Winter plays havoc with skin, especially for customers with conditions such as eczema, rosacea and psoriasis.

There’s not much we can do about biting winds, freezing temperatures and drier indoor atmospheres during winter, but there’s plenty of advice that pharmacy teams can offer customers so that their skin doesn’t suffer at this time of year. “It’s important to ensure that all pharmacy staff are well educated about the variety of different skin conditions prevalent in winter,” says Laura Crichton, brand PR manager at Nelsons. “Winter weather presents such different skin conditions from the summer months, so it’s important that staff know what common conditions to look out for and what advice to offer.”

How winter affects the skin

“Lower humidity in the atmosphere and central heating combine to dry out skin and also damage its protective barrier layer,” says consultant dermatologist Dr Nick Lowe from London’s Cranley Clinic. “The main skin conditions that tend to worsen are eczema, dry skin and psoriasis, but acne can suffer too.”

Dr Anjali Mahto, consultant dermatologist and British Skin Foundation spokesperson, adds: “Many people find their rosacea flares in the winter months. This can often be related to the wind, in addition to temperature fluctuations between the cold air and heated indoor rooms.”

 

Skincare advice to offer customers with eczema

Dr Lowe has these tips for pharmacy teams to pass on to customers with eczema this winter: ô€€€

• Avoid hot baths and showers as they damage the skin’s barrier layer ô€€€
• Use a soap substitute for cleansing the skin (e.g. one with ingredients such as glycerine or panthenol) ô€€€
• Remember that stress worsens eczema, so build in some relaxation time each day ô€€€
• Refer customers to their GP or dermatologist if their eczema worsens considerably.

According to Joanne Carey, LloydsPharmacy pharmacist and healthcare development manager, the biggest issue is ensuring that customers understand how to apply emollients correctly. “Emollients should be used all over the skin, not just the dry areas,” she says.

“If used correctly, patients should be using about 500g per week. This information may not be given by their GP, so Winter plays havoc with skin, especially for customers with conditions such as eczema, rosacea and psoriasis. this is where pharmacy staff can step in.”

Jerome Lemaire, UK marketing director at Reckitt Benckiser, which makes the E45 brand, adds: “A vital element in the treatment and management of dry skin and eczema, regardless of severity, is emollients. A complete emollient regime means using a combination of emollients as part of a daily routine.

“It’s important to avoid soaps and detergents, which can undo the beneficial effects of emollients. Pharmacists should explain that by using the right products throughout the whole day, the symptoms of mild eczema can often be relieved.” Finding the right emollient is crucial.

“The best emollient is one the patient will use and finds most agreeable,” says Mr Lemaire. “Educating the patient is also crucial to improving outcomes – if you explain the underlying cause of the dry skin condition and the need to frequently use emollients, this will lead to improved compliance.” It’s also important to explain the proper use of topical steroids.

According to Ms Carey, lots of people are afraid of using these, which means they often don’t use enough and end up having to use them for longer than should really be necessary. Ms Carey has these additional tips for pharmacy teams to pass on to customers: 􀀀

• Avoid using fragranced products on the skin – use specialist bath and shower washes instead ô€€€
• Wear gloves in cold weather ô€€€
• Use the richest emollient the person can tolerate. An ointment is good for night time use; a cream for use during the day ô€€€
• Maintain a constant temperature indoors – ideally around 18^oC in bedrooms and 21^oC in living rooms 
• Use a humidifier or bowls of water by radiators to counteract the drying effect of central heating.

Preventing rosacea flare-ups

Going from the cold outdoors to a warm indoor environment increases blood flow to the face and this can worsen rosacea in winter. To prevent problems, Dr Mahto offers these tips:

• Minimise time outdoors and use a scarf to protect the face from the wind
• Wear loose, layered clothing to protect from cold outdoor weather and indoor heat
• Use a sunscreen all year round
• Limit consumption of hot drinks and alcohol
• Continue using regular rosacea medication as directed.

For additional information about rosacea, its triggers and management, see skincare brand Dermalex’s new website.

Caring for dry lips

Lips are thin and have a poor barrier layer, so they dry out more easily than the rest of the face. It is therefore especially important that customers choose a super-moisturising, long-lasting lip protection balm and apply it daily during winter. “Frequent use is key to preventing dry, chapped lips,” says Dr Lowe.

“A good lip balm should be used before bed, not just during the day. Recommend one with ingredients such as glycerine and petroleum jelly.” If lips do become dry and flaky, customers can apply a little petroleum jelly to their lips and gently rub the area with a soft toothbrush – this will remove the dry skin and leave the lips feeling soft and hydrated.

Looking after hands

It’s important not to overlook hands during the winter. They’re often the first part of the body to dry out as they’re continually exposed to the elements. It’s good practice to recommend that customers use an SPF15 protective hand cream to stop the cold weather causing problems such as dryness and age spots. “Customers should always apply a hand cream at night before bed during the winter months,” says Dr Lowe. He also advocates using a moisturising hand wash that is soap-free. “It’s good to get into the habit of moisturising hands after washing them and carrying a hand cream with you,” says Dr Mahto. Recommend that gloves are worn outdoors for additional protection.

Comment

 

Rena Dadra, Village Pharmacy, Harlington ‘We are seeing a lot of prescriptions for young children and babies for creams for eczema-related issues. It’s a busy category for us. But many people assume that the doctors should be their first port of call for skin issues, but pharmacists and pharmacy are another place they could go to get great advice. More promotion on going to pharmacy for advice would definitely help, because we’re medically trained professionals who are here and ready to help. Doctors could also be referring people to us if they don’t have appointments available. Counselling and advice on skin conditions is something we’ve tried to improve as a team to make sure we’re giving the best and most current advice we can to patients.’