Skincare Flashcards
1
Q
How do dry skin problems develop?
A
When the balance between the skin’s moisture content and natural moisturising factors, eg certain skin lipids, is compromised. It is often temporary, but can be a symptom of a long-term condition
2
Q
What are the symptoms of problem dry skin?
A
Every customer is different, so it’s useful to use WWHAM
Problem dry skin
- Mild scaling
- Roughness
- A feeling of tightness
- Itching
3
Q
Symptoms of extremely dry skin?
A
- Roughness
- Chapping and a tendency to form cracks and fissures
- Callus formation/ scaling
- Frequent itching
4
Q
What are the symptoms of Atopic dry skin and eczema?
A
- Scaling, rough skin with thickening and cracking
- Intense itching
- Tendency to become red and inflamed (atopic eczema)
5
Q
Who suffers from dry skin?
A
Many poeple can, particularly common in children under 10 years and people over 60. It affects more women than men.
6
Q
External factors to dry skin?
A
- Environmental causes, including dry air from central heating systems and air conditioning
- Contact with chemicals, including washing detergents and soap.
- Certain skincare products and medicinal preparations
- Poor diet
- Smoking
- Exposure to UV rays
7
Q
Internal factors to dry skin?
A
- Biological skin ageing- as we age, there is reduced cell turnover, and diminished secretion of sweat and production of sebum
- Hormonal influences
- Certain illnesses eg asthma, or other skin conditions
- Genetic factors
8
Q
What are the treatment options?
A
Dry skin has been identified as a self-limiting condition, eczema is not a self-limiting condition.
There are moisturisers available for the treatment of dry skin. These all aim to replace the water lost from the skin or restore the balance of the oils in the skin’s outer layer.
Eg: Diprobase Daily Moisturising Cream, E45 Cream
The recommended first line treatment for very dry skin is emollients
9
Q
Caution?
A
Caution for customers using any type of emollient therapy should be aware of the potential risk of serious burns. Paraffin-based and paraffin-free emollients can soak into fabric such as clothing, bedding and dressings and these can become fir hazards.
- advise customers not to smoke or be near people who are smoking, naked flams, or anything that may cause a fir while emollients are in contact with their medical dressings or clothing
- Advise customers to change clothing and bedding regularly - this may remove some of the product build-up but not totally remove it
- Report any fire incidents with emollients or other skincare products via the Yellow Card Scheme
10
Q
Red flags with dry skin?
A
Refer to the pharmacist if:
- The condition has ot improved with the use of emollients
- Dry skin has cracked and the skin is broken or bleeding
- Dry skin is painful or appears to be infected
- The sufferer has extremely dry skin or eczema on their face
11
Q
Check out aveeno pages on book
A
dermexa, abby, etc
12
Q
Self-care tips?
A
- Apply an emollient at least twice a day in downward strokes. an average of 500g per week is recommended for adults for total body coverage
- Use a complete skincare regimen: shower and bath products in addition to a cream/ lotion to help lock in moisture absorbed by the skin during bathing
- Avoid using soap and overly perfumed bath/shower products, as this can aggravate the skin, lead to dryness and worsen the condition
- Wear cotton, silk, or soft man-made materials next to the skin
- Avoid contact with materials such as wool
- Children can wear cotton mittens at night to reduce the impact of scratching
- Use non-biological washing powders, which may be less likely to irritate the skin
- Keep pets out of the bedroom as fur and feathers can irritate skin
- Use a balanced UVA/ UVB high protection sunscreen that is at least SPF 30
13
Q
How do emollients help with managing dry skin?
A
- help keep skin moisturised
- reduce flaking and flare-ups
14
Q
An example of when emollients are used?
A
In treatment of atopic dermatitis, often prescribed in conjunction with prescribed products, eg steroid cream
15
Q
How do emollient products work on the skin?
A
- Emollient product form a protective layer on the skin. This helps to prevent moisture escaping from the skin and softens it, making it more pliable and comfortable
- Help to reduce roughness and dryness, and improve appearance
- May also reduce irritation and itching
16
Q
What forms can emollients be available in? Examples
A
- Creams
- Lotions
- Shower gels
An example includes Diprobase Emollient Lotion, Epaderm Cream
17
Q
Topical steroid use summay?
A
- Examples that can be bought OTC: hydrocortisone, clobetasone butyrate.
- These can be used for the treatment of mild to moderate eczema
- These are used to reduce inflammation and redness during flare-ups
- Examples of products: Eurax HC cream, E45 Hydrocortisone Cream
18
Q
What is contact dermatitis?
