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Your Skin
Q2 / 2020
Read more at www.healthawareness.co.uk
Lex from the series Epidermis by Sophie Harris-Taylor. @sophieharristaylor
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Talonted Lex Skin Positivity Campaigner
Dr Emma Wedgeworth Consultant Dermatologist and Spokesperson, British Skin Foundation
Karis Betts Health Information Manager, Cancer Research UK
The skin positivity message is crucial: all skin is good skin.
There is no one cure for eczema, but there are many treatment options to manage it.
Worried about changes or marks on your skin?
It is crucial people know the best ways to protect their skin and enjoy the sun safely.
Get to know your skin inside out... Explore our A-Z of conditions at knowyourskin.org.uk
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IN THIS ISSUE
“All skin is good skin,” says Talonted Lex
04 How to stop eczema’s vicious itch-scratch cycle
06 Looking after children’s skin in the sun
Talonted Lex Rosacea & Skin Positivity Campaigner
“Once you understand that everybody is unique and imperfect, in a wonderfully perfect way, you can truly be positive about the way that you look.” Talonted Lex talks about her journey with rosacea and skin positivity.
Why is it so important to feel positive within your skin? “Rosacea is chronic, so accepting how my skin looks and finding the positive in something I can’t change, is better than living my whole life being miserable about the way that I look.”
What sparked your skin positivity journey?
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“For a while I was ‘a rosacea blogger’, which I don’t really view myself as anymore. A lot of the stuff I talk about can be applied to anyone with skin conditions, especially when I talk about skin positivity, stress and psychological impact; I think that transcends rosacea.”
How to manage the mental health fall out of psoriasis Business Development Manager: Roz Boldy Email: roz. boldy@mediaplanet.com Content and Production Manager: Kate Jarvis Managing Director: Alex Williams Head of Business Development: Ellie McGregor Digital Manager: Jenny Hyndman Designer: Thomas Kent Content and Social Editor: Harvey O’Donnell Paid Media Strategist: Ella Wiseman Mediaplanet contact information: Phone: +44 (0) 203 642 0737 E-mail: uk.info@ mediaplanet.com All images supplied by Gettyimages, unless otherwise specified
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© I M AG E P R OV I D ED BY TA LO N T ED L E X
INTERVIEW WITH
What advice do you have for people struggling to feel comfortable with their skin? “I’ve developed a bit of a catch phrase: ‘Your skin does not define you; in fact, it’s the least interesting thing about you.’ But it’s hard to remember that when it affects going to work, going on a date. I’ve heard from people who have completely retreated from everyday life because they can’t deal with how people react to them. Skin conditions and visible differences can be incredibly isolating, so, finding an online community of people who look and feel as I do has been transformative for me. I encourage anyone who feels lost or lonely in their condition to seek out the online spaces created by those who understand.”
How are you using your voice to help people with self-acceptance?
How did you find out you had rosacea?
“I see my role as being two-pronged. Firstly, to provide advice and connect people under the broad umbrella of skin positivity. Whether we’re talking about vitiligo, rosacea, scars, my underlying message is to be okay in your skin. “Secondly, my aim is to bring awareness to those who don’t suffer with a skin condition, so they might learn and think twice about how they respond to people who do have one.”
“After doing sports at school my friends would joke about how red I went; when I started drinking in my late teens, I would often go red, and I just thought that was ‘how my skin went’. “It got worse and worse to the point that my skin actually went purple. It was very sensitive, burning, itchy, bumpy, and dry, but oily at the same time. The university GP diagnosed it almost straight away; I had never heard of it.
Although rosacea may be considered a superficial condition by those who don’t understand it, we cannot separate the psychological impact of skin conditions from the physical conditions. It was a scary thing to be told my issue was chronic and thinking that my face would always be that way.”
