training
skills March - April 2012
COUNTERSKILLS training programme
Skin structure and function of skin scalp, face, body and sensitive skin common problems top tips for healthy skin
5
workbook
skill builder: advising confidently using WWHAM activities & assessment merchandising aid
Supported by:
Skin
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Alphega Pharmacy team continue to offer comprehensive support and training packages for the whole pharmacy team. For more information please contact: Member Support on
[email protected] or speak to your Alliance Healthcare account manager. Content developed by:
2 Counterskills
Skin
Market overview The Medicated Skincare market it made up of Medicated and Dry Skin and is worth a total of £146m but has remained flat year on year. This is predominately weather driven as we have experienced a very mild winter. Within this mix Medicated Skin has seen an increase of +2.9% as people that buy into the Medicated Skin market do so because they need to. The Dry Skin market saw a decline of -2.28% and this is where the weather has an effect. The split of the two sub categories is as follows:
The Medicated Skincare market presents a huge opportunity in Pharmacy as currently most of the spend is going to multiples (ex-prescription sales), however if you get the offering right there is a really good chance to steal market share of over the counter sales. 40% of consumers seek pharmacy assistance prior to making a medicated skincare purchase
Total Market Share
Dry Skin Treatment is the prime drive of sales in pharmacy, however there is a definite opportunity on the Medicated Skin category. Brands should be merchandised together and clearly presented (face on) on the shelf. This will:
£3.23m
Medicated Skincare
£25.24m
Dry Skin Treatments
Merchandising – Dry/Medicated Skin
• Improve clarity at fixture and will result in faster product selection
• Introduce your customers to Chemist Sector Share of Market
other products available from their preferred brand, which may lead to an increase in their basket spend and encourage regime usage
Medicated Skincare
£76.75m
£69.04m Dry Skin Treatments
(IRI value sales 52 w/e 31st December 2011)
Counterskills 3
Skin
Market overview Promotional offers should be mounted in prime locations:
Chemist Market Split
• Typically, with the most
footfall and at eye level, where possible £9.92m
• Create impact by displaying promotions with sufficient stock and point of sale materials to advertise your promotional offer.
The remainder of the skincare market is made up of Facial, Hand and Body. This subcategory is worth £627.79m and has seen a small decline of -0.95% year on year.
£17.32m
Hand and Body Facial Beauty Skincare
(IRI Vales Sales 52 w/e 31st December 2012)
Merchandising – Mass Skin Total Market Split
£177.1m
£450.6m
Hand and Body Facial Beauty Skincare
4 Counterskills
Allocate sub category and brand space in line with market share and use our star ratings to choose the best sellers for your fixture. Maximise the number of products per brand. Less brands with more depth of product per brand continues to offer a wider range of benefits to the shopper, and stands out on shelf to help direct consumers to the fixture. The skincare shopper actively seeks out new products so try to keep some shelf space free for new product development which will be launched throughout the year. Swop slow moving lines for new products. You may even allocate part of your fixture for new products if you have the space or feature on hotspots. Try to incorporate some cosmetic cotton wool such as pads or balls to encourage cross category and impulse purchase.
Skin
Section 1: Introduction Having healthy skin is part of what makes us look and feel healthy. Skin conditions can have a dramatic effect on how we feel, so being able to support your customers with the right products and skin care routines will be invaluable to them. Skin is the largest organ of the body and although resilient to day to day encounters, can be sensitive and delicate. It has a number of functions. These are: Protecting the body’s organs from injury and infection
•
• • Stopping the body from dehydrating • Acting as a waterproof barrier rotecting the body from injury (such as • Pfrom heat or pain) through the nerve Controlling the body’s temperature
endings within its structure
• Flexibility to allow movement. The structure of skin is shown below: 1
2
3
6
The skin has two main layers:
he epidermis. This is the top layer. Its • Tfunction is to protect. It is made up of a layer of fibrous protein material called keratin. Keratin gives the skin it’s strength and flexibility. This top layer is constantly dying off and being replaced by new skin. This layer also contains melanin which protects the skin from sunlight by darkening the skin when exposed, otherwise know as a suntan
he dermis. This lower layer contains • Tblood vessels, nerves and hair follicles,
sweat and sebaceous (oil) glands. It supports the epidermis and keeps it moist. Skin conditions are very common and can affect different parts of the body in different ways. This workbook will look at common conditions affecting the:
• Scalp • Face • Other areas of the body. In addition it will look at what customers can do to look after their skin on a day to day basis, keeping it looking and feeling healthy.
4 5
7
1. Hair
5. Hair follicle
2. Epidermis
6. Nerves
3. Dermis
7. Blood Vessels
4. Sweat and sebaceous glands
Counterskills 5
Skin
Section 2: Skin conditions affecting the scalp Scalp conditions aren’t usually serious but can cause discomfort and in some cases can be embarrassing. Common problems are:
• Dandruff • Seborrhoeic dermatitis • Hair loss (alopecia). Dandruff Dandruff is the most common scalp condition you are likely to be asked about. It is caused by a build up of dead skin cells on the scalp which can occur:
• When hair is not brushed regularly
• By an overgrowth of a fungal yeast
• When there is a lack of Vitamin B in the diet.
Symptoms
The skin cells build up and form itchy white clumps which are visible in the hair and can fall onto the shoulders.
Treatment
Treatment is with shampoos containing the following: An anti-fungal. This includes zinc pyrithione, coal tar and arachis oil extract of coal tar, ketoconazole, selenium sulphide, ciclopirox olamine, undecenoic acid. They help reduce the overgrowth of fungal yeast
•
6 Counterskills
keratolytic. This includes salicylic acid, • Abenzalkonium. They help remove the build up of dead skin cells and can be found in combination with some antifungals.
