Skin

Question 1

What formulations do emollients come as?

Answer 1

Gels, cream, ointments, lotions, soap substitute and sprays

Question 2

What is the role of an emollient?

Answer 2

Restore the skin barrier, moisturise skin and reduce irritation to prevent allergens and infection

Question 3

What advice would you give with an emollient?

Answer 3

1. Apply a generous amount as often as possible, a minimum of twice a day
2. Take a supply with you to work or school
3. Smooth it in the same direction as hair growth (no rubbing)

Question 4

What are the safety precautions to take with emollients?

Answer 4

1. Avoid fire, open flames and smoking
2. Take care when using it in the shower, you could slip so use hot water to wash away any residue
3. If you are using a tub use a clean spoon to take out the product

Question 5

Why should aqueous cream be avoided?

Answer 5

Contains sodium lauryl sulphate (SLS) which is an irritant that leads to thinning of skin and water loss

Question 6

How should you apply an emollient with a steroid cream?

Answer 6

Apply the emollient, wait 30 minutes and apply the steroid cream

Question 7

What are the age restrictions for topical corticosteroids?

Answer 7

Hydrocortisone (1%) 10 and over
Clobetasone (eumovate) 12 and over

Question 8

Counselling for topical corticosteroids

Answer 8

1. Apply a thin amount to the affected area
2. Use for a maximum of 7 days
3. Do not use it on the face, broken or infected skin and ano-genital areas

Question 9

Withdrawal advice for long term use of corticosteroid creams

Answer 9

1. Withdrawal gradually by reducing frequency and potency
2. Use it intermittently
3. Psoriasis - switch to a lower potency + Vit D preparation

Question 10

Presentation of eczema

Answer 10

Itchy, dry, cracked skin that can be red and swollen

Grey/ darkened skin in black and Asian people

Question 11

Presentation of contact dermatitis

Answer 11

Itchy, blistered, dry and cracked skin

Question 12

Presentation of rosacea

Answer 12

1. Thickening skin around the nose
2. Persistent redness/flushing of the skin that intensifies sometimes and visible blood vessels on the face
3. Swelling, burning or stinging, can be around the eyes
4. Red papules and pustules

Question 13

Triggers of rosacea

Answer 13

Photosensitivity
UV radiation
Smoking
Hot or cold temperatures
Spicy food and hot drinks
Alcohol
Stress and exercise
CCBs and topical corticosteroids

Question 14

Counselling points for rosacea

Answer 14

1. Avoid triggers by keeping a diary to identify them
2. Use a high UV sunscreen daily and avoid sunbeds

Question 15

Over the counter treatments for rosacea

Answer 15

Non-oily emollient like diprobase gel

Gentle soap free cleanser

Question 16

First line treatment for erythema in rosacea

Answer 16

Brimonidine 0.5% gel OD PRN

Question 17

Treatment for pustules or papules in rosacea

Answer 17

Topical azelaic acid (pregnancy)

Topical ivermectin for 8-12 weeks

Topical metronidazole (pregnancy)

Question 18

Oral treatments for rosacea

Answer 18

6-12 weeks:
Oxytetracycline or tetracycline

Erythromycin