A
- A type of eczema that COMMONLY (maybe not all the time, check) affects hands and causes red, itchy and scaly skin. In severe cases, the skin can become blistered, very dry and cracked.
19
Q
When does contact dermatitis occur?
A
- When a sufferer comes into contact with a particular substance, for example an irritant that can affect the skin on contact (irritant contact dermatitis) or an allergen that affects the skin via the immune system (allergic contact dermatitis).
20
Q
How to tackle contact dermatitis?
A
- Identifying and avoiding triggers
- Regular use of emollients can soothe irritated skin
- Corticosteroid creams can be applied to treats evere symptoms.
21
Q
Symptoms of psoriasis?
A
- Red, flaky patches of skin covered with silvery scales
- People with psoriasis often experience periods of mild or no symptoms, followed by periods when symptoms are more severe.
22
Q
When does psoriasis occur?
A
When the body’s natural process of producing skin cells is accelerated
- This creates a buildup of cells on the skin’s surface. It is not fully understood why this happens, but it may relate to the immune system.
23
Q
Is there a cure for psoriasis?
A
- Although there is not a cure for it, a range of treatments include topical gels, creams and ointments are usually recommended
- Phototherapy and systemic treatments may be recommended depending on the condition’s severity
- Best to refer people with psoriasis to the pharmacist, because although some OTC treatments are available, others may require a prescription from the GP.
24
Q
WWHAM questions
A
- Who is it for?
It may not be the customer who needs the treatment. If the customer is a representative, it is important that they are able to fully explain to the patient how the product should be used. Always refer them to the patient information leaflet (PIL) or directions on the packaging. - What are the symptoms?
Refer the customer to the pharmacist if there are signs of an infection. - How long have the symptoms been present?
This will help you find out the cause of the condition. - Action already taken?
This will help you establish if the customer has already tried a product that hasn’t helped or wasn’t appropriate. - Medication?
It is important to refer the patient who is taking any other medication to the pharmacist
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Recognition aid for
1. Dry skin
1. Skin will appear rough and scaly
1. Feeling of tightness and skin might itch
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2. Extremely dry skin
2. Skin will be red, rough and itchy
2. Chapping an a tendency to form cracks and fissures is common
2. Calluses and scaling may appear
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3. Atopic eczema
- Skin will be scaly, rough and thick and it may crack
- Tendency to become red and inflamed
- Intense itching
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4. Psoriasis
- Red flaky patches of skin covered with silvery scales
- Can experience periods of mild or no symptoms followed by periods when symptoms ar more severe.
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When is dandruff most common?
Most common in men than women, and people in their 20s and 30s are most likely to be affected.
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What is dandruff caused by?
Build up of dead skin cells on the scalp/ This can occur as a result of the following:
- Not brushing the hair regularly, so dead skin cells are not encouraged to shed as often as they should
- An overgrowth of a tiny fungal yeast called Malassezia
- Nutritional deficiencies, such as a lack of vitamin B or essential fatty acids.
It can also be made worse if the customer is stressed or has been ill.
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What are the symptoms of dandruff?
When dead skins cells are built up on the scal, they collect together to form white clumps that can be seen in the hair and often fall onto the shoulders. As well as looking unsightly, it can be very itchy.
32
What are the treatment options for dandruff?
Can be managed using specialist shampoo, including
1. Anti-fungal ingredients such as ciclopirox olamine and ketoconazole
2. Salicylic acid: helps to prevent and remove the build up of dead skin cells on the scalp
3. Coal tar: make the customer aware that this can stain fabric and baths.
Examples include: Oilatum Scalp Anti-Dandruff Shampoo, Neutrogena T/Gel Therapeutic Shampoo.
33
What to advise dandruff patients that are trying out treatment options?
1. Advise customers that they may need to try a few different shampoos before finding the one that works best for them.
2. Dandruff should improve within a few weeks of starting treatment, but is likely to come back when the treatment is stopped.
3. Excessively blow drying the hair at a high heaa setting can dry out the scalp and lead to conspicuous dandruff formation. Recommend that customers avoid this where possible.
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What is seborrhoeic dermatitis?
A type of inflammation that can cause severe dandruff and also affect other areas of the body.
The cause is not fully known but it is thought to be triggered by an overreaction to the same fungus that causes dandruff
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Symptoms of seborrhoeic dermatitis?