Practical advice
should be used continuously • Sashampoos symptoms may return if stopped
f one shampoo doesn’t seem to have • Ibeen effective, it is worth advising your customer to try another with different ingredients
are should be taken when brushing/ • Ccombing the hair not to scratch the scalp at a healthy balanced diet with • Ebread, pasta, fortified breakfast cereals
(fortified means the manufacturers of the cereals have added extra vitamins and minerals to the cereals) or lentils (all rich in vitamin B).
Skin
Seborrhoeic dermatitis
Practical advice
Seborrhoeic dermatitis is when the skin is inflamed and causes dandruff. It is thought to be caused by the same fungal yeast that can cause dandruff.
f one shampoo doesn’t seem to have • Ibeen effective it is worth advising your
should be used continuously • Sashampoos symptoms may return if stopped
customer to try another with different ingredients
Symptoms
This condition can be mild and is normally experienced in the same way as dandruff. It can however be more severe and the following symptoms are experienced: Patches of greasy, scaly and red skin develop, which then form yellow crusts which can be very itchy and raised, which in turn causes the scalp to become very sore
•
are should be taken when brushing/ • Ccombing the hair not to scratch the scalp colouring or perming • Athevoidhairbleaching, as this will further irritate the skin.
f these flakes fall onto other areas of • Ithe skin, it can infect these areas, most commonly the eyes.
Treatment
Treatment is with shampoos containing antifungals.
When fer to re
Customers who have tried over the counter (OTC) shampoos with no success should be referred to the Pharmacist as they may require a prescribed intervention.
Counterskills 7
Skin
Section 2: Skin conditions affecting the scalp Hair loss (alopecia) Hair loss (or alopecia) is not uncommon and affects around 50% of women and 90% of men. Hair is lost every day (between 50-200 hairs) as part of the normal hair growth cycle. Hair can be five years old before it is shed and a new hair appears in its place. As we age, the amount of time a hair lasts for can be reduced (less than two years) and eventually regrowth stops, leading to thinning of the hair. This thinning can then lead to noticeable patches of hair loss on the scalp. This can be embarrassing and make people self conscious about their image.
Symptoms
Hair starts to thin and/or recede. It can be due to one or more of the following: The ageing process; hair can be lost in response to a change in androgen levels (male hormone which exists in both men and women). This can start at puberty and continue into the late sixties
•
hair loss and how it occurs can • Gbeenetics; inherited medication or therapy (such • Pasrescribed chemotherapy which may be used to treat cancer) can sometimes cause the loss of hair.
Treatment
Treatment is with minoxidil. This is available in two strengths, 2% and 5%. The 2% can be recommended for both men and women and the 5% should only be used in men. It is rubbed into the scalp twice a day and usually takes three or more months for any effects to be visible. It should be used on an
8 Counterskills
ongoing basis and can help to prevent further loss of hair and aids re-growth. It is only suitable for customers over 18 and under 60 years of age.
Skin
T
MEMBE R RE
N io at
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INform
WWHAM!
Section 0: Lorem ipsun
•
PORTA IM
ho is it for? You will need to know the age and gender of your customer to help you decide the best course of action
W
hat are the symptoms?
Refer to the Pharmacist if: A customer has severe scaling of the scalp or it looks like there maybe an infection of the scalp
H
ow long have they had the symptoms?
Refer to the Pharmacist if: Any symptoms are getting worse
A
ctions taken so far:
Refer to the Pharmacist if: Medication has been tried already and caused irritation, itching or a burning sensation
M
edication, if any, taken at the moment?
Refer to the Pharmacist if: The answer is yes
Counterskills 9
Skin
Section 2: Skin conditions affecting the scalp
ACTIVITY Please read the scenario below. A woman of about 45 comes into your pharmacy. She says that she has had dandruff for about three weeks. She has not done anything about it as she had hoped it would just go away. She asks for some advice on what she should do. Write in the box below what you would do in this situation.
my r we ans
Ask your Pharmacist to review your answer and discuss it with you if required. 10 Counterskills
Skin
Product recommendations
Exorex Coal tar solution 5% v/w cutaneous emulsion Key attributes:
• Exorex Lotion is a clinically proven treatment for mild to moderate psoriasis
• The patented formulation contains 5% coal tar
solution (v/w) in a base of esterified essential fatty acids
• Exorex Lotion can be diluted to suit individual requirements
Why Stock It?
• Clinically proven • Easy to apply – will not damage healthy skin areas • Can be used by adults and children • No strong odour • No maximum dose per week OTHER ADVICE
The Exorex range also offers fragrance-free Hair and Body Shampoo and non-irritant Moisturising Cream to complement the lotion
Exorex Lotion Abbreviated Prescribing Information Presentation: Cutaneous emulsion containing coal tar solution 5% v/w in an emollient base containing a complex of esterified essential fatty acids. Indications: Treatment of psoriasis of the skin and scalp and administration: Adults and children over 12 years of age: Ensure that the lesions are clean. Apply a thin layer of Exorex two or three times per day to the affected areas. Massage gently and leave to dry. For young children under 12 years of age and the elderly: The emulsion may be diluted by mixing with a few drops of freshly boiled and cooled water in the palm of the hand. Contraindications: Sensitivity to coal tar or any of the ingredients. Presence of folliculitis and acne vulgaris. Conditions characterised by photosensitivity. Inflamed or broken skin (open exuding wounds or infection of the skin). Warnings and precautions: Discontinue use if irritation occurs. Coal tar enhances photosensitivity of the skin, avoid exposure to direct sunlight after application. Apply with
caution to the face and use with care near the eyes and mucous membranes. Do not apply to genital and rectal areas. Pregnancy and lactation: Inadequate evidence of safety, it is recommended that the use of coal tar in pregnancy and lactation be restricted to intermittent use, in a low concentration on a relatively small percentage of body surface and that use during the first trimester be avoided. Undesirable effects: Skin irritation, photosensitivity of the skin. Coal tar may cause acne-like eruptions of the skin. Refer to the Summary of Product Characteristics for further information. Package quantities and cost: 100ml £8.11; 250ml £16.24. Legal category: GSL. Marketing Authorisation Number: PL 06166/0001. Marketing Authorisation Holder: Forest Tosara Limited, Baldoyle Industrial Estate, Grange Road, Dublin 13, Ireland. Further information available from: Forest Laboratories UK Ltd, Riverbridge House, Anchor Boulevard, Crossways Business Park, Dartford, Kent DA2 6SL. Date of revision: August 2009.
