Pharmacy expert Deborah Evans shares advice for pharmacy staff supporting patients with scars

2nd February 2018

In category | Blog

Pharmacies provide far more than prescriptions and are becoming far more involved with health promotion campaigns and provision of services. Effective health promotion activities within the pharmacy, provision of resources such as leaflets, training the whole team and prominent merchandising can all contribute to raising awareness of what else the pharmacy has to offer.

Typically, people see the pharmacy as a place to get their prescription, how can pharmacist’s encourage people to see the pharmacist as an HCP who can provide advice on topics such as scar care and skin care? By identifying the opportunities to offer proactive advice we can help to change these perceptions; so when someone has said they are going in for an operation for example, they are provided with advice on scar management. Below, I offer advise for pharmacists when advising patients on the most common patient queries we see that will help you do just that.

Advising patients looking for information on pregnancy skincare

As pharmacists, we see pregnant women from the very start – before they conceive and are planning a baby right the way through to when they have had their child and may ask us for advice around feeding, the baby’s health (and skin). We help out when they get symptoms such as heartburn and constipation in mid to late pregnancy, as well as early on when feeling queasy or want to know what they can take for a cold, headache or other common ailment.

When advising on pregnancy and skincare, first find out what the mother-to-be has been told already either by her midwife, friends or family. It can get very confusing with the advice you receive from many people during pregnancy and and you would not want to add to the potentially conflicting advice. The help to give would depend on what stage of pregnancy the patient is at, whether she has had children before, if she is planning a normal delivery or has an elective caesarean. By finding out more about the person, you can tailor your support and get her involvement in the decision-making. If her concern is stretch marks, then it is best to encourage her to put on weight gradually rather than quickly, eat a nutritious diet rich in Vitamin C, Zinc and B Vitamins, drink plenty of water, take regular activity and massage in an oil, such as Bio-Oil, rich in Vitamins A and E twice daily from week 13. Also provide her with suggested websites and resources to find out more.

Pharmacy advice for patients with scars

In pharmacy, we commonly see scarring caused by wound healing, operation sites and acne. We may also see scarring arising from injection sites, tattoos, piercings and burns. There are some key questions I would ask when providing advice for someone worried about scars or with them already. Scars can be distressing to an individual as the skin with have an altered appearance and the scar may limit normal functionality or be uncomfortable, itchy or painful. Questions would include the site of the scar, skin type, how the scar came about, the age of the scar and patient, what they have done to manage the healing process so far and what impact the scar is having on them. I would also ask to see the site to establish the type of scar and consider a realistic outcome of treatment. It’s important to establish their biggest concern and what is most important to them so that expectations can be managed. There may also be a case of referring the individual for any severe or abnormal scarring where there may be significant pain or distress. Many scars will benefit from massaging and the application of a moisturiser such as Bio-Oil; this should be done in a circular motion and not too hard to cause discomfort. More specific treatment may require a referral or signposting the individual to their nurse or doctor, however we can help to reassure, moisturising options and advice on cover-up if required. I often recommend Bio-Oil as a product; there is an evidence base for its use in scars, stretch marks and uneven skin tone.

Advise for a patient with a burn

After ensuring that the individual has cooled the area with cool or lukewarm running water for around 20 minutes, I tend to recommend neat lavender oil for minor burns which seems to take the sting out of the burn and reduce scarring, although there are no trials to provide evidence of that. If the large or deep burns – bigger than the affected person’s hand, burns of any size that cause white or charred skin, burns on the face, hands, arms, feet, legs or genitals that cause blisters and all chemical and electrical burns, then the individual should be referred to accident and emergency.

Advise to help support skin recovery post-surgery

Following a wound or medical procedure, there is a window of opportunity to help ensure a scar heals well. There are a number of things an individual can do to help care for their scars. In the first weeks after the surgery, they will need to: keep any dressings on unless advised to remove them; keep the dressing dry; wrap cling film over the treatment site when showering and; if the wound is exposed, salt water bathing daily is helpful, ensuring the area is gently dried afterwards. Once the wound has healed then using micropore tape or steri-strips can help protect the scar from stretching to minimise wound opening. Once the wound has fully closed and at least four weeks after the stitches have been removed, then massaging an oil, such as Bio-Oil, once or twice daily will keep the scar hydrated and soften scar tissue. This should be done consistently for at least 3months to help support the skin’s natural healing process. If going out in the sun, then the individual should wear high factor sun protection.

Training for pharmacists to support people in self-caring for their skin

Like any topic, there is always something new to learn and having seen the Bio-Oil professional series, I would recommend the resources as being very relevant for pharmacists to help them empower patients to self-care for a range of skin care conditions.

Complimentary CPD training for pharmacists:

Bio-Oil Professional a complimentary training for pharmacists on the topic of managing scarring in primary care, with a certificate sent upon completion:

Resources for your patients:

 

Deborah Evans

This article was written by: Deborah Evans

Deborah is considered a national pharmacy leader and Fellow of the Royal Pharmaceutical Society. She led the national, award-winning Healthy Living Pharmacy (HLP) pathfinder work programme. Her professional achievements include being made a Fellow of the Royal Pharmaceutical Society, Faculty Fellow of the RPS and visiting senior lecturer at King’s College, London. Deborah feels it is important to connect with patients and still works regularly in community pharmacy connected to a GP surgery.


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