Learning scenario
Learning scenario
Joanna, 43, comes to the counter for advice. She has suffered with eczema in the past, and she has found that her skin is particularly dry at the moment. Joanna explains that it can sometimes become itchy and looks scaly, so she tries to hide it. She wants to manage it now to try and prevent it from getting worse. Through your consultation you identify that she doesn't moisturise daily as she has not found a cream that works for her.
What advice could you give to Joanna?
INCORRECT
Joanna should be advised to use an emollient (even when the skin is clear) to help hydrate and restore her skin barrier
INCORRECT
A topical corticosteroid should not be used to manage dry skin. Joanna should use an emollient to help hydrate and restore her skin barrier
CORRECT
People's skin needs can vary, and she may not have found the right emollient for her. Daily use of emollients is encouraged even when skin is clear
INCORRECT
There are no signs to refer to the GP, such as an infection. Self-management of dry skin is advised by the NHS, and Joanna should feel enabled by the pharmacy team to manage her dry skin confidently
REFERENCES
1. NHS England (2018), Conditions for which over the counter items should not routinely be prescribed in primary care: findings of consultation and next steps, NHS Board Paper. Available at: www.england.nhs.uk/wp-content/uploads/2018/03/08-pb-29-03-2018-otc-fully-combined.pdf
3. Andy Tisman (2008), Driving the self care agenda, PAGB Annual Review, IMS Health. Available at: https://www.pagb.co.uk/content/uploads/2016/06/Driving-the-self-care-agenda-AndyTisman.pdf
4. Etat Pur, The Hypodermis. Available at: www.etatpur.co.uk/index.php/hypodermis
5. Harwood et al (2017), Lipid functions in skin: Differential effects of n-3 polyunsaturated fatty acids on cutaneous ceramides, in a human skin organ culture model, Biochim Biophys Acta, Elsevier, Issue 1859, DOI 10.1016/j.bbamem.2017.03.016
6. Coderch et al (2003), Ceramides and skin function, Am J Clin Dermatol, 2003;4(2):107-29, DOI 10.2165/00128071-200304020-00004. Available at: www.ncbi.nlm.nih.gov/pubmed/12553851
7. Purnamawati et al (2017), The role of moisturizers in addressing various kinds of dermatitis: a review, Clin Med Res, 15(3-4): 75-87, DOI 10.3121/cmr.2017.1363. Available at: www.ncbi.nlm.nih.gov/pmc/articles/PMC5849435/
8. Grice EA, Segre JA (2011), The skin microbiome, Nature reviews Microbiology, 2011;9(4):244-253.
9. NHS Choices (2016), Overview atopic eczema, NHS. Available at: www.nhs.uk/conditions/atopic-eczema/
10. National Eczema Society, Emollient prescribing for eczema: information for patients. Available at: www.eczema.org/documents/759
11. National Eczema Society, Emollients. Available at: www.eczema.org/emollients
12. Wallo et al (2012), Colloidal oatmeal formulations as adjunct treatments in atopic dermatitis, Journal of Drugs in Dermatology, Vol. 11(7)
13. Grais ML (1953), AMA Arch Derm Syphilol 1953;68:402-407.
14. Van Onselen J (2011), Dry skin conditions: an evidence-based focus on natural oatmeal emollients, Primary Health Care, Vol. 21
15. Kurtz ES and Wallo W (2007), Colloidal oatmeal: History, chemistry and clinical properties, Journal of Drugs in Dermatology, Vol. 6
16. Fowler et al (2012), New learnings on the clinical benefits of colloidal oatmeal in atopic dermatitis, The Dermatologist
17. Johnson & Johnson. Data on file
18. Johnson & Johnson. Data on file
19. NICE Guidance, Quality statement 2: Stepped approach to management, NICE clinical guideline 57. Available at: www.nice.org.uk/guidance/qs44/chapter/Quality-statement-2-Stepped-approach-to-management
20. NHS Choices (2016), Complications atopic eczema, NHS. Available at: www.nhs.uk/conditions/atopic-eczema/complications/
Online references last accessed October 2019
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