Adverse events should be reported. Reporting forms and information can be found at www.mhra.gov.uk/yellowcard. Adverse events should also be reported to Forest Laboratories UK Ltd. Tel: +44 (0) 1322 421800
Date of preparation: April 2012
Counterskills 11
Skin
Section 3: Skin conditions affecting the face Facial skin problems can be a very sensitive subject and embarrassing to discuss. Common conditions you will be asked to advise on are:
such as some oral contraceptives, steroids and some anti-epilepsy drugs.
• Acne • Impetigo.
Symptoms
Acne Acne is a very common condition affecting 85% of young people between the ages of 12-25. Most of the time people grow out of suffering with acne, but in some cases it can persist into their 30’s. It can vary in it’s severity from a few spots to inflamed, widespread spots. It also can affect more than just the face; some people suffer with spots on the back and chest. The main cause of acne is over-sensitive oil producing glands in the skin (or sebaceous glands) which produce too much oil. This causes the pores to become blocked with oil and dead skin cells, leading to black heads, white heads and larger inflamed spots. Some prescribed medicines can cause acne
Symptoms of acne include: Inflamed red or pus filled spots
• lackheads (this is when the blocked • Bpore is seen as a dark plug (the darkness is the dead skin cells reacting with oxygen in the air)
hiteheads (a bump under the skin’s • W surface not open to the air)
n severe cases deep painful spots which • Ican lead to scarring.
Treatment
A good skincare regime is crucial to help bring the symptoms under control and minimise scarring. Skin should be washed with an oil free acne or anti-bacterial wash. Soap should not be used on the face as it dries the skin too much and the sebaceous glands overcompensate by producing extra oil to lubricate the skin.
This is shown on the diagram below:
• Hair • Open pore • Spot (pus filled pore) • Sweat and sebaceous glands • Hair follicle • Nerves • Blood Vessels 12 Counterskills
Skin
Then every couple of days a face scrub (a product which has sandy grains within it) should be used on clean skin to remove any dead skin cells and unblock pores. An oil free moisturiser should then be used to stop the skin from drying out. This should be done morning and night. Over the counter products can also be used containing the following: Nicotinamide. This is an antiinflammatory and is used to reduce the redness caused by inflamed acne spots. It should be applied twice a day
•
alicylic acid. This helps promote the • Sremoval of dead skin cells and so helps unblock pores
enzoyl peroxide. This works by • Breducing the bacteria which sometimes
ustomers should not touch, squeeze or • Cpick at spots as this can cause infection and scarring
cne is not caused by poor hygiene and • Awashing the skin too much will make it worse
f cosmetics are used then oil-free • Iproducts should always be chosen and must be removed before going to bed
roducts containing tea tree oil (an • Pessential oil which has antibacterial and antifungal properties) can sometimes be helpful and are available as a face wash, scrub etc. Neat tea tree oil however should not be applied directly to the skin.
causes pus filled spots and helps to remove dead skin cells and therefore unblock pores. Care needs to be taken when using products containing this ingredient as they can bleach towels, clothes and bed sheets
ntiseptics. These work by reducing the • Abacteria. These products are useful in mild to moderate acne. For more severe cases, prescription medicines maybe required.
Practical advice
cne treatments should be used • Aregularly and a good skincare regime adopted
eep hair clean and off the face to stop • Kgrease from the hair getting on the face
Counterskills 13
Skin
Section 3: Skin conditions affecting the face Impetigo
Treatment
Impetigo is a highly contagious bacterial infection of the skin. It is common in children in their early school years, although people of any age can suffer with it.
Practical advice
Symptoms
Impetigo occurs as weeping blisters commonly around the mouth and nose. It can also be caught in a cut or graze. Blisters eventually dry out and form a crusty scab which tends to be itchy, and so if scratched the scab weeps and the infection spreads. As it is commonly found on the face it can look like a cold sore to begin with but it doesn’t have the tingle stage. Similarly it can start as a cold sore which then becomes infected.
• Treatment is with an antibiotic. area should not be touched • Tashethisinfected may spread the infection kissing others to stop passing on • Athevoidinfection
have been using a lipstick/ • Ilipf customers salve when infected then they should stop using it and throw it away as continuous use may re-infect
owels and face clothes should not be • Tshared.
When fer to re
If you suspect impetigo then refer the customer to the Pharmacist as they may require a prescribed intervention.
14 Counterskills
Skin
T
MEMBE R RE
N io at
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W
INform
WWHAM!
Section 0: Lorem ipsun
•
PORTA IM
ho is it for? n adult suffering with acne for the first time should be referred to A the Pharmacist
W
hat are the symptoms?
Refer to the Pharmacist if: The customer is female, suffers from excess facial hair, has persistent acne and is experiencing hair loss, as it could be a sign of something more serious
H
ow long have they had the symptoms?
Refer to the Pharmacist if: Any symptoms are getting worse
A
ctions taken so far:
Refer to the Pharmacist if: Medication has been tried already and been unsuccessful for a period of two months
M
edication, if any, taken at the moment?
