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Pharmacists are becoming the first healthcare professional (HCP) from
whom people with dermatological conditions seek advice as increasing
out-of-pocket expenses for medical consultations create a barrier to
healthcare services for individuals.
Internet information, of varying
reliability, also has more people
aware of the over‐the counter (OTC)
medications commonly used to treat
education (ECE) is more important
than ever with pharmacists needing to
explain and demonstrate treatments
to help consumers understand what
they need to undertake to control their
condition. Pharmacists now need not
only to be proficient at dispensing but
also be highly skilled communicators
to improve consumer adherence and
One in three children in Australia
suffers with eczema (also termed atopic
Although more commonly
associated with children, eczema can
commence or reappear in adolescence
and may persist throughout life.6
Eczema is caused by genetic,
environmental and immunological
factors and is usually expressed as dry,
flaking, very itchy skin with varying
intensities of inflammation.
significant psychosocial impact on
sufferers and their families.
Mutations in the enzyme filaggrin,
production of less moisturising factors
and lamellar lipids and a damaged
skin barrier are recognised factors
involved in the development of
Filaggrin helps form the
stratum corneum: as filaggrin breaks
down, the resulting amino‐acids from
the degredation become moisturising
factors and lower the skin pH. Other
by‐products act in a photo‐protective
Failure of this results in
inflammation, staphylococcal infection
and possible allergic triggers, especially
Effective management necessitates
regular application of ‘emollient therapy’‐
non‐soap based cleansers and ‘leave on
products’ (often termed moisturisers)‐ to
replace the skin barrier and rehydrate the
The cornerstone of cost‐effective
treatment, when inflammation occurs,
is the use of topical corticosteroid
(TCS) preparations or topical
immune‐modulatory products, such as
Effective patient education
Clear explanation and demonstration
of treatment recommendations are
important professional practice
standards, part of good consumer care
and builds trust between consumers
ECE helps improve
treatment adherence as consumers
become active participants in the
care process enabling understanding
of what, why, how and when the
products are needed.
Eczema Care Plan should be provided
to all consumers needing ongoing
treatments to assist consumer re‐call18
and ensure the medical practitioner’s
» ORIGINAL PAPER
Deryn Thompson RN, BN, MN, Lecturer, School of
Nursing & Midwifery, University of South Australia,
Eczema RN, Women’s & Children’s Health Network,
Associate Professor Kingsley Coulthard, BPharm,
MPharm, Fellow Pharm Society, Accredited Pharmacist,
Adjunct Assoc Professor, School of Pharmacyand
Medical Sciences, University of South Australia.
The authors have no conflict of interest nor received
financial support to write this article.
(MP) recommendations are clear
and accurate. Morren et al.
this, recognising that adherence
to dermatological treatments is a
major issue for pharmacy consumers.
They suggest that pharmacists:
provide detailed information about
the products and how to apply them.
check what other HCPs involved with
consumers’ care have suggested.
determine if those suggestions were
clearly explained and application
demonstrated because consumers
need this information.
never assume that consumers know
how to apply topical products.
not use jargon as consumers
frequently report leaving medical
consultations not understanding the
meaning of medical terms used.
For consumers who do not have a
written eczema care plan, pharmacists
should ascertain what suggestions the
MP made and what consumers have
Eczema management made easier:
a pro-active approach for consumer
education and dispensing.
BY DERYN THOMPSON & ASSOCIATE PROFESSOR KINGSLEY COULTHARD
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