Acne is one of the most common skin conditions and most commonly affects adolescents. It causes spots to develop on the skin, usually on the face, back and chest. The spots can range from surface blackheads and whiteheads to deep, inflamed, pus-filled pustules and cysts. Acne cannot be cured, but it can be controlled with creams, lotions and gels that can be bought in the pharmacy. Customers with persistent acne that has not responded to OTC treatments may need to see their GP for prescribed antibiotics. Refer to the pharmacist if unsure. The key advice for managing acne is: cleanse, treat, moisturise.
Bed bugs are blood-sucking parasites which hide in the cracks and crevices of mattresses and bed frames and come out to feed on unsuspecting hosts during the night. Bed bug bites usually appear in a straight line on exposed areas of skin, such as the face, neck, hands, and arms. Antihistamine cream can be recommended if the bites are itchy. Bed bugs are extremely difficult to get rid of, so advise customers to contact a professional pest control firm to eradicate the infestation. Some councils also offer a bed bug eradication service.
Corns and calluses are hard, thickened areas of skin that are caused by rubbing, friction or pressure. They often form on the feet and can make walking painful. The cause is usually ill-fitting footwear. OTC treatments such as protective corn plasters, customised soft padding, foam insoles, foam wedges to place between the toes, special rehydration creams for thickened skin and products containing salicylic acid which soften the top layer of dead skin, may provide relief. When recommending products, also advise customers to wear shoes that reduce the pressure on the toes and feet.
Dandruff occurs when the skin cells on the scalp die and shed faster than normal. This leads to patches of dead skin flakes forming on the surface of the scalp. The scalp may feel dry and itchy. Daily washing of the hair with a mild shampoo may clear the problem. Recommend an anti-dandruff shampoo for more severe cases and advise customers to avoid using hairspray or other products that may irritate the scalp.
Eczema, also known as dermatitis, is a long-term dry skin disease. Eczema causes areas of skin to become itchy, dry, cracked, sore and red. Scratching can cause the skin to bleed and lead to secondary infections. Eczema can affect people of all ages, but is primarily seen in children. There is no cure, but treatment can ease or control symptoms and prevent flare-ups. Treatment consists of avoiding triggers that irritate the skin (e.g. allergens, soaps and detergents) and using emollients (specialist moisturisers) every day. The pharmacist or GP may also advise the use of topical steroid creams or ointments when eczema flares up.
Fungal skin infections are caused by different types of fungi and yeasts which thrive in dark, moist, warm environments. One of the most common fungal infections is athlete’s foot, which causes a particular fungus to grow between the toes and makes the skin scaly, flaky and dry. Most cases can be cured with over-the-counter antifungal products and good basic hygiene.
Guttate psoriasis is a form of psoriasis that causes small red spots on the skin. It occurs most often in children, adolescents and young adults and is often triggered by a bacterial sore throat. Usually the rash resolves within a few weeks or months without treatment. In the meantime, you can advise customers to use emollients to ease their symptoms.
A wide range of skincare treatments are avaliable in pharmacy
Herpes simplex is a viral infection that causes cold sores to appear as small blisters, most commonly on the lips or around the mouth. They usually clear up on their own in about 10 days. OTC antiviral creams will speed up the healing time, but work best if they are applied as soon as the first signs of a cold sore (a tingling sensation in the affected area) appear.
Impetigo is a contagious skin condition that is most common among children. It typically affects the skin around the nose and mouth, where it causes inflamed red sores, scabs or moist-looking golden crusts. Antibiotics are usually needed to clear up impetigo because it can easily be passed from person to person if left untreated.
Juvenile plantar dermatosis, also known as sweaty sock syndrome, involves the cracking and peeling of the soles of the feet. The condition is most common in boys between the ages of three and 14 and is caused by friction from the foot moving up and down in a shoe, especially when it is sweaty. Advise customers to buy wellfitting leather shoes, to wear cotton socks and to have some days with little or no walking to allow the skin to heal. Putting plasters over the cracked skin and applying a greasy moisturiser or barrier cream may help too.
Keratosis pilaris is a common, harmless, inherited skin condition where the skin becomes rough and bumpy, as if covered in permanent goose pimples. It is sometimes referred to as ‘chicken skin’. There is no cure, but you can advise customers to use soap-free cleansers, to moisturise the skin when it is dry and to rub it gently with an exfoliating pad or pumice stone to clear away the rough areas.
Acne is one of the most common skin conditions and most commonly affects adolescents
Lichen planus is an itchy rash with purple-red coloured bumps that are slightly raised, shiny and have a flat top. It usually occurs in adults. The condition is thought to be linked to the immune system and sometimes occurs as a result of an abnormal immune response to certain medicines. Steroid creams or ointments may be prescribed to help relieve the itch and control the rash.