Refer to the Pharmacist if: The answer is yes
Counterskills 15
Skin
Section 3: Skin conditions affecting the face
ACTIVITY Please read the scenario below. A woman of about 20 comes into your pharmacy. She has very bad acne. She is already treating this but wants to find out if there is any general advice you can give her. Write in the box below what you would do in this situation.
my r we ans
Ask your Pharmacist to review your answer and discuss it with you if required. 16 Counterskills
Skin
Product recommendations
PureActive Key attributes:
• Fights spots • Fades marks • Results from Day One
OTHER ADVICE Deeply cleanses to clear pores and help protect against the appearance of spots and blackheads Reduces the appearance of marks left by imperfections Tested on spot-prone skin, it has INSTANT ACTION delivering RESULTS FROM DAY ONE*
Counterskills 17
Skin
Product recommendations
Aveeno® Cream Key attributes:
• Aveeno
® Cream is clinically proven to soothe and relieve dry, eczema prone skin from day one1
• Formulated with naturally active colloidal
oatmeal and rich emollients to moisturise and soothe dry, eczema prone skin
• Regular use helps prevent dryness and irritation • Available on prescription • Available in 100ml and 300ml sizes • Also available in the Boxed Range: Aveeno ®
Lotion, Aveeno Bath and Shower Oil and Aveeno® Colloidal Bath sachets ®
Why Stock It?
• Voted Skincare Pharmacy Product of the Year 2012
• Fastest growing emollient brand on prescription2
OTHER ADVICE
For more information and to sign up to receive free samples please visit www.aveeno.co.uk/healthcareprofessional
1 Ref: Double blind randomised, comparative clinical study using Aveeno cream, 50 subjects, 2010 2 Ref: IMS November 2011, MAT value sales
18 Counterskills
Skin
Product recommendations
Oxy Clearlight
Key attributes:
• • Harnesses the healing power of blue light Targeted treatment for spots and acne
technology used extensively for years by dermatologists in specialist clinics
• Penetrates deep enough to kill P. acnes (spotcausing bacteria)
• Visibly reduces spots and acne • Easy to use Why recommend? • Clinically and scientifically proven • Recommended by doctors and dermatologists • Naturally effective • Kind to skin: NO heat or discomfort, NO harmful UV rays
• Does NOT cause drying, peeling or discomfort • Hygienic, safe and re-usable device Any other advice? • Use OXY Clearlight to treat active breakouts,
or whenever you feel a spot erupting, to visibly reduce the appearance of spots and acne
• Can be used with your daily spot treatment • Can be used whenever you experience a spot
OXY Seaweed Power range*
• Seaweed Power Anti-Spot Action • Reduces spot-causing bacteria • Reduces redness • Dissolves oil* • Removes dead skin and unblocks pores* Why recommend? • Contains unique seaweed ingredient* • Clinically proven** • Gentle yet effective • Suitable for sensitive skin • No alcohol* • No parabens • No SLS (sodium lauryl sulphate) Any other advice? • Research has shown that a two-step routine Key attributes:
with OXY Seaweed Power Fresh Skin Wash and the OXY Seaweed Power Deep Calm Balm produced a significant reduction in the lesions associated with spots, including whiteheads, blackheads, papules and pustules
outbreak
*Does not apply to OXY Emergency Spot Treatment Gel ** OXY Seaweed Power Fresh Skin Wash and OXY Seaweed Power Deep Calm Balm are clinically proven when used in combination morning and night
Counterskills 19
Skin
Section 4: Other skin conditions In addition to skin conditions affecting the scalp and face there are several other skin conditions to consider. These are:
• Dry skin • Eczema • Psoriasis. Dry skin Dry skin affects many people. It can occur in different forms and degrees of severity. It tends to affect women more than men and is especially common in children and people over the age of 60. Usually skin is soft and supple. This is achieved by the body adjusting the amount of water and oil stored within the layers of the skin. When the supply of oil and water to the skin is reduced, the skin can become dry leading to chapping, itching, and potentially broken and sore skin. Dry skin can be caused by a variety of factors including: Cold, windy or sunny weather and air conditioning can all cause the skin to dehydrate
•
• Contact with chemicals or cleansers • Frequent soaking in water s we get older the flexibility and • Asuppleness of our skin decreases and dry skin is more likely
• Smoking dehydrates the skin poor diet can also lead to • Adehydrated skin. 20 Counterskills
Symptoms
Symptoms of dry skin are: Skin that feels tight
• • Skin that looks scaly and dry • Skin that is rough to the touch • Itchy skin hickening of the skin and sometimes • Tcracks appearing in extreme cases. Treatment
Treatment of dry skin conditions is with emollients. These products replace lost water and/or restore the balance of oils in the skin’s surface. They do this by forming a smooth, oily layer across the skin surface. Emollients work in two ways: They trap water in the outermost layer of the epidermis. This then passes into the skin cells which expand and close up creating a barrier
•
his watertight layer then prevents • Teveryday irritants passing through to irritate the skin.
Emollients soothe the skin and make it feel more comfortable, helping keep it moist and flexible to prevent cracks. They need to be applied liberally and frequently in order for them to be effective. For an adult using an emollient twice a day for one week, the following quantities are suggested for the associated area of skin:
Skin
Application area
Creams
Lotions
Face
15-30g
100ml
Both hands
25-50g
200ml
Both arms
100-200g
200ml
Both legs
100-200g
200ml
Trunk
400g
500ml
Groin and genital area
15-25g
100ml
It is vital for the effective management of dry skin conditions that people understand the importance of using enough of their chosen emollient, to ensure they are getting the most from their treatment. If insufficient emollient is used, the skin will continue to be dry.
Emollients are available as creams, ointments, lotions and shower gels and contain some or a mixture of some of the following ingredients: Lanolin (some people are sensitive to lanolin and should avoid products containing this ingredient)
•
• Soft paraffin • Liquid paraffin • Glycerol • Colloidal oatmeal.
Other ingredients are included to help with the itching that is sometimes felt when someone has dry skin. These ingredients are: Urea
• • Crotamiton.
