The local pharmacy is the most easily accessible place for customers to get on-the-spot advice on medical skin conditions, as well as general skincare tips for all the family. ‘Advice in convenience stores or supermarkets is rarely given,’ says Emma Charlesworth, communications manager at Numark. ‘It is important that pharmacies recognise this is where they can offer a point of difference and help increase customer loyalty.’
The British Skin Foundation’s spokesperson, consultant dermatologist Dr Anjali Mahto, says: ‘It would be helpful if pharmacy staff developed links with their local dermatology unit to understand how we use common treatments. One of the biggest problems we face is steroid phobia for inflammatory skin conditions such as eczema. It is important to encourage patients to use their topical treatment in the way that has been prescribed.’
At LloydsPharmacy, Joanne Carey agrees. ‘Patients may not be using their skin treatments in the correct way,’ she says. ‘The best advice a pharmacist can give is about correct application techniques to achieve optimum benefits from their treatments, which should help patients to better manage their condition.’
The average skincare category accounts for 5 per cent of total OTC shelf space, says Numark. ‘It’s important this space works hard for you and the range stocked provides maximum return in terms of profitability as well as offering customers a range of solutions,’ says Ms Charlesworth.
‘Consider the layout of your pharmacy and ensure skincare treatments are unobstructed and clearly visible. Signposting products for eczema, rosacea, psoriasis, etc, will help shoppers navigate the shelves easily,’ says Annelies Smits, senior international brand manager at Dermalex. ‘Assess your typical shopper and ensure you stock the right range of specialist skincare treatments to meet their needs.’
‘When building a skin conditions category, ensure the treatment of scars and stretch marks is considered as a specific condition,’ says Steve Riley, clinical pharmacist for Bio-Oil. ‘Reassure customers how common scarring and stretch marks are. Provide them with the information they need, using resource tools such as the SCAR guide to improve understanding of how to treat scars and stretch marks.’
‘To build a good category you will need a range of products to provide choice. Skincare treatments are subjective and the best treatment will be the one that customers are happy to use. The product range should cover treatment areas but also suncare, shaving, etc,’ says Ms Carey.
Caroline Fredj at GSK says: ‘GSK recommends pharmacy staff offer customers appropriate support and advice and recommend how much, how often and how to apply emollients. Invest time in pharmacy learning resources, such as MyPharmAssist, designed by GSK.’
‘Link sales should be straightforward, whether recommending a treatment regime within medicated or dry skincare or suggesting a cleanser and moisturiser to someone buying a toner,’ says Ms Charlesworth. ‘For customers with dry skin there are a variety of treatments available that can complement each other, such as emollients and bath preparations.’
‘In winter, anyone with dry skin and the elderly need to use a moisturiser daily. Makecustomers aware of the difference between types of emollient. Lotions are thinner and less moisturising than creams, which are less emollient than ointments,’ says consultant dermatologist Dr Susan Mayou at London’s Cadogan Clinic. ‘It’s fine for patients to use a mixture of different types.’
‘Research shows that 44 per cent of parents claim their child has experienced a dry skin condition, which highlights a huge opportunity to drive penetration into the £172 million skin health category,’ says Ms Fredj.
Top tips for managing dry skin include:
– Always apply moisturising hand cream after washing hands.
– ‘Limit time in the bath or shower to five to 10 minutes and use warm, not hot water,’ says Dr Mahto. ‘And wash with a gentle, fragrance-free cleanser or soap substitute.’
– ‘Look for products that will strengthen the skin’s lipid barrier to help skin retain moisture,’ says Imane Mahlous, Eau Thermale Avène skincare expert.
About 90 per cent of teens get acne and it can have a huge impact on self-esteem, so needs to be handled tactfully by pharmacy staff.
‘For mild acne, recommend a benzoyl peroxide 5 per cent product, which is best for oily skin and blackheads. Customers with pustules and papules should be referred to their GP for advice and treatment,’ says Dr Mayou. ‘Be aware that younger teens may present with acne but also have sensitive skin, so need to be wary of using harsh treatments on their skin.’
Topical retinoids (eg adapalene, tretinoin) are helpful in treating comedonal acne. ‘These can cause local irritation to the skin and it may be helpful to warn patients of this. Usually their use needs to be built up gradually to reduce redness and peeling,’ says Dr Mahto.
Advice to pass on to customers who want to manage acne:
– Use a gentle cleanser, twice daily. Pick one with blemish-fighting ingredients such as salicylic acid or benzoyl peroxide
– Use an oil-free, non-comedogenic moisturiser
– Use oil-free foundation
– Use fast-acting spot treatment gels/creams
– For more severe acne sufferers, blue-light therapy devices are now available for home use.
This is one of the most common skin conditions you’ll come across, with one in five children affected and one in 12 adults, says the National Eczema Society. People with eczema have skin that is less able to produce fats and oils and is less effective at retaining water. The protective barrier is weak and damaged.
