Following my first blog I was pondering the next topic to cover while at a local car boot when I spotted several stalls selling emollients. It had to be the topic, in a climate where we are encouraged to save the NHS money I wondered how many more emollients are being prescribed and then sold in a variety of settings – yes they are being sold online too.
Emollients are the mainstay of treatment when managing dry skin conditions. The term comes from the Latin meaning to soften, and commonly the terms ‘moisturiser’ (to add moisture) and ’emollient'(to soften) are used interchangeably.
As more staff are now able to prescribe these treatments, I feel more emphasis and focus should be placed on the important part they have to play. When I see patients and their families in clinic’s they often come armed with a very long list or carrier bag full of products they have been prescribed or purchased. They are often confused and unhappy and are not using the products correctly.
Providing a treatment plan for dermatology patients involves more than a prescription and for our patients it needs to be realistic and achievable. It’s our responsibility as prescribers to help them. I link this to baking – yes I am a fan of Bake Off. If we want our patients to have a positive outcome with their treatments we need to keep it simple with a few ingredients (products), or set them up to fail with a long list of ingredients that may or may not work. So think of the analogy as a simple victoria sponge cake or a wedding cake - which could you manage?
There is more to emollients than meets the eye; they are a medication that’s applied to the skin and have no lesser importance than any other medications administered orally or via other routes. Therefore, they afford the same principles of prescribing. They come in a variety of formulations and sizes, and the consistency and choice are important aspects for patients. Having an understanding of the ingredients, additives, modes of action and adverse effects are key and for patients they need to know how to apply and use them effectively.
When prescribing them, reviewing these aspects are fundamental, and yes, cost is important in this current climate. But the most cost effective measure is ensuring the emollient being used is the one appropriate for the condition being treated. Therefore this doesn’t allow surplus products to be wasted or as I see them – being sold on.