Some people may be prescribed or advised to use a topical steroid cream to treat flare ups. These are very different to emollients and should be applied thinly up to twice a day. Over the counter topical steroid creams must not be sold for use on the face, eyes, genital area, on broken skin or where there is a possible infection. Further information on the use of over the counter topical steroid creams can be found later in this section.
Counterskills 21
Skin
Section 4: Other skin conditions Practical advice
•
mollients should be rubbed into the E affected area gently until fully absorbed twice a day
•
he best time to use emollients is T straight after a bath or shower. Rather than drying the body completely customers should pat the body dry but not completely dry, and apply the emollient. This method helps to rehydrate the skin quicker and more effectively
t may help some people to avoid • Iwearing wool next to their skin as this may irritate the skin
he use of non biological washing • Tpowders may help reduce irritation
22 Counterskills
ustomers should told to avoid using • Csoap and strongly perfumed shower and bath additives
oap substitutes (e.g. aqueous cream) • Sare effective in cleansing the skin as they don’t dry the skin like soap. Make sure the customer knows that soap substitutes do not foam up like soap
aving a good skin regime will help to • Hsettle some conditions (e.g. applying an emollient after bathing or showering every day)
he use of cotton mittens may be • Thelpful with children while they are in bed to stop them from scratching and making their skin sorer.
Skin
Eczema Eczema is an inflammation of the skin, sometimes referred to as dermatitis. It appears as dry, flaky patches of skin which can occur anywhere on the body. It can be very itchy, become red and inflamed, and in some cases may crack, bleed or weep. It can be quite a debilitating problem as the itching can lead to loss of sleep. In addition the appearance of the skin along with the constant need to scratch can lead to low confidence and self esteem. The repeated pattern of itching and scratching is known as the itch scratch cycle. There are a number of types of eczema:
• Atopic
• Allergic • Irritant • Asteatotic. Atopic eczema Atopic eczema is the most common form of eczema and involves three contributory factors: An inherited predisposition to suffering with an atopic disease (such as asthma, hay fever or eczema)
•
• Abnormal immune response nvironmental factors such as pollen, • Ecentral heating.
It can affect people of any age and effects between five and 15% of children in the UK by the age of seven. Around 75% of children grow out of suffering from this type of eczema by the age of 16. It can however sometimes return in later life.
Symptoms
• Dry, flaky, itchy skin irst signs may be areas of dry skin on • Fthe face and inside of the elbow and back of knees
• Usually starts in the first two years of life lare ups can be triggered by soap and • Fdetergents, skin irritations, house dust mites, pets, rough clothing and stress.
Allergic eczema Allergic eczema or allergic dermatitis develops gradually over time. It is caused when the skin has an allergic reaction to something it has come into contact with, such as washing powders and jewellery. Flare ups can be triggered by nickel (found in jewellery, zips and watch straps), perfumes (found in toiletries and cosmetics) and preservatives (found in toiletries, cosmetics and some topical medicines). Customers who have developed a reaction to a washing powder will normally find they have a rash around areas where clothes are close fitting such as waistbands, bras and pants.
Symptoms
• Painful red, split or weeping skin. Counterskills 23
Skin
Section 4: Other skin conditions Irritant eczema
Symptoms
Irritant eczema or contact dermatitis affects around 9% of people in the UK. It usually affects the hands. It is caused by a reaction to regular contact of an irritant such as detergents, cosmetics, bleach, raw food, metals and chemicals. Nurses, hairdressers, cleaners and chefs suffer with this due to the constant exposure to irritants of this nature.
t generally starts on the shins, but can • Ioccur on upper arms, thighs and lower
• Skin has a ‘crazy paving’ appearance rooves or fissures appear in the skin • Gwhich may be pink/red, sore and itchy back
f left untreated it can result in deep, • Ipainful fissures and bleeding.
Symptoms
kin looks like a burn; painful, red and • Sulcerated.
Asteatotic eczema Asteatotic eczema is normally seen in people over the age of 60. It is thought to be the result of excess water loss from the skin, leading to a reduction of skin elasticity. Incidence is highest in the winter and cold climates and affects more men than women. Flare ups can be triggered by taking long hot baths, washing frequently, scrubbing and vigorous drying of the skin, dehydration, a side effect of taking diuretics and following the discontinuation of steroid therapy.
24 Counterskills
When fer to re
If there is flaking, blistering or signs of an infection (weeping and or yellow/green discharge) you should refer the customer to the Pharmacist.
Skin
Treatment
Treatment is with one or more of the following products: Topical steroids such as hydrocortisone and clobetasone. These are available over the counter for mild to moderate eczema and should be applied thinly up to twice a day
•
emollient which can be used as often • Aasnneeded to help hydrate the skin rea and crotamiton containing • Uproducts can be used if itching is a problem. Over the counter topical steroid creams must not be sold for use on the face, eyes, genital area, on broken skin or where there is possible infection. Hydrocortisone can be sold to adults and children over the age of 10, and clobetasone to adults and children over the age of 12. Customers should not use over the counter topical steroid creams for longer than seven days.
Practical advice
f the cause is an allergy or irritation • Ithen the items/products causing the eczema should be removed where possible. If this is not possible, (e.g. hairdressers who are allergic to chemicals used in their day job) then customers should be encouraged to try a barrier between their skin and the allergen such as gloves
f skin is inflamed or itchy, tell your • Icustomer to place emollients in the
fridge so they are cool when applied
ool can sometimes irritate the skin and • W so wear materials such as silk and cotton instead
f children are scratching during the • Inight, cotton gloves may help
ashing bedding and vacuuming carpets • W regularly can help reduce dust mites which can be the cause of the irritation.
Psoriasis Psoriasis is a long term condition which can affect the scalp, legs, back, arms and chest. A trigger is required for psoriasis to develop, which can be a throat infection, certain medications, an injury to the skin or stress. Skin cell renewal normally takes between 2128 days. In people suffering with psoriasis, this process is only between two-six days. It is not contagious but can look unattractive which causes embarrassment for the sufferer. There is currently no cure for it so any help you can offer to sufferers will be most appreciated.