What is the most important thing for you to achieve in your campaigning? “I want to be the resource that I needed when I was diagnosed at 21, when I felt so lost. Every single thing I put on the internet has been to help that 21-year old version of me. “The skin positivity message is crucial: all skin is good skin. We should all be a little bit kinder to people regardless of how they look and focusing less on people’s appearance. “We need to move into a space where we have a full range of all forms of beauty. It’s so important to me to spread the message that there is more than one way to be beautiful and more than one way to live your life.” Written by: Kate Jarvis
Read more at talontedlex.co.uk/
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This article is sponsored by Garnier
© F IZ K ES
Protecting your face from the sun before you apply make-up may require a bit more thought, especially if you’re prone to breakouts.
Sun cream tips:
what you need to know Choosing a skin care routine that also protects you from the rays of the sun may seem like a difficult task, especially if you have acne. But thanks to new, better formulated products, you can stay safe while continuing to look and feel great.
S Dr Justine Kluk Consultant Dermatologist
Read more at garnier.co.uk/ sun-protection
ummer in the UK is widely unpredictable: will we wake up to a glorious sunny day or another downpour? Regardless of the sky outside, we are all still at risk from some of the more harmful rays – UVA and UVB, especially during the warmer months between April and September. That’s why sun cream is so important. You might already be aware of the dangers if you are susceptible to burning or if you have a skin disorder or issues with excess pigmentation that are aggravated by sunlight. However, people with conditions, such as acne, often avoid sun cream in case it makes their skin flare up. But, thanks to new technology, this is no longer the case. Harmful rays While UVB is responsible for sunburn and skin cancer, UVA ages our skin and could also contribute to skin cancer risk if exposed over time. Consultant Dermatologist, Dr Justine Kluk, believes that, while us Brits love to top up our tan, we’re not so great at topping up the sun cream. This is why
she recommends choosing a broad spectrum SPF 30 or above to wear daily in the sunny season, even if you’re indoors, as UVA rays can penetrate through window glass. She says: “SPF, or sun protection factor, protects our skin from UVB rays. If your skin would normally burn within 10 or 20 minutes of exposing it to the sun without protection, applying adequate quantities of SPF 30 means that it would take up to 30 times as long for the same to happen. This is why using a high SPF is important. SPF 30 blocks approximately 97% of UV rays.” She added: “Also, look for products that offer UVA protection. If you sit next to a window on a regular basis, you may find yourself in the rays of the sun more than you think, which can lead to premature ageing of the skin.” Different types of sun cream Here in the UK, there are two types of sun cream that are readily available: those that you can wear instantly (physical) and others that take between 15 and 30 minutes to activate (chemical). Understanding this should play a part in which sun cream you choose to use and
re-apply during the day. Most sun creams are fine to be mixed if desired, as long as you are sure of the application timings, and if you’re sweating or swimming, make sure to re-apply. While you can cover your body easily with loose clothes, protecting your face from the sun before you apply makeup may require a bit more thought, especially if your prone to breakouts. Sun creams designed for all-over use may feel a little thick or heavy and might be bad news if you’re prone to break outs. Instead, Dr Kluk advises you use a facial sun cream like Garnier Ambre Solaire UV Face Fluid. She says: “Traditional sun cream under make-up may feel too greasy and could also cause spots in acne-prone skin. Face Fluid is a great solution for everyday sun care, with a lightweight, noncomedogenic (or non-pore blocking) formula that doesn’t contribute to formation of blackheads. It won’t aggravate existing conditions such as acne or oily skin and goes on perfectly underneath your make-up. It’s also really affordable.”
Garnier Ambre Solaire UV Face Fluid SPF 50+ This sun cream is has a lightweight formula, with a non-greasy finish and includes some of the latest in skin technology with the use of intelligent polymers that create a more even distribution on the skin with a barely-there finish. And it's currently only £7, so it's really affordable!
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Eczema in children
This is an advertorial by Derma UK
How to stop eczema’s vicious itch-scratch cycle An emollient cream repairs the skin’s barrier and may provide instant relief to eczema patients. But to stop flare-ups, emollients must be used frequently and liberally.
