People
with eczema often have a lot of different treatments. They come in a variety of
shapes and sizes, in pots, tubes and pumps. At my clinic, I ask my patients to
bring all their treatments with them; most people have at least a carrier bag with
them………..one patient even brought their treatments on a small trolley. So
imagine how hard it is to not only learn how to use and apply all these
treatments effectively; but to keep supplies and prescriptions up-to-date. On
top of this you have the need for a substantial bathroom cabinet or extra
shelving to store all your ointments.
I
have to say though; it is very helpful for the patient and incredibly useful for
me, as a clinician, to physically see all their treatments. You would be amazed
how many treatments are white with red writing! What is often astonishing is
how many treatments have not really been used. Many of the steroid tubes, for
example, have barely been squeezed. Pots and pumps of emollients have often
been used for 3-4 months, when a 500g container should only last one week. A
little detective work by looking at the label and dispensing date is often all
that is needed for me to assess under-treatment. However, my patients are very
honest and will admit under-use, which consequently means that their eczema is
not optimally treated or even under control.
So
why is under-treatment of eczema such an issue for so many people, especially
if they have so many pots and tubes? Firstly, different treatments are often
prescribed on return visits to their health care professional. The patient will
generally report that the treatment is not working and they would like to try
something else. So the health care
professional prescribes something else and for a short time the patient is
happy. Actually, what needs to happen is for the health care professional to
take some time exploring with the patient why they do not think the treatment
is working, asking them about their daily skin care routine, where, when and
how much they apply. Then asking pertinent questions, such as: Are there any
treatment that give them particular concerns?
This
dialogue between health care professional and patient can be incredibly revealing.
Generally, a small change in attitude towards a treatment, such as dismissing
fears about topical steroids or explaining how much should actually be applied (approximately
500g of emollient a week for an adult and 250g
a week for a child); can actually be life changing as far as self
management of eczema is concerned.
Sometimes,
the patient is right-they do have too many treatments. Finding the right
emollients, wash products and moisturizer, and having a range of treatments for
flare-management can quickly make extra space in that bathroom cabinet
disappear. Therapeutic clothing, such as the DreamSkin polymer coated silk
compliment all eczema treatments and has therapeutic effects which may help
reduce the need for other treatments.
Here
is one final tip for you. If you pay for your prescriptions, don’t skip or
ration your treatments due to prescriptions charges. Each year, take out an
investment in your skin care by applying for a NHS Prescription payment
Certificate (£29.10 for three months or £104.00 for a year). With this
certificate there is no limit to the number of prescription items and if you
need more than 13 items a year you will save money on the current item charge
of £7.65. So, if you have eczema, there are massive saving to be made.
Eczema
Expert