Symptoms
aised red patches of skin or plaques • Rcovered with silvery white scales. The scales are dead skin cells waiting to be shed
• The plaques can vary in size and shape. Treatment
Treatment is with products containing the following: mollients which can sometimes be • Eenough to control the symptoms in mild psoriasis
Counterskills 25
Skin
Section 4: Other skin conditions nti-fungals such as coal tar can be • Auseful as they help to remove scales and reduce inflammation
•
S alicylic acid helps to remove the build up of dead skin cells and can be found in combination with some anti-fungals.
Practical advice
are should be taken when brushing/ • Ccombing the hair not to scratch the scalp
• Avoid bleaching, colouring or perming
When fer to re
26 Counterskills
the hair as this will further irritate the skin on the scalp
your customer to apply emollients • Atodvise wet skin following bathing rather than to dry skin as they are absorbed better this way
sing aqueous cream as a soap • Usubstitute will also help
should be advised not to pick • Catustomers any scales as this will expose the layer of skin underneath which may then become infected.
You should refer customers with psoriasis to your Pharmacist as they may need help from a specialist.
Skin
T
MEMBE R RE
N io at
n TO
W
INform
WWHAM!
Section 0: Lorem ipsun
•
PORTA IM
ho is it for? Pregnant and breast feeding women and children under 12 years old should be referred to the Pharmacist Diabetics with problems associated with hands or feet should be referred to the Pharmacist as they are prone to circulation problems
W
hat are the symptoms?
Refer to the Pharmacist if: They have a rash which doesn’t disappear when pressed with a glass as this may be an infection of the blood (septicaemia) such as meningitis If there is any sign of an infection (yellow discharge or weeping) If the skin is broken If there are any associated symptoms such as pain and general signs of being unwell
H
ow long have they had the symptoms?
Refer to the Pharmacist if: Any symptoms are getting worse
A
ctions taken so far:
Refer to the Pharmacist if: Medication has been tried already and been unsuccessful
M
edication, if any, taken at the moment?
Refer to the Pharmacist if: The answer is yes
Counterskills 27
Skin
Section 4: Other skin conditions
Please read the scenario below.
ACTIVITY
A man of about 20 comes into your pharmacy. He explains that he works as a full time chef and has just started in a new restaurant. Since he started, his hands have become very red and sore. As he is preparing food for most of the day he is often washing his hands. He wants to know what he should do about it. Write in the box below what you would do in this situation.
my r we ans
Ask your Pharmacist to review your answer and discuss it with you if required. 28 Counterskills
Skin
Product recommendations
Sudocrem Key attributes:
• The nations favourite nappy rash cream,
Sudocrem Antiseptic Healing Cream, is used by millions of mums, dads and healthcare professionals to treat sore skin caused by nappy rash
• Sudocrem Antiseptic Healing Cream is proven
to soothe, heal and protect your baby’s delicate skin and works in three ways: - It contains an emollient that soothes sore or inflamed skin - It works as a mild local anaesthetic to help ease pain and irritation
OTHER ADVICE
- A water-repellent base forms a protective barrier, helping to stop any irritants (urine and faeces) coming into contact with the skin Why Recommend?
• The formula is clinically proven to successfully manage nappy rash and soothe, heal and protect a baby’s delicate skin
• While the principle use for Sudocrem is to treat nappy rash, it can also be used for other skin conditions that require a soothing, protective antiseptic cream such as incontinence dermatitis and pressure sores
Sudocrem have released two new products, the kids and babies mousses. Specially formulated for delicate skin, the mousses are hypoallergenic and free from colours, preservatives, perfumes and parabens. Both products use Proderm Technology ®, a proven leap forward in simple and effective skin care. Sunscreen mousse – A high factor sun protection product that is easy to apply and has a very water resistant rating. Moisturising mousse – A gentle, super-nourishing mousse that intensively hydrates skin from the moment it's applied.
Always read the label
Counterskills 29
Skin
Product recommendations
Care Aqueous Emollient Cream SLS Free 100g Key attributes:
• 2 in 1 emollient and soap substitute for the treatment of dry skin conditions
• Free from Sodium Lauryl Sulphate (SLS) • Colour and fragrance free • Suitable for all ages Why Recommend?
• Convenience for patients – 2 in 1 emollient and soap substitute
• It is free from Sodium Lauryl Sulphate
(SLS) which can be found in some other emollient creams
• Sodium Lauryl Sulphate (SLS) can: - Thin the skin’s protective barrier with long term use1 - Reduce thickness of the skin by 10% in four weeks1 - Cause water loss, allowing irritants to penetrate1 - Caused a stinging sensation in 56% of children2
All the Care you need! 1 Ref: Tsang M, Guy RH, Effect of Aqueous Cream BP on human stratum corneum in vivo. British Journal of Dermatology, 2010 Nov; 163 (5): 954-958 2 Ref: Cork MJ, Timmins J, Holden C, et al. An audit of adverse drug reactions to Aqueous Cream in children with atopic eczema. Pharmaceutical Journal 2003
30 Counterskills
Skin
Section 5: Healthy skin There are a number of factors that determine how quickly skin ages, including genetic factors such as natural skin type, environmental factors such as exposure to sunlight and external factors such as whether or not people smoke. Age is another vital factor; skin is very different at 20 years of age to how it is at 70 years of age.