1. In mild cases, severe dandruff may be the only symptom
2. In more serious cases, patches of red, scaly, greasy skin may also develop. Yellow-brown crusts can form on top of these patches, which may be itchy and slightly raised.
The scalp may also be itchy and sore. Some people can develop symptoms on the outer ear and eyelids.
3. In severe cases, the rash can affect most of the face, scalp. neck, armpits, chest and groin
36
Seborrhoeic dermatitis treatment options?
An antifungal shampoo can be recommended, but if it is not sufficient to control the problem, the GP may prescribe an oral antifungal or antibiotic treatment.
37
Any red flag symptoms of scalp problems?
Refer to the pharmacist:
1. If the customer has severe scaling on the scalp that is also affecting other areas of the body
2. If you think the customer may have scalp psoriasis
3. Any customer who experiences irritation, itching, or a burning sensation, after using an anti-fungal shampoo
4. Any customer whose scalp appears to be infected
38
Where can scalp psoriasis occur?
On parts of the scalp or on the whole scalp
39
What similarities and differences are there between psoriasis and scalp psoriasis?
It forms in the same way as on other parts of the body, but the hair traps the scale and stops it from being rubbed away as it would, for example, on the elbows
In addition, the hair acts as a physical barrier obstructing the application of creams and ointments to the affected skin. The result can be stubborn, thick, scaly plaques that require specially formulated scalp treatments.
40
What are the symptoms of scalp psoriasis?
Scalp psoriasis causes red patches of skin covered in thick, silvery-white scales. Some people find the condition extremely itchy, while other cases are very mild. Severe cases can lead to hair loss, although this is usually only temporary.
41
What are the treatment options for scalp psoriasis?
1. There are treatment options that can help scalp psoriasis, but they all need to be used regularly and it's important for customers to find one that fits in with their lifestyle.
2. Tar shampoos, gels, ointments, and creams are commonly used to treat psoriasis. They may need to be combined with other ingredients, such as salicylic acid to help remove scale, or coconut oil to moisturise the skin
Examples: Polytar Scalp Shampoo
42
Something to remind customers using medicated treatment options for scalp psoriasis?
Remind them that medicated shampoos are designed for the scalp, not for the hair, so using a regular shampoo and conditioner after a scalp treatment will reduce any unpleasant smells associated with medicated shampoos.
Some customers may prefer a coal tar-free product. These can reduce scaling and plaques, and moisturise and restore the skin barrier.
Example: Dermalex Scalp Psoriasis Treatment Gel
Further treatments, such as topical steroids, are available from the GP.
Severe cases should be referred to the pharmacist.
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WWHAM questions for scalp concerns?
1. Who is it for?
It may not be for the customer who needs the treatment. Not all products are suitable for children
2. What are the symptoms?
Some conditions have very similar symptoms, so if you are not sure about the cause of the condition, refer to the pharmacist.
3. How long have they have the symptoms been present?
Conditions such as dandruff usually start to improve after a few weeks. However, the symptoms may return return if the customer stops the treatment.
4. Action already taken?
This will help you to establish what products the customer has already used - some people need to try a few different products before finding the one that works best for them.
5. Medication?
Refer any customer who has an established medical condition or is taking any other medicines.
44
Self care tips for scalp health?
1. Avoid bleaching, colouring or perming the hair
2. Try not to scratch the scalp or scrape it when brushing or combing the hair
3. Massage the scalp gently when washing the hair
4. Eat a healthy, well-balanced hair
45
When does acne usually start?
Normally starts during puberty and tends to resolve itself once a person reaches their mid-20s. However, in some cases, it can continue into adult life.
46
What are the causes of acne?
There are a number of factors that can cause this, but it begins with the hormone testosterone.
During puberty, the body becomes more sensitive to testosterone, which can lead to greater amounts of sebum being produced by the sebaceous glands in the skin.
47
What is sebum?
A natural, oily, substance that reaches the surface of the skin through special ducts that lead into into hair follicles.
Sebum help to keep the skin moist and waterproof.
48
When can sebum become a problem for patients?
Sebum help to keep the skin moist and waterproof.
However, when too much is produced, it can get trapped in hair follicles, along with skin cells, and cause a blockage. This is what causes whiteheads and blackheads.
49
What is acne triggered by?
A bacteria called (Propionibacterium acnes or P.acnes.
Skin is covered with bacteria, which normally doesn't cause problems.
However, a change in skin acidity levels encourages the growth of P.acnes, which feed on sebum. If bacteria get into a blocked follicle, it can become infected and lead to an inflamed spot.