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he word ‘eczema’ is derived from a Greek word meaning ‘to boil over’. This is apt; it’s a good description of the red, inflamed, itchy patches that can occur on the skin with eczema flare-ups, be they mild, moderate or severe. Actually, eczema isn’t just one condition: it’s the umbrella name for a group of skin complaints, which include atopic eczema and contact eczema (or dermatitis). It’s very common; it can occur in both childhood or adult life, and its many and varied triggers may include food allergies, cold weather, and household irritants such as house dust, central heating and air-conditioning. How emollient creams work to treat eczema Managing the symptoms associated with eczema may be a challenge, particularly in children. But it’s important to manage it well, because when inflamed skin is broken it becomes open to superficial skin infections. So starts a vicious itchscratch cycle: the more external aggravators invade broken skin, the more inflamed and uncomfortable
Eczema is extremely common, affecting up to 20% of children in the UK. For the majority of sufferers, the condition is mild, however, it can be severe and may impact sleep, school and day-to-day life.
it becomes, and the greater the temptation to scratch it. The key to effective management is repairing the integrity of the skin barrier with an emollient cream, like Ultrabase®. With one application of an emollient you may feel a soothing relief from irritation — but you can’t stop using it at that point. In order to reap the benefits of an emollient, you must apply frequently and liberally. The more emollient you apply the more likely you will minimise the continuous itch-scratch cycle. Emollients like Ultrabase® lock in the moisture; leaving the skin feeling hydrated.
WRITTEN BY
Dr Emma Wedgeworth Consultant Dermatologist and Spokesperson, British Skin Foundation
Frequent applications are necessary for optimum relief It is important to use an emollient in a way that suits you and your lifestyle, so that doing so it becomes less of a chore. Some emollients have a bland and clinical smell, but emollient cream Ultrabase® has a citrusrose oil scent that makes it more enjoyable to use, while leaving your skin feeling rehydrated and refreshed. Written by: Tony Greenway
Read more at healthawareness.co.uk
More info: Ultrabase is available from all good pharmacies and www.sk1n.co.uk You can also find more information on the above products from www.dermauk.co.uk/Ultrabase
Please refer to the full SPC text before prescribing this product. Adverse events should be reported. Reporting forms and information can be found at http://yellowcard.mhra.gov.uk .Adverse events should also be reported to Derma UK on +44 (0)191 375 9020.
©LISA KINGDON
ULTRABASE® - Abbreviated Prescribing Information Presentation: Ultrabase® is a white cream containing white soft paraffin 10% w/w. Uses: Ultrabase® is a moisturiser that can be used as an emollient. It can also be used to dilute dermatological preparations and as a vehicle for other dermatological medicines. Additionally, it may be alternated with topical corticosteroids when the latter are being gradually withdrawn, and may be continued alone after complete withdrawal of the topical corticosteroid. Dosage: The cream should be smoothed onto the skin as often as required. Contraindications: Hypersensitivity to any of the ingredients. Warnings and Precautions: Contains stearyl alcohol which may cause local skin reactions. Contains methyl parahydroxybenzoate and propyl parahydroxybenzoate which may cause allergic reactions. Instruct patients not to smoke or go near naked flames - risk of severe burns. Fabric (clothing, bedding, dressings etc) that has been in contact with this product burns more easily and is a serious fire hazard. Washing clothing and bedding may reduce product build-up but not totally remove it. Side Effects: Hypersensitivity skin reactions including erythema and pruritus have been reported. Package Quantities: 500g pump dispenser. Basic NHS Costs: £8.67 (500g). Legal Category: GSL. Marketing Authorisation Number: PL 19876/0014. Marketing Authorisation Holder: Derma UK Ltd, Toffee Factory, Ouseburn, Newcastle upon Tyne NE1 2DF, UK. “Ultrabase” and “Derma UK” are registered Trade Marks. Date of Revision of Text: August 2019.
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czema occurs as dry, red, flaky, itchy patches, often in the creases of the elbows and knees, although it can appear anywhere on the skin. The itching of eczema can be incredibly uncomfortable and distressing. Eczema is particularly common in children, but, by the age of 11, 60-70% of affected children will be relatively clear of eczema.