The face There are a number of steps that a customer can follow to assist them in maintaining a healthy looking face.
emove mascara with a cotton bud • Rdipped in eye cleansing lotion, taking care not to push the bud in the eye. To make the job easier advise them to keep their hair off their face
emove the eye shadow by gently • Rwiping it off with clean cotton pads
moistened with eye cleansing lotion
our a little face cleansing cream • Pinto the palm of one hand and dab it generously over the nose, chin, forehead and cheeks using two fingers of the other hand
Cleansing
assage the cream into the skin, • M starting under the throat, using a gentle
Cleansing removes dust, dirt, make up and dead skin cells from the skin. This action allows the pores to open up and breathe.
ontinue massaging the cream up to the • Cforehead, using the fingertips
Washing with soap does clean the face, but too much washing or using harsh soaps can wash away the natural oils that are needed to keep skin healthy. Using cleansers is a more gentle way of cleaning. Cleansers you use with water (removed using water to wash away) tend to suit normal, combination and oily skins. If the customer’s skin is dry (often the case if they are over 45 years old as sebum production slows down with age), a cleanser used without water (wiped off with clean cotton pads) is probably a better option.
Cleansing tips
Advise the customer to: Remove make up before going to bed so that they reduce the risk of bacteria building up on their skin
•
upward motion
massage the cream from the eyes • Gtoently the nose
assage cream back over the chin, • M which is particularly prone to blackheads emove the cream from the face with • Rclean cotton pads in each hand. Start
under the chin and work over the cheeks and onto the forehead.
Toning Toning helps to remove any residual dirt or cleanser left on the face after cleansing. It also helps in restoring the natural pH level of the skin, making it ready to be hydrated. Toners with glycolic or alpha hydroxy acid are best for toning for almost all kinds of skin.
Counterskills 31
Skin
Section 5: Healthy skin Toning tips
•
Immediately after cleansing, apply toner with a clean cotton pads all over the face except the eyes and lips
ipe the toner in an upward and • W outward direction.
Exfoliating As new skin cells are created in the skin’s lower layer, (the dermis) and travel to the surface of the skin they die and become saturated with keratin. Exfoliation removes the outer layer to reveal the newer skin beneath. This shedding of the outer layer unclogs pores, keeps skin clean, and helps reduce acne breakouts. Exfoliation should always be done after cleansing and toning of the skin.
Exfoliating tips
There are a number of different types of exfoliation products available: Chemical exfoliators which should be left on the skin for as long as is recommended on the packet, usually between five and 10 minutes. The exfoliator should then be washed off with water
•
ream exfoliators which are suitable for • Csensitive, more delicate skin. They should be applied in a thin layer over the face and left to dry. Once dry, the paste can be peeled off which will lift the dead skin off the face
exfoliators which can have • Ga ranular gel or cream consistency. They are
suitable for tougher skin, particularly men before shaving. They should be
32 Counterskills
mixed with a drop of water between the fingers and applied across the whole face, working the product into the skin with circular motions. It should be removed with warm water or a damp flannel.
Skin
Facial masks A facial mask is a creamy paste (or gel) applied to the face, after it has been cleansed. It often contains minerals, vitamins, essential oils and fruit extracts.
If customers are looking for a boost of radiance, exfoliating masks will help. They should choose a peel off mask which will exfoliate their skin leaving it smooth and fresh. Many exfoliating masks use fruit extracts to naturally exfoliate.
Masks are removed by either rinsing the face with water, wiping if off with a damp cloth, or peeling off by hand.
Facial mask tips
There are different kinds of masks to suit different skin types. For example: Dry clay/mud masks which draw out impurities (and sometimes, natural oils, too) from the pores
•
ream/gel masks which stay damp to • Chydrate the skin
style masks, where a paper mask • Sisheet dampened with liquid to tone and
se facial masks regularly. This will help • Uskin texture and radiance. Do not do it more than once a week. Improvements won’t be more dramatic and may do more harm than good
uration for wearing a face mask • Dvaries with the type of mask, and
manufacturer’s usage instructions. The time can range from a few minutes, to overnight.
moisturise the skin
ybrid/clay and cream masks that • Hinclude small beads for removing dead surface skin cells. People with oily or combination skin should use a clay mask. Clay is great for removing excess oil, deep cleaning the pores and preventing and clearing up blackheads. Natural clay is a great detoxifying treatment for the face without leaving the skin feeling dry. People with dry skin should use a cream/gel mask to add moisture. Using this type of mask will rejuvenate and plump the skin. Many masks for dry skin include a bit of “sink-in” effect. This is where the mask is left on the skin for up to 10 minutes and then rubbed in a bit more before the excess is wiped off.
Counterskills 33
Skin
Section 5: Healthy skin Moisturising Moisturising protects skin from the elements as well as preventing it from drying as skin ages faster when dehydrated. Without moisture, the skin will not remain smooth and supple. Moisturisers form a film over the skin which contains and supplements the natural moisture. In addition moisturising creams offer many active anti-ageing benefits. Some claim to make skin smoother, others tighter and more radiant.
Moisturising tips
Advise the customer to: Dot moisturising cream lightly all over the face using the tips of their fingers
•
ress the fingers of both hands into the • Pcentre of the forehead and work the cream slowly outwards. Pat the cream gently around the eyes
•
ork the cream around the jaw line, W chin and mouth with the middle fingers of both hands
assage the cream over the throat with • M alternating hands, using upward strokes from collar bone to chin
se a moisturiser with a high SPF • U(around 15) each day as UVA rays will take the bounce out of the skin
se a moisturiser with high antioxidants. • UThese natural substances protect cells from damage inducing free radical molecules. Research has also shown that antioxidants can stimulate new skin cell growth. Because of these protective qualities, manufacturers are including
34 Counterskills
antioxidants in more facial moisturisers as a soothing element for irritated skin and to safeguard against the sun’s ultraviolet rays. A few antioxidant rich ingredients to look for include green tea, pomegranate and resveratrol.
