Skin deep – the practitioner’s role in recognising common skin conditions

According to the Centre of Evidence Based Dermatology, 54 per cent of the UK population experiences a skin condition in any given twelve-month period. Skin conditions are in fact the most common reason why people consult their general practitioner with a new problem. As patients increasingly also turn to cosmetic practitioners for solutions to their skin conditions, practitioners are well-placed to provide patients with skincare advice and treatment options to address their specific requirements.

Skin conditions can leave patients feeling concerned about their appearance, resulting in them seeking treatments to help manage and hopefully eradicate the problem. For practitioners it is important that you are able to recognise common skin conditions in order to offer the most suitable treatments, and best outcomes, for your patients.

 

Psoriasis

With August being National Psoriasis Awareness Month, it is the perfect opportunity for practitioners to educate and inform patients about the common skin condition.

Psoriasis is a skin condition that affects around two per cent of people in the UK. It equally affects both men and women, of all races and all ages, and can display on a variety of body parts at any given time. People with psoriasis have an increased production of skin cells – normally, skin cells are made and replaced every three to four weeks, however with psoriasis, the process only takes around three to seven days. This results in a build-up of skin cells, which creates the patches associated with psoriasis.

The cause of psoriasis is not completely understood, however it is thought to be related to problems within the immune system and genetics.

Characteristics: Red, flaky, crusty patches of skin covered with silvery scales.

Areas most affected: Elbows, knees, scalp and lower back, but can appear anywhere on the body.

Treatments available: Topical treatments such as creams and ointments are recommended in the first instance. Corticosteroids, for example, reduce the inflammation and  itching associated with the condition. Dithranol, Vitamin D3 analogues (a form of synthetic vitamin D that you rub on your skin) and Vitamin A derivatives have also been shown to slow skin cell growth. Phototherapy is also another option for more persistent symptoms. If the skin does not respond to the previous treatments then systemic treatments may be offered in the form of oral or injected medicines, as instructed by a doctor.

Find out more about psoriasis.

Moles

Moles are growths on the skin that are usually brown or black. They mostly appear in early childhood and during the first 25 years of a person’s life – it is normal to have between 10-40 moles by adulthood.

Moles tend to change slowly throughout the years – they may become raised or change colour slightly or may just stay the same. As a practitioner, it is your responsibility to look out for any cancerous moles and to provide patients with treatment options or refer them to their GP.

Characteristics: Moles can be flat or raised, however irregular enlarged moles may either indicate skin cancer or developing skin cancer. Find out how best to advise your patients on identifying any cancerous moles here.

Areas most affected: Moles can appear anywhere on your body.

Treatments available: Moles can either be removed by laser removal or excision, depending on their size and shape. Non-cancerous moles do not pose a risk to the patient and therefore do not require removal or treatment unless requested for cosmetic reasons.

Read more about moles.

Rosacea

Rosacea is a common skin condition and can affect all skin types, but predominantly fair-skinned people aged 40 to 60 years old. It is a chronic condition – it can persist for a long time and the severity tends to fluctuate depending on the patient. Triggers can include the sun, alcohol, exercise, high and low temperatures, hot drinks, spicy foods and stress. It is the practitioner’s responsibility to advise patients on how best to manage these triggers and provide suitable treatment options if necessary.

Characteristics: Persistent redness caused by dilated blood vessels, small bumps and pus-filled spots, pustules.

Areas most affected: Cheeks, forehead, chin and nose.

Treatment options: Topical treatments such as metronidazole and azelaic acid cream are usually prescribed first, however light-based treatments such as pulsed dye laser (PDL) or intense pulsed light (IPL) have been shown to reduce the appearance of rosacea.

Read more about rosacea.

Acne

Acne is a common skin condition that tends to start in puberty and varies in severity from a few spots, to a more significant problem that may cause scarring and impact on self-confidence. The acne bacterium (known as Propionibacterium acnes) lives on everyone’s skin. It usually causes no problems but, in those prone to acne, the build-up of oil produces an ideal environment in which these bacteria can multiply. This triggers inflammation and the formation of red or pus-filled spots. Patients may wish to seek cosmetic treatment for acne and acne scarring.

Characteristics: Comedones (blackheads and whiteheads), papules, pustules, nodules, cysts

Areas most affected: Acne can occur anywhere on the body but most commonly appears on the face, neck, back and chest.

Treatment options: It is the practitioner’s responsibility to ensure the patient has a good skincare regime and to recommend ingredients that will help with their overall skin health and their acne. As well as creams and serums, cosmetic treatment options include dermabrasion, skin peels and laser, which can help treat acne scarring.

Read more about Acne.

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Skin conditions are often complicated to treat and may require different approaches dependent on individual patient circumstances. You can encourage your patients to help their skin health personally by:

  • Reducing stress where possible – unmanaged stress can lead to skin condition breakouts, in addition these breakouts can lead to poor self-esteem. Controlling stress though mindfulness and exercise can have a significantly positive impact on your body as a whole
  • Eat a healthy balanced diet – it goes without saying that putting the right things into your body helps keep you fighting fit; eating at least the recommended five fruit and vegetables a day is extremely important for meeting all the key requirements of your body. Drinking sufficient water also helps to hydrate your skin, which can reduce the likelihood of developing some skin conditions when combined with other factors
  • Quit smoking – smoking is extremely damaging to your skin, damaging the collagen and elastin that keep your skin supple and wrinkle free. Smoking also contributes to wrinkles by narrowing the blood vessels in the skin, decreasing blood flow. Read more about how smoking can damage your patient’s skin
  • Get enough sleep to allow your body to wind down from a busy day and recharge your batteries
  • Avoid sun damage – repeated sun exposure can be extremely damaging to your skin, causing skin problems such as sunspots, melasma and photoageing. Read more about how to stay safe in the sun, and best advise your patients.

 

Practitioners should ensure they are in a position to be able to identify common skin conditions and advise their patients on a course of action, providing suitable treatments if appropriate. In some instances practitioners may need to encourage patients to seek medical advice, for example if a mole is showing signs of being cancerous. As ever, understanding your patient’s specific needs, identifying exactly what your patient hopes to achieve from a treatment and managing their expectations is invaluable when it comes to being able to provide practical and meaningful support for your patients.

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