50
Can acne affect both men and women?
Yes, but in slightly different ways:
1. Young men are more likely to have acne that is severe and long lasting.
2. Women are more likely to have acne that comes and goes - this is often due to their menstrual cycle
51
What else can acne be a symptom of?
eg PCOS or rosacea. If this is suspected, refer to the pharmacist
52
What are the symptoms of acne?
Acne varies in severity
Spots normally appear on the face but can also be found on other parts of the body, such as the neck, back and chest.
Customers with acne may also notice that their skin feels greasy and looks shiny.
53
What different types of spots can be found in acne?
1. Whiteheads: also known as closed comedones, these are spots that have a firm white centre. The skin covering a whitehead is not broken.
2. Blackheads: also known as open comedones, these are spots that have a firm brown or black centre. The discolouration can be seen through the broken skin and is caused by the skin pigment melanin oxidising; it is not dirt as is often thought.
3. Papules: aka nodules or pimples
These are red, raised spots that feels harder than pustules.
They don't have a visible white or yellow head and don't burst open.
They are normally found in more severe cases of acne and are more likely to lead to scarring.
4. Pustules: red, raised spots that contain pus, which can normally be seen as a yellow head. Spots may look inflamed and may burst, releasing the pus.
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What are the treatment options for acne?
There is no cure for acne, and the treatment options depend on the severity of the condition.
Cases of severe acne are often referred by a GP to a dermatologist for treatment with oral antibiotics and topical, prescription-only products.
Moderate acne is often treated using a combo of meds including, in some cases, oral antibiotics.
For mild acne, there is a variety of OTC products available that customers can use to manage their condition.
Let the customer know of the different formats eg creams, gels, lotion and cleansers, you can help them choose a product that suits their needs.
55
What products can be provided for people with acne? Self care tips?
1. Benzoyl peroxide
2. Nicotinamide
3. Antiseptics/ antimicrobials
4. Light therapy
Self care tips
1. Advise the customer to resist the temptation to squeeze r pick spots. This will help to reduce scarring
2. Recommend that they wash skin with a gentle cleanser morning and night. Avoid very hot water, strong detergent and harsh astringents. Gently pat skin dry with a clean towel
3. Their hair should be washed regularly, especially if it falls over their face
4. There is no evidence that greasy or sweet foods cause or aggravate acne. However, a healthy, balanced diet important for general health
5. There is no evidence that acne is made worse by wearing makeup, but customers could try to use oil-free products and non- comedogenic products (ie won't clog pores)
56
How does benzoyl peroxide work?
Works by reducing bacteria and removing dead cells from the skin
57
What can customers notice when using benzoyl peroxide?
1. Their skin may become dry or red and may peel when using it. If this is the case, they should use a lower strength product or stop the treatment for a few days and then start again.
2. May cause bleaching of hair and clothing.
3. Can make the skin more sensitive to sunlight, so customers should be advised to avoid excessive exposure to sunlight and ultra-violet (UV) light from sunbeds.
58
What can help with tacking the side effects with benzoyl peroxide (red, dry peeling skin)?
An oil-free moisturiser can help combat the dryness
59
An example of a benzoyl peroxide product?
Acneside 5% gel
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What is nicotinamide?
An anti-inflammatory compound designed to tackle the redness and tenderness associated with inflamed acne spots
61
How often should nicotinamide be used?
Twice a day, morning and night, after washing and drying the skin
62
Will nicotinamide bleach clothing or bedding?
No
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Examples of nicotinamide?
Freederm Treatment 4% w/w gel
Nicam 4% gel
64
What are examples of antiseptics/ antimicrobials used in acne?
Cetrimide and triclosan
65
What do antiseptics and antimicrobials do for acne?
Reduce the effects of bacteria by inhibiting their growth on the skin
66
Examples of antiseptics/ antimicrobial products?
Quinoderm antibacterial Face Wash
67
Light therapy summary?
There are makss available that deliver visible light in red and blue wavelengths, achieving complementary anti-inflam and anti-bac effects, while helping to protect the skin barrier. Daily use is said to demonstrate improvement of acne and skin quality eg skin texture, clarity and blotchiness
Example: Neutrogea Visibly Clear Light Therapy AcneMask
68
Points to consider when recommending a topical product?
Use the packaging information to highlight the instructions.
Emphasise that, for the best results, product should be used regularly and give it time to work (about 2 months)
If there is no improvement, encourage the customer to return to the pharmacy as there are other treatment options available
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