Melanoma is a severe and potentially life-threatening skin cancer. Warning symptoms include the appearance of a new mole or a change in an existing mole – e.g. it is getting bigger; changing shape; developing an irregular edge; changing colour; becoming itchy or painful; bleeding; is asymmetrical, crusty or inflamed. Anyone with a suspicious mole should see their GP as soon as possible.
Nickel allergy commonly develops as a result of ear piercing or wearing nickel-containing jewellery, watches, jean studs or buckles. It causes dermatitis at the site where the nickel has been in contact with the skin. Advise customers to avoid contact with objects that can cause a reaction. Antihistamine creams or tablets can help to ease mild symptoms.
Otitis externa is an infection of the skin of the ear canal. Symptoms include ear pain, which can be severe, itchiness, discharge of liquid or pus from the ear and some degree of temporary hearing loss. The inflammation may be caused by infection, allergy or another cause, such as swimming. Refer customers with suspected otitis externa to the pharmacist, who will be able to confirm the diagnosis and either offer OTC treatment or refer the customer to their GP.
Psoriasis is a skin condition that causes red, flaky, crusty patches of skin covered with silvery scales, normally on the elbows, knees, scalp and lower back. The patches may be itchy or sore. Psoriasis occurs when the process by which the body produces skin cells is accelerated. The cause of this is thought to be related to the immune system. There is no cure, but treatment from the GP will usually help to keep the condition under control.
Quaternium-15 is a preservative used in many cosmetics and industrial products. It can cause an allergic reaction and contact dermatitis, especially in those with sensitive skin. If a reaction is suspected, the customer should avoid products that contain this ingredient and use emollients to keep their skin hydrated. If the condition does not clear up, the pharmacist or GP may advise the use of topical corticosteroids.
Rosacea is a long-term skin condition which most commonly affects middle-aged and fairskinned people. It often begins with flushing, but additional symptoms include burning and stinging sensations, permanent redness, spots and small blood vessels in the skin becoming visible. The exact cause of rosacea is unknown, but the range of possible causes include abnormalities in the blood vessels of the face, a reaction to microscopic mites commonly found on the face, problems with the immune system, sun damage and genetics. Treatment involves a combination of self-help measures, such as avoiding triggers and using products for sensitive skin. A GP may prescribe topical treatments and antibiotics if the condition is severe.
People with sensitive skin may complain that their skin is prone to itching, dryness and irritation. There are many causes, ranging from allergies, the use of skincare and household products, exposure to extremes of the weather, central heating, dirt and pollution and hard water – the list is endless. Advice should include choosing moisturising products that do not contain perfumes, dyes or harsh chemicals; drinking plenty of water to keep the body hydrated; using a moisturiser with an SPF to protect the skin from the sun; using soap- and alcoholfree cleansers, and patting rather than rubbing skin dry after washing to avoid unnecessary irritation.
Thrush is an infection of the skin that is caused by candida, a group of yeasts. Most women experience occasional bouts of vaginal thrush, which causes itching, irritation and swelling, sometimes with a creamy white, cottage cheese-like discharge. Thrush can be treated with OTC creams, pessaries or tablets.
Urticaria, also known as hives, is a raised, itchy rash that appears on the skin. It can be triggered by an allergic reaction to substances such as latex; exposure to cold or heat; infection; chemicals found in food, and some types of medication. In many cases, treatment isn’t needed because the rash gets better on its own. However, OTC antihistamines can be recommended to speed up healing and stop any itching.
Vitiligo is a condition that makes the skin turn white in patches where there is a lack of melanin, a chemical that gives the skin (and the hair) its natural colour. It is not clear exactly why this happens, but it has been linked to faults in the immune system and nerve endings in the skin. The white patches – which must be protected from the sun – are normally permanent, but can be hidden with camouflage cosmetics. GPs can offer advice on possible treatments.
Warts are raised bumps on the skin caused by the human papillomavirus (HPV). They often develop on the hands or feet – verrucas, for example are warts on the soles of the feet. Most warts are harmless and clear up without treatment. A range of wart and verruca treatments, including creams, gels, paints and medicated plasters, are available OTC to help the warts clear up more quickly.
Dry skin can occur for many reasons – from the weather and washing with soap-based products to certain medical conditions and the natural ageing process. Customers with dry skin should avoid cleansers and wash products that contain soap, detergents and fragrance, and opt for moisturising, fragrancefree, emollient types instead.
Yaws is a chronic skin infection caused by the same family of bacteria as syphilis. However, it is only commonly found in about 14 tropical countries, so you are unlikely to see a case in a UK pharmacy.
Herpes zoster, commonly known as shingles, is a viral disease that is characterised by a painful skin rash with blisters. Shingles is triggered by an initial infection with chickenpox, which may live in the nerve tissues for years before reactivating as shingles. The shingles rash is contagious until all the blisters have scabbed and are dry. While it is contagious, people with shingles can pass chickenpox (but not shingles) on to other people. Refer customers with suspected shingles to the pharmacist.