Medical moisturisers (emollients) are an essential daily step. They increase water levels in the surface of the skin, boosting the skin’s barrier function. Avoiding soaps, bubble baths and shower gels also helps, as these damage the skin barrier. Once redness and inflammation have developed, this needs to be treated with an antiinflammatory cream. Steroid creams are the mainstay of treatment and can be very effective Why do children get eczema? and safe if used appropriately. People Eczema is a combination of skin are often worried about using steroids dryness and a change in the skin’s but, in fact, we see far more damage to immune system, which causes the skin with untreated eczema. redness and itching (inflammation). For mild eczema, the steroid cream We know that eczema is linked to is used as and when needed. If the other conditions eczema is more like asthma, food severe, the cream allergies and is used for longer hayfever and there and followed up is a strong genetic by a ‘proactive’ component. If one approach; using Eczema is particularly parent has eczema, the creams twice asthma or hayfever, weekly to prevent common in children, but, a baby has a one flare ups. There by the age of 11, 60-70% in four chance of are some newer of affected children will be anti-inflammatory developing eczema and if both parents which relatively clear of eczema. creams, are affected, it’s one can be helpful in in two. combination with Certain environmental conditions steroids. may also impact; cold weather, indoor In a very small percentage of cases, heating and skincare are among some creams won’t be effective enough and of the common culprits. Food allergies children may need to see a hospital co-exist in up to 40% of children with specialist. Other options are light eczema, but usually aren’t the actual treatment (phototherapy), tablets or cause. However, occasionally food can injections. influence eczema, particularly in very Eczema in children is very common young babies. and can significantly impact on quality of life. Research over the past 20 years How do you treat eczema? has given us a fascinating insight into Unfortunately, there is no one cure eczema and this is now translating into for eczema, but there are many different treatments. treatment options to manage it.
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Frequent moisturising is the key to healthy skin A good skincare regime is one that suits your lifestyle and your eczema, says a consultant dermatology nurse.
INTERVIEW WITH
Paula Oliver Independent nurse consultant in dermatology, In association with and reimbursed by Aspire Pharma
Written by: Amanda Barrell
Read more at dermato-logical.co.uk
WRITTEN BY
Andrew Proctor Chief Executive, National Eczema Society
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oisturising properly and regularly may seem like a chore, but it is the best way to keep eczemaprone skin healthy. A “back-to-basics” skincare regime hydrates and protects the top layer of skin, easing the scratch/itch cycle, said Paula Oliver, an independent nurse consultant in dermatology. “Sometimes, people think an active treatment is the only way to make things better but moisturising is the first line of defence in any skin condition,” she says. Choosing a product What constitutes “the right product” is different for everyone, she says, adding that moisturisers and emollients “essentially do the same thing”. “What’s more important is finding the right formulation for your lifestyle and your condition. It could be the best product in the world, but if people do not like the way it looks or feels, they won’t use it.” Lotions and creams may be easier to use and seem to absorb into the skin faster than ointments, however,
if the eczema is more severe then an ointment may be more appropriate. Gel emollients are oil in water, they are useful for application to the scalp and face. Ointments are greasy so may be less cosmetically acceptable, and you have to take care that the product doesn’t mark clothing or soft furnishings. Using a combination of products is often the best solution, says Paula. “People could use a lighter formulation in the morning and the greasier product before bedtime when they can wear an old pair of pyjamas, for example. Or people with severe eczema on one part of the body could use ointment there, and cream everywhere else,” she says. “It’s about finding what works for you.” It’s worth noting that products containing sodium lauryl sulfate (SLS), parabens or perfumes, may not suit people with skin sensitivities, she added. Using the product People with eczema should aim to moisturise between two and four times a day, and Paula says applying the product after a shower or bath could
help them build a routine. “Pat yourself dry with a nice fluffy towel then put the product on while the skin is still damp. It will help lock in the moisture,” she says. “Use a liberal layer and try using downwards strokes, going the way the hair lays. It goes on a lot quicker that way. Avoid rubbing the skin, because that can irritate the scratch/itch cycle.” COVID-19 hand care The general advice for people with eczema is to avoid soap, but that has changed with the advent of COVID-19. “It’s been a really difficult time for dermatology patients, because of the intensive hand washing, and the fact that only soap will kill the virus. “Our advice is to wash your hands with soap for 20 seconds, then wash again with your soap substitute and apply lots of emollient. Another tip is to apply lots of emollient at bedtime and wear cotton gloves while you sleep.” Effective skincare, she concluded, was a long-term commitment – but one that helped people to cope with the life-altering symptoms of eczema.
