, is important.

There is a range of complications that pharmacy staff need to be aware of so that customers can be referred to the pharmacist where appropriate. These include bacterial infection (signs of oozing and/or crusting), viral or fungal infections, and when the diagnosis is unclear.

Supporting customers

As there is no cure for eczema, it has to be managed using the following strategies:

• Using emollients frequently and liberally, as recommended by clinical guidelines. They should be used at all times, including when the eczema is under control, to maintain the skin’s barrier function
• Avoiding triggers (see panel)
• Minimising scratching, which can be difficult as scratching gives a sense of relief. However, it can also result in damage to the top layer of the skin, leading to further water loss and dryness, making eczema worse and increasing the risk of infection
• Applying topical corticosteroids during flare-ups or on a regular basis if recommended by a specialist or GP, and for 48 hours after the flare-up has been controlled.

If a customer needs further support, a GP may recommend other options such as the use of stronger products that are available on prescription, wet wrap therapy or antihistamines.