Many people with skin conditions such as eczema, psoriasis and acne, as well as scars and old or unwanted tattoos, can find their self esteem is negatively affected. This article looks at skin camouflage, a cosmetic technique that can nonetheless provide patients with a way of lessening the psychological impact of skin conditions.
With so much choice, there can be uncertainty around which skin preparations to use in people with skin that is damaged or in danger of becoming compromised. However, community nurses are ideally placed to carry out skin assessments, provide education and work with patients to identify an effective emollient package. Patient choice is crucial and should be available to patients of all ages with vulnerable, dry or scaly skin conditions. Patient education and written management plans are also essential for the successful management of dry skin conditions. However, choosing one type of bath additive or emollient over another can create confusion for healthcare professionals and patients alike and this article sets out some basic principles for successful management.
Vulval health disorders can be painful and chronic conditions. The link between long-term painful illness and the mental wellbeing of patients is firmly established. Taking into account the nature of vulval health conditions, it is important to gain an understanding into the impact they can have upon a patient’s quality of life. As part of an initiative aimed at expanding insight into the realities of living with this type of problem, the British Association of Dermatologists surveyed 325 British women who had suffered, or were currently suffering, from a vulval health disorder.
The study took the form of an online survey, collecting mostly quantitative data, with some qualitative insights. Responses were gathered under the categories of demographics; vulval condition; treatment; physical impact; impact upon career and social life; impact upon romantic and/or sexual relationships, and effect on emotional and mental wellbeing. Eighty-nine percent of survey respondents reported that their vulval health disorder had negatively affected their emotional and mental wellbeing. Patients suffering with a vulval health disorder were twice as likely to have suffered with depression and 22% reported having contemplated self-harm or suicide as a result of their condition. Overall, vulval health conditions were found to have a significant impact on quality of life for patients, affecting every aspect to some extent.
Many skin conditions, while no longer requiring hospitalisation, still require a level of knowledge and skill from community nurses, particularly with assessment and diagnosis. Atopic eczema is one such skin condition and can cause significant discomfort, particularly when inflamed skin becomes virally infected, leading to to complications such as eczema herpeticum and molluscum contagiosum. Both of these viral infections can increase the discomfort of eczema, leading to a variety of symptoms including blisters, sore skin, itch and rash. It is important that community nurses are able to identify skin conditions of this type and know whether to treat themselves or refer on to dermatological specialist nurses for more specialised management.
Skin reactions and insect bites associated with the spring and summer months are commonly seen in community settings. In this article, the author provides an overview of the most common skin reactions, including skin cancers, that can occur through increased exposure to the sun, as well as highlighting management techniques for community nurses faced with patients who have seasonal-associated skin complaints. With prevention being key, particularly where melanoma are concerned, this article provides a useful source of information for community nurses dealing with skin problems at this time of year.
Atopic eczema is a frustrating and complex skin condition that has no cure. However, with good support, education and the correct application of topical treatments it can be well-controlled. Community nurses can provide patients with information about their condition, how to apply their topical treatment effectively and how to manage flares and maintain a routine that will improve the eczema and the patient’s quality of life. Any information provided should be reinforced with written information and a treatment plan, with follow-up support offered as needed.
Psoriasis can be a long-term condition, which is a significant problem for approximately 2% of the UK population. Recent NICE guidance on the treatment of psoriasis provides much-needed advice and reminds clinicians of the importance of assessment (both physical and psychological) and of talking to patients about side-effects and mode of action. Primary care nurses are in a great position to work with patients to ensure that they have the optimum treatment regimen, and that they have realistic expectations as to how it will work. An optimum regimen should always include an emollient, a topical product to treat plaques on the body along with topical products for scalp, face and flexures as necessary.
Rebecca Penzer, Community Dermatology Specialist Nurse/Clinical Lead Community Dermatology, Community Nursing and Therapy Norfolk Community Health and Care NHS Trust
Maureen Benbow gives an overview of the structure and functions of the skin and discusses the financial implications to the health service of skin failure
Maureen Benbow MSc BA RGN HERC Senior Lecturer, University of Chester
Article accepted for publication: March 2007
