10-minute clinic: dry skin and eczema

This handy 10-minute clinic is designed to act as a quick reference guide that will help you when advising customers in different category areas. The flowchart leads you through the decision-making process to help you respond to customer queries. This month, we look at the advice you can offer and the products you can recommend to customers suffering with dry skin and eczema.

At a glance

Use with caution

Customers who are using emollient therapy should be aware of the potential risk of serious burns, according to the Medicines and Healthcare products Regulatory Agency (MHRA). 

Emollient products are not flammable themselves. However, they act as an accelerant, increasing the speed of ignition and intensity of fire when fabric with dried-on residue is ignited. 

Fabrics that have come into contact with an emollient, such as clothing, bedding and dressings, can be highly flammable, even after washing. This holds true for paraffin-based as well as paraffin-free emollient products. 

The MHRA therefore says that patients should be advised: 

• Not to smoke, use naked flames (or be near people who are smoking or using naked flames) or go near anything that may cause a fire while emollients are in contact with their clothing or medical dressings
• To change their clothing and bedding regularly – this may remove some of the product build-up, but not all of it. 

Whenever you talk to a customer, remember WWHAM

Who is it for?

It may not be the customer who needs the treatment. If the customer is buying for someone else, it is important that they are able to fully explain to the patient how the product should be used. Always refer them to the patient information leaflet (PIL) and directions on the packaging.    

What are the symptoms?

Refer the customer to the pharmacist if there are symptoms of an infection.     

How long have the symptoms been present?

This will help you to establish the cause of the condition.

Action already taken?

This will help you to establish if the customer has already tried a product that hasn’t helped or wasn’t appropriate.   

Medication? 

If the patient is taking any other medication, it is important to refer the customer to the pharmacist. 

You don’t have to ask these questions in order, and a customer might give you some of this information before you ask for it. As long as you start a conversation, you should be able to get the information you need in order to make a recommendation.

The golden rule to remember is: if in doubt, refer to the pharmacist. 

Don’t be embarrassed to ask for their advice as they have a lot of information about products and symptoms to hand that you may not be aware of.  

When to refer to the pharmacist 

• If the condition has not improved with the use of emollients
• If dry skin has cracked and the skin is broken or bleeding
• If dry skin is painful or appears to be infected
• If the sufferer has extremely dry skin or eczema on their face. 

Self care tips

• Apply emollient at least twice daily in downward strokes – an average of 600g a week is recommended for adults
• Use a complete skincare regimen: shower and bath products, as well as cream and/or lotion for moisturising
• Avoid using soap and soap-based bath and shower products as these can really dehydrate the skin. Soap substitutes (e.g. emollients) should be used instead
• Wear cotton, silk or soft man-made fabrics next to the skin, but avoid wool
• Children can wear cotton mittens at night to reduce the impact of scratching
• Use non-biological washing powders, which may be less likely to irritate the skin
• Wash bedclothes and vacuum beds and carpets frequently to control house dust mites
• Keep pets out of the bedroom because fur and feathers can irritate the skin
• Wear an effective UVA/UVB high protection sunscreen in the spring and summer. 

Signposting

• The NHS - Ezcema
• National Eczema Society