Melanie Sutherland
Dermatology Nurse Registrar at NNUH Trust and Trustee, British Dermatological Nursing Group (BDNG)
Sarah Copperwheat
Community Dermatology Nurse CNWL NHS Trust, Trustee, British Dermatological Nursing Group (BDNG) and Chair, Dermatology Council for England
Emollients are an integral part of treatment for all dry skin conditions. They often get overlooked and not enough attention is given to their importance.
An emollient is a product that helps to hydrate the skin by either trapping moisture in the skin called occlusion or increase the amount of moisture in the skin called humectant.
Emollients come in different formulations such as ointments, creams, lotions, gels and sprays. As a general rule, the drier the skin, the greasier the emollient that is recommended.
However, the best emollient should be based on the one the patient likes and more importantly the one they will use. They can be used as a soap substitute and/or a leave on treatment.
Accessibility of emollients on NHS
In 2017, the cost of medicines prescribed in primary care was 9.1 million. NHS clinical commissioners approached NHS England to discuss ways of reducing this which led to a consultation process.
Consequently, a document titled ‘Conditions for which OTC items should not routinely be prescribed in primary care – guidance for CCG’s’ was published. On the list were emollients for dry skin. However, further into the document, it was clearly stipulated that those patients with a diagnosis of eczema, psoriasis, ichthyosis or a chronic skin complaint were still entitled to receive emollients on prescription.
In 2017 the cost of medicines prescribed in primary care was 9.1 million.
Greater clarity needed
Unfortunately, not all CCG’s saw this information, and patients had their emollient prescriptions stopped. This led to many patients contacting the National Eczema Society and Psoriasis Association to clarify the situation.
In response to this, letter templates were put onto support group websites to be used by patients to ask their GP to prescribe the emollients they were entitled to. However, this process took time, meanwhile people with skin conditions suffered.
Impact of stress on skin conditions
Emollients are a vital component to any dry chronic skin treatment regime, to have these items stopped albeit for a short time causes confusion, upset and financial difficulty for many. The added stress from this situation also often negatively affects skin conditions. To be stopped from using the most important part of a daily routine has had a significant effect on the quality of life of chronic skin condition sufferers.
If you have a diagnosed chronic dry skin condition, make sure you are aware of your rights and obtain the emollient needed from the GP.
