Managing eczema
Paaven Patel, Operations and Quality Assurance Pharmacist at Specialist Pharmacy, shares five ways your pharmacist can help manage eczema.
Eczema, a type of dermatitis, is a chronic inflammatory skin condition which is characterised by dry, itchy, and inflamed skin. The skin can appear red and blistered and can be caused by a variety of factors such as genetics, environmental triggers, and allergies. According to the data in the UK, eczema is a common condition that affects around one in five children and one in 10 adults in the country.1
Now, more than ever, patients are seeking therapeutic options which are specifically tailored to their therapeutic needs, considering unique allergies, sensitivities, and intolerances. As the body’s largest organ, what you put on your skin matters and through personalised medication, we can really improve a patient’s overall health. Personalised medicine is useful for guiding the selection of medications based on the patient’s genetic profile, medical history, and responsiveness to previous treatments. One of the main reasons why a prescriber will want to look into personalised therapy is due to patient dissatisfaction with their current treatment plan. If a patient is not complying due to a dislike of the consistency, smell, or side effects of their current treatment, then they are not going to be getting the desired results needed to treat their condition. In these circumstances, a preparation which has been prepared specifically for their needs may be the perfect solution to improve adherence and allay any fears or concerns that the patient might have about their treatment.2
For patients who are suffering with symptoms caused by eczema, a prescriber can work closely with a compounding pharmacy to formulate an all-in-one medication that can relieve redness, itching and swelling. The aim would be for patients to receive the exact required dose to relieve their symptoms, rather than using a standard medication which could potentially be too strong or not strong enough. Furthermore, ingredients can be combined in a synergistic approach, for example, vitamin E could be combined with hydrocortisone to relieve symptoms of redness and inflammation while adding moisturising effects. Another approach can be adding a numbing agent, such as lidocaine with clobetasone, which can help reduce the need for scratching whilst also treating inflammation.
Working with a compounding pharmacy means that only the highest quality ingredients are incorporated being into a medication. Compounding allows for the thoughtful consideration of how active pharmaceutical ingredients are best suited in a specific vehicle, thereby maximising efficacy and tolerability and providing the flexibility to customise treatments according to the patient’s concerns. The dosage strength of the active ingredients can be adjusted to meet patient requirements, and unique combinations of active ingredients can be developed in physiologically relevant ratios. Additives or ingredients to which the patient is allergic/sensitive can be removed, and the base can be changed, for example, if a patient prefers a cream to a gel, creating a superior product in terms of patient satisfaction and results. The tailored approach is very often driven by the patient and their personal preference. It will provide the best dose and form and deliver the benefits needed, with a far reduced risk of any side effects and improved adherence to therapy.3
Pharmacists can play a crucial role in helping patients manage eczema as they can help develop a personalised treatment plan which can offer a more effective and targeted approach to managing the condition. Five ways in which pharmacists can help manage eczema are explained below.
Genetic testing: Genetic testing can help identify specific genetic variations associated with eczema and reveal specific biomarkers that will dictate whether a particular medication will be effective for that patient. The skin microbiome plays a role in eczema development, so by analysing an individual’s skin microbiota, one can help in identifying imbalances and guide interventions to restore a healthier skin microbiome.4
Allergen testing: Pharmacists can offer advice on allergen avoidance or testing strategies. This may include information on hypoallergenic products, like detergents and soaps, and guidance on identifying and minimising exposure to common allergens, such as dust mites, pet dander, and certain foods. Allergen-specific IgE blood tests or skin prick tests can pinpoint the specific allergens that trigger a person’s eczema. This information can guide allergen avoidance strategies.5
Signposting and referrals: Pharmacists can assist in monitoring a patient’s progress in managing their eczema. They can help patients track their symptoms and the effectiveness of their treatments. If a patient’s eczema worsens or does not respond to over-the-counter treatments, pharmacists can refer them to a dermatologist or healthcare provider for further evaluation and management.
Expert medication information: For patients with more severe eczema, pharmacists can provide information about prescription medications commonly used to manage eczema, such as topical calcineurin inhibitors (e.g. tacrolimus) and topical corticosteroids. They can also explain the potential side effects, proper application methods and adherence strategies.
Condition education: Pharmacists can provide information on potential eczema triggers, such as dietary or environmental factors and how to manage the condition with advice on gentle skincare products. They can also advise on over-the-counter products where it could potentially be indicated for the patient. Engaging patients in their care and educating them about their condition is a fundamental aspect of personalised medicine. Understanding the individual’s needs and preferences is key to designing a successful treatment approach.6
Pharmacists play a key role in the management of eczema. Not only do they provide emotional support for what can be an incredibly distressing condition that may drastically impact their quality of life, but they can also answer questions and provide guidance to help patients manage their condition effectively. Some patients may prefer natural remedies, while others may want pharmacological interventions. The treatment plan should be aligned with the patient’s preferences and priorities, and a pharmacist can help make this personalisation happen.