This article is sponsored by Aspire Pharma
Everyday tasks can be painful with eczema Most people have heard about eczema, but few realise just how difficult and painful it can be. The skin is often unbearably itchy and uncomfortable, and the relentless daily challenge to care for it can be exhausting.
or some people with eczema, doing everyday tasks like cooking or even bathing can be extremely painful, because the skin is so cracked, sore and raw. Alongside the painful physical symptoms, many children and adults experience related sleeplessness, low self-esteem, bullying, anxiety, and other mental health problems. Eczema is a serious, debilitating, long-term medical condition that has a huge impact on millions of children, adults and their families. The most common form, atopic eczema, affects one in five children and up to one in ten adults in the UK. Around a third of those with eczema have either moderate or severe symptoms. Eczema and dry skin Using emollients is essential to help repair and protect the body’s natural skin barrier and reduce the
itch association with eczema. Skin is made up of several layers, each containing skin cells, water, oils and fats. Together, these help maintain and protect the condition of the skin. If you have eczema, your skin is less able to retain water. Gaps open up between the skin cells and the protective barrier doesn’t work as well as it should. Moisture is lost from the deeper layers of the skin, allowing bacteria or irritants to pass through more easily. Emollients are therefore needed to repair and protect the skin barrier, to stop the skin from drying out and being damaged. How should emollients be used? Emollients should be used for moisturising the skin several times a day, and for washing, even when the skin isn’t red and inflamed. Emollients come in various forms, lotions, creams, gels and ointments. You’re likely to need more than one
kind of emollient, depending on the dryness of your skin, the part of the body affected and the time of year. NHS emollient rationing Having a good skincare routine is crucial if people are to self-manage their eczema well, and in doing so reduce the need for more expensive medical treatments. It is not always straightforward to find the right emollient with such a wide range of products available. Different emollients suit different people and finding the best ones for you usually involves some trial and error. The best emollients are the ones that people are willing to use regularly because they work best for them. This is why National Eczema Society is so concerned about moves by the NHS to restrict availability and range of emollients on prescription, for both children and adults. We hear from many people that they are having
their emollient prescriptions changed, reduced or stopped. NHS England prescribing guidance on leave-on emollients says that emollients can be prescribed for people with eczema. Even so, this is not always followed. The Society has produced its own guidance for people on how to advocate with their GP or nurse for access to emollients on prescription, citing the research evidence and clinical guidelines. The Society is also hugely concerned about the latest moves to stop making bath emollients and therapeutic silk garments available on prescription too, including for people with more severe eczema. Despite strong feedback from patients and compelling research evidence, decision makers are seemingly not listening.
Read more at healthawareness.co.uk
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Looking after children’s skin in the sun
Staying safe in the sun
Were you told that WRITTEN BY your freckles were Dr Rachel Abbott ‘sun kisses’ when Consultant Dermatologist, you were a child? Or University Hospital given oil to rub on of Wales, Cardiff and your skin to make it Spokesperson, British tan? Luckily for our Skin Foundation children, we now know that freckles and a tan are signs of damage to our skin from ultraviolet (UV) radiation – usually from the sun. And that overexposure to sun damage causes sunburn, photo-ageing and skin cancer, particularly in people with less pigmented skin.
