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SKIN


are available in different strengths depending on the severity of the eczema: mild (hydrocortisone), moderate (such as clobetasone butyrate) or stronger (such as mometasone).


Antihistamines can often help relieve the itching that’s associated with atopic eczema, and are available in sedating and non-sedating form. Sedating antihistamines can often cause drowsiness well into the next day and so can cause difficulty for children with eczema during school time.


Medicated bandages, clothing or wet wraps can bring great benefit to eczema sufferers if worn over areas of skin affected by the condition. The bandages can also be used over emollients or with topical corticosteroids to not only prevent scratching, but also to allow the skin underneath to heal.


Corticosteroid tablets are very rarely used to treat atopic eczema, but may occasionally be prescribed for short periods of five to seven days to help bring particularly severe flare-ups under control.


Since there is no cure for psoriasis, it has to be treated and managed by the patient in conjunction with their GP or pharmacist.


As with eczema, treatment usually begins with emollients and topical corticosteroids in the form of creams, ointments or gels.


In the event that these treatments are unsuccessful, many patients are referred to secondary care for a course of phototherapy, where the patient’s skin is exposed to certain types of ultraviolet light.


In phototherapy, Ultraviolet B (UVB), which is present in sunlight, penetrates the skin and slows the growth of affected skin cells. Treatment involves exposing the skin to an artificial UVB light source for a set length of time on a regular basis. There are two types of UVB treatment: broad band and narrow band. Several studies have indicated that narrow-band UVB clears psoriasis faster and produces longer remissions than broad-band UVB.


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During UVB treatment, the patient’s psoriasis may worsen temporarily


Up to £400,000 savings for Northern Ireland Health Trusts


before improving, and the skin may also redden and itch from exposure to the UVB light. Occasionally, temporary flare-ups can occur with low-level doses of UVB, but these reactions tend to resolve with continued treatment.


UVB can be combined with other topical and/or systemic therapy (below) to enhance efficacy, but some of these may increase photosensitivity and burning, or shorten remission.


Systemic medications – oral and injected medications that work throughout the entire body -


are used for patients with moderate to severe psoriasis. They’re also useful for who are not responsive, or are


unable to take topical medications or UV light therapy.


Often, different types of treatment are used in combination.


Because psoriasis is unique to each patient, a treatment that works for one person doesn’t necessarily work for another, so one of the main problems with the treatment of psoriasis is finding the treatment that is best suited to the individual. As such, treating psoriasis can be a process of trial and error, and many patients find this frustrating to the point where they can find themselves emotionally low. Patients who find themselves demotivated or ‘down’ should be signposted to their GP for extra assistance. •


AVOIDING DRY SKIN CONSULTANT DERMATOLOGIST AND BRITISH SKIN FOUNDATION


TRUSTEE, DR BAV SHERGILL, HAS SOME TOP TIPS FOR HOW PATIENTS CAN PROTECT THEIR SKIN IN COLD WEATHER The dreary British weather can play havoc with the skin, especially for those with existing skin conditions like eczema or psoriasis. In cold weather the body is exposed to harsh changes, leading the blood vessels in the skin to change rapidly to account for the fluctuating temperature. This can leave the skin looking flushed, red and weather beaten. Wind, rain, central heat- ing and soggy clothing can all irritate the skin.


With that in mind, patients should: • Make sure they’re moisturising regularly and using an emollient that’s right for them – keeping skin moist is imperative to avoid it getting cracked and infected


• Be careful with the kinds of clothes they wear. Some materials, lamb’s wool, for example, may irritate skin and cause flare-ups.


• Regularly apply moisturisers and lip salves. This will help replenish the lost moisture from the skin. All skin types benefit from a moisturiser.


By changing from branded emollients to the cost effective Zeroderma emollient range, Northern Ireland Health Trusts could save almost £400,000 a year.


The Zeroderma emollient range now offers more choice with four creams, one ointment, one gel and two bath additives - providing complete emollient therapy for moisturising, washing and bathing.


Zeroderma products are similar in formulation to around 50% of currently prescribed emollients. They are all sodium lauryl sulphate (SLS) free and available on prescription.


Offering cost savings of up to 37%, many Trusts have adopted the Zeroderma range onto their formularies and cost savings are being made without compromising on patient care.


For further information or patient evaluation samples, email: zeroderma@thorntonross.com or visit www.trderma.co.uk


Thornton & Ross, Linthwaite, Huddersfield. HD7 5QH Phone: 01484 842217 | Web: www.trderma.co.uk


• Avoid harsh, alcohol-based cleansers and soaps. They should also stay away from cleaning products that contain alcohol and go easy on the exfoliation.


• Protect skin with warm clothing (a scarf, hat and gloves) whilst outside. If the rain makes clothes damp, they should ensure that they change into something dry as soon as possible and don’t leave wet clothes in contact with their skin which may cause further irritation or chaffing.


• Not turn up the thermostat for increased heat while indoors, since the drier air in centrally heated buildings means the skin can dry out


• Avoid the temptation to have a long hot bath, as this can strip away much needed natural oil from the skin. They should try and shorten the length of time and remember to keep the water temperature warm not hot


• Apply a moisturiser to skin straight after a bath or shower while the skin is still slightly damp. Drying the skin vigorously with a towel can damage it, so they should pat dry and not rub


www.britishskinfoundation.org.uk PHARMACY IN FOCUS - 23


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