Pots, tubes and pumps – so many treatments

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