‘Check eczema to see whether it is infected before recommending a treatment,’ says Dr Mayou. ‘It doesn’t have to be inflamed or weepy, even a small degree of redness can indicate infection. This needs referral to a GP.’
A new app has been introduced to encourage children to apply emollients. Called EmolliZoo and introduced by Dermal Labs, it is interactive and teaches children about eczema and emollients.
The National Eczema Society has introduced an online advice programme for sufferers, at www.eczemaadvice.co.uk. Developed with E45, it features an interactive symptom checker, case study videos, advice on how skin works and how to manage eczema.
Here is Dr Mahto’s advice to pass on to eczema sufferers:
– Use a topical steroid for flare-ups, as directed by the GP. Don’t use topical steroid at the same time as your moisturiser
– allow 20 minutes between treatments, otherwise you dilute the steroid.
– Smooth emollient onto skin in direction of hair growth. Don’t rub.
– Choose an emollient with a pump dispenser if possible. If you have a pot, use a clean spoon to remove product, not fingers.
– If the GP has prescribed tacrolimus or pimecrolimus, be aware that in 50 per cent of people this can cause burning or stinging the first few times it’s used. This does not indicate allergy and it is important to persevere.
‘It’s important that customers with psoriasis use an emollient daily in addition to any prescribed treatments. Emollient should normally be applied before the psoriasis treatment,’ says Dr Mayou. ‘Psoriasis can be triggered by stress, so encourage relaxation techniques such as yoga and mindfulness and encourage patients to adopt a healthy lifestyle.’
He advises reminding patients to make sure treatments are being used as prescribed by their doctor. ‘Small amounts of UV radiation can be helpful in improving psoriasis, but take care not to get sunburnt,’ he says.
Finding skin cancer early saves lives and pharmacists are in a good position to encourage customers to seek advice early if they spot anything new or unusual on their skin. Remember the ABCD rule: asymmetry (two halves of the mole not the same), border (edges are irregular, blurred or jagged), colour (uneven), diameter (wider than 6mm).
Other signs to watch for: a new growth or sore that won’t heal, a spot, mole or sore that itches or hurts, a mole that bleeds, crusts or scabs.
‘Remind customers of the importance of using sunscreen daily during summer’ says Dr Mayou.
‘Even medical creams and lotions contain preservatives and can sting sensitive skin. Ointments are preservative-free, so recommend these to customers with sensitive skin who complain of stinging/burning when using emollients,’ says Dr Mayou.
General skincare tips
Dermalex, a range for eczema, rosacea and psoriasis, is being launched into independent pharmacy. The launch will be supported by a £1.5 million campaign. Pharmacy teams can register for Omega Pharma’s training seminars, which will focus on making a difference to customers suffering with chronic skin conditions.
Bio-Oil has a number of online resources available for health professionals, including the quick reference SCAR and CARE guides.
GSK has launched a daily moisturising product into its Oilatum Junior range. Oilatum Daily Junior Lotion is suitable for babies and children, designed to moisturise dry skin every day, and is suitable for eczema-prone skin.
Coll Michaels, Calverton Pharmacy, Luton ‘We have a small section of skincare, but we don’t carry many of the premium brands. It really depends on the area your pharmacy is in what type of products you can carry and which ones you can’t. We have to put more expensive products in a locked cabinet, because things do tend to go walkabout. I used to have very upmarket West End pharmacies and we had only the best products, but in my current pharmacy, we don’t stock anything priced above £5. Generally, I think the skincare category lacks credibility, compared to other parts of what the pharmacy offers.’
Fiona McElrea, Whithorn Pharmacy, Whithorn ‘I’d say this is a very important category for us, and we stock a lot of skincare products. This ranges from dry skin conditions, for adults and children, to bites and stings, and sun damage. Our best selling brands are the E45 range, Oilatum, Cetraben and Epiderm. To be familiar with each product and how to use them is really important. Some people are allergic to certain additives, so doing a bit of background research into that has really helped me give advice. I think we have the category merchandised quite well. With skincare in particular, people usually go for the brands they are familiar with and the branded products sell very well. Some of the products are quite expensive, which can puts a few people off, but if they are eligible to be prescribed on the minor ailments scheme then they might be sold that way instead.’
Shaheen Bhatia, Broadway Pharmacy, Bexleyheath ‘More and more people are suffering from skin conditions, so this is quite an important area. Parents of children with eczema want to know about getting the right product. General baby products aren’t necessarily suitable, so they need to speak to us about using an emollient, and at what stage they would to be referred to the GP. E45, Cetraben and Aveeno and good sellers. Personally, I would swap toiletries for these type of products and highlight that you’re more health oriented. One way to improve the category is to speak to the reps, and take information leaflets from them as updates. For some people emollients seem to be trial and error, and they will need advice until they find something that works for them.’