Toddlers and young children As with everything, sun protection becomes more challenging when children start moving. Get to know your child’s Fitzpatrick skin phototype, which stays the same throughout life. Children with less pigmented skin will need sun protection during the spring and summer in the UK, while those with deeply pigmented skin may only require sun protection when the UV index is high (≥6). General sun protection measures should be considered when the UV index is ≥3:
Seek shade between 11am–3pm (consider a tent with UV protection at the beach)
Use clothing to cover up (sun suits with UV protection are great when getting wet outside) Wear a hat (legionnaire style – a baseball cap with a flap at the back - provides protection to the ears and neck and generally stay on when they are running around) Wear sunglasses Use high factor (>30SPF), broad spectrum (4*) sunscreen – preferably fragrance free to reduce potential allergens. Older children From the age of five and above children may want more say in their choice of clothing, hats and sunglasses to encourage them to wear them. They can help apply sunscreen and, at this age, colourful or familiar branded sunscreens can help to keep them engaged. Peer behaviour has increasing influence and so children may only want to wear their hat at school if their friends are wearing them too. Helpfully, some UK schools have sun safety policies in place that ensure play areas are shaded, children are encouraged to wear hats outside, and sunscreen is provided when appropriate. Further support is available at
www.sunsafeschools.co.uk.
©ROMOLOTAVANI
Infants Sun safety is one of the few things that is straightforward for babies – never leave them in direct sunlight. Use pram or buggy shades when you are out and about and be wary of traditional babies’ sun hats as these often only cover the top of the head. Sunscreen is not recommended for babies as their skin is thinner, so their skin is more likely to absorb the ingredients of sunscreen and may develop a reaction to one of them.
WRITTEN BY
Karis Betts Health Information Manager, Cancer Research UK
Although this summer might be different to those before, many of us are making the most of the weather where we can and spending time outdoors. But, while we’re all keen to enjoy the sunshine while it lasts, we should still be mindful of sun safety.
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s well as a nasty sunburn, too much sun exposure can cause skin cancer. There are roughly 16,000 new melanoma skin cancer cases each year in the UK, and up to nine in ten cases could be prevented by being safe in the sun. That’s why it is crucial people know the best ways to protect their skin and enjoy the sun safely. What about skin checks? We always say it’s a good idea to know what your skin normally looks and feels like, but there’s no need for regular skin checks, or to track moles
Our top tips ® In the UK, the sun is strongest between 11am and 3pm between the beginning of April and the end of September. ® It’s a good idea to check the UV index on the weather forecast, as the sun isn’t always strongest when it is hottest and UV rays can get through the clouds.
Call your doctor. In most cases it won’t be cancer – but if it is, finding it early can make a real difference. on diagrams or apps as they haven’t shown any benefits. Most moles are nothing to worry about, but sometimes the cells can become abnormal and develop into melanoma skin cancer. If you have any moles that get bigger or their colour or shape changes then it’s important to speak to your doctor. But unusual or changing moles aren’t the only thing to be aware of when it comes to skin cancer. Other things to watch out for include any change in a patch of skin or a nail, whether it’s something new that pops up or something that’s been there a while and has started look or feel different. Call your doctor. In most cases it won’t be cancer – but if it is, finding it early can make a real difference.
Read more at healthawareness.co.uk
® If it’s moderate or high (three or above), then that means we should consider taking steps to protect our skin. ® The best way to do this is by spending time in the shade, covering up with loose clothing and using sunscreen as last line of defence for parts left exposed by clothing. Use one that has at least SPF15 and four or more stars; put plenty on and re-apply it regularly.
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This is an advertorial by Derma UK
Keeping your skin cool in the summer and protected all year round
Although this summer might be different to those before, many of us are making the most of the weather where we can and spending time outdoors. ~ Cancer Research UK
In summer, it’s important to moisturise after sun exposure to avoid dry and dehydrated skin. But we shouldn’t forget that healthy skin maintenance is crucial throughout the year.
