Caring for dry and damaged skin in the community

Abstract

Community nurses are ideally place to fully utilize nurse prescribing to improve the accessibility to emollient therapy for any patient with dry skin, regardless of cause. Skin diseases affect 23% of the general population and patients accessing care in the primary setting contribute to 15-20% of general practice appointments.

Skin Microbiome in Atopic Dermatitis and Features of Various Background Skin Care

“…Препараты с большим содержанием жиров более эффективны для очень сухой, потрескавшейся кожи, [34]. Вместе с тем исследования двойным слепым методом показывают, что иногда лосьон оказывается более увлажняющим, чем крем: сравнение лосьона и крема с 0,05%-ным пропионатом галобетазола в тесте «сухого бритья» показало, что лосьон обеспечивал большее увлажнение, измеренное при помощи теста на трансэпидермальную потерю воды и проводимость в сравнении с кремом на 2 и 4 часах наблюдения [35].…”

Recommended use of emollients in inflammatory dermatoses

“…Washing with soap depletes NMF and therefore affects the ability of the epidermis to bind and retain water. 4,5 Second is the barrier action of the hydrolipid film created by cerimides and other lipid molecules, which interface with the corneocytes that make up the stratum corneum. 1,2,4 Using a soap substitute Ideally a soap substitute should be used when the skin is cleansed.…”

“…4,5 Second is the barrier action of the hydrolipid film created by cerimides and other lipid molecules, which interface with the corneocytes that make up the stratum corneum. 1,2,4 Using a soap substitute Ideally a soap substitute should be used when the skin is cleansed. This can be any water-soluble emollient lotion, cream or ointment, eg aqueous cream or emulsifying ointment.…”

“…• creating a greasy layer on the surface of the stratum corneum that penetrates the upper layers thus mimicking the barrier effect of the hydrolipid film, trapping in moisture and preventing TEWL 6 • flattening out surface irregularities, causing the skin to feel soft and supple; in addition, this improves the extensibility of the skin and prevents painful fissures, which has importance in managing conditions such as psoriasis 4 • reducing itch by alleviating dryness; in addition, when creams or lotions are applied to the skin, water evaporates from the warm skin giving a cooling antipruritic effect • reducing both the need for topical steroids and the occurrence of flare-ups; the importance of an effective emollient regimen for prophylactic use, as well as during flares, has also been recognised 7 • anti-inflammatory effects in their own right; however, emollients alone are considered to be unable to control inflammation but can be used effectively to do so in conjunction with topical steroids and immunomodulatory drugs. 1…”

“…Many authors have recognised the benefits of a complete emollient regimen in managing inflammatory dermatoses, as the use of emollients helps to recreate the barrier function of the skin, providing comfort and protection as well as reducing TEWL. [1][2][3][4] Thorough patient assessment is essential: some patients look warily when asked whether they bath or shower, what they add to the bath, when they put on their moisturiser and how much they apply. However, it is the only way to determine whether the patient is using a thorough emollient regimen or only moisturising once a week.…”