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n the heat of the summer sun, our skin can suffer. We don’t even have to be doing serious sunbathing for it to feel rough and dehydrated. And while it’s important to drink plenty of water to keep internally hydrated when the weather heats up, we have to look after the health of our skin from the outside. Every skin type is susceptible to damage in the sun and while lighter skin tones are more at risk, those with darker tones aren’t immune. So get a good sun block (factor 30 or above) and – this is the thing most people forget– make sure you moisturise regularly to maintain the integrity of your skin barrier. Cooling and soothing benefits of a menthol in aqueous cream An aqueous cream such as Menthoderm® contains a concentration of menthol, an ingredient that elicits a cooling sensation when applied topically and is known to alleviate symptoms of dry, itchy, irritated skin. It’s free of Sodium Lauryl Sulfate which can aggravate certain skin conditions, including eczema, and is often used as an alternative to
after sun lotions. The menthol in aqueous cream leaves skin feeling rejuvenated, moisturised and refreshed, but it’s not just for use in summer. Applying a cream such as Menthoderm® gives a cooling effect to alleviate itchy symptoms of obstetric cholestasis in pregnancy, Also, women going through the menopause can use it to soothe the surface of the skin, wherever they feel a hot flush; and it can be used to cool down heated skin during or after sporting activity. In winter, central heating can have a drying effect on the surface of our skin and we can’t get away from it either, because heating is on in our cars and offices, too. The constant flow of dry air – and other factors such as detergents and perfumes – can have a very drying effect on our skin. It’s important to always take care of it by moisturising. The fact is that healthy skin maintenance is crucial throughout the year. It might not be so obvious, but our skin is under pressure even when the sun isn’t shining. Written by: Tony Greenway
More Info:
©RIDOFRANZ
Menthoderm® is available from all good pharmacies and www.sk1n.co.uk
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This is an advertorial by Derma UK
How to manage the mental health fall out of psoriasis Psoriasis affects around 2% of the British population, meaning that over a million of us live with scaly, itching patches of skin. So, why isn’t the mental health fall out of the condition discussed more openly?
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hat do Kim Kardashian, Cyndi Lauper and Art Garfunkel all have in common? Psoriasis. According to NICE (the National Institute for Health and Care Excellence), up to 2.2% of Brits have the condition. That means that over a million people deal with dry, red, plaque-covered patches of skin. Types of psoriasis There are four types of psoriasis. The way people may go about managing and thinking about their skin may depend on which type they have:
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Chronic (long-term) plaque psoriasis: the most common type of the condition. Plaques (scales) cover the knees, elbows, trunk and scalp.
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Guttate psoriasis: often develops after a streptococcal throat infection and is more common in teenagers and children. Symptoms include small, drop-shaped sores on the chest, arms, legs and scalp.
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Palmoplantar psoriasis: affects mainly the hands and feet.
Pustular psoriasis: a rare type of psoriasis that causes pus-filled blisters. Having a dry skin condition can take a huge toll on your mental health. If you’ve got palmoplantar psoriasis, for example, you might feel uncomfortable shaking hands or touching public surfaces, while chronic plaque may make wearing shorts or skirts a real body confidence battle. Mind versus skin Back in April, talkhealth teamed up with the British Skin Foundation to host an online clinic on mental health and skin. We found that so many of our members were either struggling with their mental health because of their skin issues or that their mental health was triggering debilitating symptoms. Steve* lived with a generalised anxiety disorder, which he said was making his psoriasis worse. What could he do, he * Name has been changed to protect the privacy of the individual
asked, to better manage both? Consultant dermatologist, Dr Alia Ahmed, said that the link between psoriasis and psychological health is well known, but it’s hard to say if one causes the other; it’s a chicken-egg scenario. However, “we do know that treatment of both the mind and skin together generally leads to better outcomes,” she explained. “People with psoriasis do tend to have higher levels of anxiety and depression than those without skin conditions. I would suggest seeing a psychodermatology service to address both issues concurrently. This may include better medical treatment of your skin coupled with psychological interventions or anxietyreducing medications.” Tools for tackling the itch Another member said that her psoriasis had got worse during lockdown, something registered clinical and health psychologist, Dr Andrew Thompson, said was only to be expected. As well as recommending mindfulness practice, physical exercise and staying in touch with friends and family, he suggested trying an approach called ‘habit-reversal’ to break the itch-scratch cycle. Habit-reversal involves monitoring your itch using a clicker or tally counter, before looking to substitute scratching behaviour with an alternative response. More information can be found on habit reversal at www.skinsupport.org.uk. Skin is our biggest organ, so it’s no wonder that when it’s not feeling or looking its best, we see our mental health start to deteriorate. With increasing attention being paid to mental health, we need to start seeing more emphasis on the link between common mood disorders and skin issues Catriona Williams – particularly Chief Executive, psoriasis. talkhealth Partnership
Why you need to manage psoriasis of the scalp Different types of psoriasis – including scalp psoriasis – can be physically and psychologically debilitating. That’s why good management is key to bring symptoms under control.
P
soriasis is a chronic, long-term and potentially debilitating skin condition, caused by an increased production of skin cells. It’s defined by the appearance of red, itchy, scaly patches on the body. These are commonly found on the knees and elbows, as well as the base of the back and the scalp. Stress and hormonal changes can be trigger factors. There are different types of psoriasis and characteristically, patches of psoriasis are raised, red around the edges and silvery on top. The problem with this condition is that it doesn’t just affect people physically. It may also affect them psychologically. That’s why it’s so important to treat psoriasis and bring it under control whenever and wherever flare-ups occur. This can be difficult with scalp psoriasis, however, where symptoms can range from one or two small disc-like patches, to coverage of the entire scalp. Scalp psoriasis makes the head extremely itchy and flaky. Patches become visible because the skin becomes caught in the hair as it flakes off, so it can look similar to very severe dandruff.
Managing symptoms with effective treatments A treatment, such as Sebco™, has mild anti-itch and antiseptic properties, and can be used for the removal of scaly skin. It is available over the counter and on prescription for those over 12 years old. It’s especially designed for areas of hair growth, and contains coal tar solution, sulphur and salicylic acid in a coconut oil base. This is an old formula based on an ointment which contains ingredients that have been popularly used by dermatologists and doctors for over 70 years. Coal tar solution has the effect of slowing down over-production of the skin cell-rate and works with the salicylic acid and the sulphur to loosen and lift scale. The coconut oil acts as a moisturiser to bring the flare-up under control. While there’s no ‘cure’ for psoriasis, symptoms can be managed so that patients are able to live with the condition. Don’t put up with psoriasis. Treat it, instead.
It doesn’t just affect people physically. It may also affect them psychologically.
Written by: Tony Greenway
Sebco is available from all good pharmacies and www.sk1n.co.uk You can also find more patient information on the above products from www.dermauk.co.uk/sebco SebcoTM Prescribing Information Presentation: Ointment containing coal tar solution 12%, salicylic acid 2%, sulfur for external use 4%. Uses: Treatment of common scaly scalp disorders such as psoriasis, eczema, seborrheic dermatitis and dandruff. Dosage: Gently rub into scalp, leave in contact for approximately one hour. Wash out using warm water and mild shampoo. For severe scalp conditions, use daily for 3-7 days until improvement is obtained then intermittently as necessary. For less severe conditions such as dandruff use intermittently as necessary, e.g. once a week. If symptoms persist after 4 weeks consult your doctor. For children 6-12 years use under medical supervision only. Not recommended for use on children under six years. Contraindications: Skin infections of the scalp, or known sensitivity to any of the ingredients. Use in Pregnancy and Lactation: To be used at the discretion of the prescribing doctor. Warnings and Precautions: Instruct patients not to smoke or go near naked flames - risk of severe burns. Fabric (clothing, bedding, dressings etc) that has been in contact with this product burns more easily and is a serious fire hazard. Washing clothing and bedding may reduce product build-up but not totally remove it. Avoid contact with eyes, and any areas of broken skin. Coal tar may stain clothes and jewellery. Remove or protect these items during treatment. Side Effects: May cause skin irritation, folliculitis and rarely photosensitivity. In the event of such a reaction, discontinue use. Prescribers should consult the Summary of Product Characteristics in relation to other side effects. Pharmaceutical Precautions: Store below 25°C. Do not refrigerate. Replace the cap after use and return tube to carton. Discard tube no later than 4 weeks after opening. Package Quantities: 100g tube, 40g tube. Basic NHS Price: 40g £7.91, 100g £13.38. Legal Category: GSL. Marketing Authorisation Number: PL 19876/0001. Full prescribing information is available on request. Marketing Authorisation Holder: Derma UK Ltd, The Toffee Factory, Lower Steenbergs Yard, Ouseburn, Newcastle upon Tyne NE1 2DF, UK.“Sebco” and “Derma UK” are registered Trade Marks. Date of Revision of Text: November 2019.