Practical advice
There are some general points that customers can be advised on to help them maintain healthy skin: Give up cigarettes. Smoking stops oxygen getting to the skin cells and can cause premature ageing, as well as puckering lines around the mouth
•
ake sure they are getting enough • M sleep. A few good nights sleep improves complexion
ut down on excessive alcohol • Cconsumption. Drinking robs the skin of vital nutrients and causes facial blood vessels to dilate. These may dilate permanently, leading to red spider veins
void yo-yo dieting. This is another • Acontributing factor to premature wrinkling as overstretched skin is baggier skin
rink plenty of water to keep the skin • Dhydrated. As skin changes with age there are some additional factors that customers need to consider.
Skin
Customers in their 30’s
Customers in their 40’s
Customers in their 50’s and above
• Customers should eat a balanced diet rich in antioxidants such as vitamins A, B, C and E. These fight off free radicals in the environment (unstable molecules that attack cells in our bodies and speed up ageing). These vitamins will help the skin repair itself, stay moist and produce the enzymes that stabilise collagen production • For further protection, they could try using an antioxidant face cream, such as one that contains vitamin E • Use a vitamin-packed night cream. Research indicates that the temperature of skin rises at night, so nutrients are better absorbed.
• Customers should try using a cream containing alpha hydroxy acids (AHAs). These help strip the dead outer epidermal cells away by dissolving protein bonds, leaving the face looking fresher • As deeper wrinkles start to form, customers may wish to experiment with a retinoid cream that uses a pure form of vitamin A. These creams can help to reduce the signs of fine lines, wrinkles and age spots, although those with sensitive skins will find they sting their skins at first.
• Stick to a gentle cleanser/toner to clean the skin, avoiding irritants and astringents such as alcohol • Use a good moisturiser with a built in SPF, and keep out of the sun • Try a cream with an anti-ageing formula such as retinol or idebenone. Use these products at night because they make skin more sensitive to sunlight.
Counterskills 35
Skin
Section 5: Healthy skin The body Taking care of the skin on your body is just as important as looking after your face. There are a number of steps that a customer can follow to assist them in maintaining soft and supply skin.
Cleansing
Cleansers are designed to remove dirt, sweat, sebum, and oils from the skin through the action of surfactants. These work by surrounding dirt particles and oils, dissolving them in water, and removing them as water runs over the skin. However, surfactants can have harmful effects on the outer layer of the epidermis causing: Dryness
• amage to the barrier function of the • Dskin • Redness • Irritation • Itching.
Common bar soaps contain the most aggressive surfactants. They do the best job of picking up dirt and grime from the skin but they have a high pH, making them irritating to the skin. There are soaps that have had various elements added to them so that they are not so drying to the skin. These include: Superfatted soaps
• • Transparent soaps • Syndet bars ombination bars (combinations of • Csuperfatted soap and syndet bars). 36 Counterskills
Liquid soaps (or body cleansers) were first introduced in the 1990s, revolutionising the skin care marketplace by offering a less damaging alternative to soap. The production of liquid soaps is a more straightforward process compared to bar soap production. This makes it possible to use milder surfactants and better moisturisers. There are three types of liquid body cleansers: Humectant rich cleansers
• • Emollient rich cleansers • Low foaming cleansers.
Skin
Humectant rich cleansers Humectant rich cleansers benefit the skin by attracting water from the dermis into the epidermis, increasing the water content in the epidermis. Most body washes fall into this category and contain glycerin as the humectant. These cleansers typically contain (in order): Water
• odium Lauryl Sulfate – a harsh • Ssurfactant
• Glycerin – the main humectant ocamidopropyl Betaine – another • Chumectant. Because this type of cleanser contains water soluble ingredients, most of the moisturising ingredients get washed away in the rinse. They don’t leave enough moisturiser on the skin to moisturise it.
Emollient rich cleansers Emollient rich body cleansers are better for the skin than humectant rich cleansers because they are milder and more moisturising. The surfactant used in these washes is milder than the surfactant used in other washes, causing less damage to the skin. Also, because the emollient is not water soluble, it stays on the skin and moisturises it. These cleansers typically contain (in order): Water
• lycine Soja (soybean oil) and/or • GHelianthus Annuus (sunflower seed oil)
mmonium Lauryl Sulfate – a milder • Asurfactant.
Low foaming cleansers This category of liquid cleanser is often used on the face, but there are low foaming body washes. Low foaming cleansers have little to no surfactant to damage the skin, but they don’t contain any ingredients to replace moisture in the skin. There are no humectants or emollients in the ingredients and the surfactant (Sodium Lauryl Sulfate) is farther down the ingredient list meaning it is present in smaller quantities.
Cleansing tips
hile it may feel relaxing, a hot bath • W is not good for the skin. Hot water will strip the moisture and oils out of the skin, leaving it parched, dry and scaly. Use warm water instead of hot water, and limit the bath to 15 minutes at the most. If taking a shower then it should be for even less time than this
bath will leave the skin stripped • Bofubble the oils the skin needs. Instead of using a bubble bath, find a soothing oatmeal or milk powder. Another product to try is bath oil. A cap full of oil will leave the skin even more hydrated than before
hen drying, gently pat the water off • W the skin instead of rubbing the skin dry. By patting dry, or gently rubbing, the skin will be able to retain more of its moisture.
– emollients
• Petroleum
Counterskills 37
Skin
Section 5: Healthy skin Exfoliating The body, like the face, is covered in a layer of dead skin cells. If your customer wants healthy smooth skin, then they must slough off these dead skin cells. Exfoliating the body once or twice a week is usually enough, however, women with oily skin should exfoliate more often than those with dry skin.
Exfoliating tips
stepping into the shower, brush • Bdryefore skin with a loofah, body brush or exfoliating gloves. This will help remove the loose skin and prepare the skin for the exfoliating process
on’t exfoliate the skin if there is • Dsunburn or the customer has any open cuts or wounds
se a pumice stone on the feet to • Ueliminate rough spots and calluses pply the exfoliating cleanser in a • Acircular motion starting with the
bottoms of the feet and working up
o not scrub too hard around the bikini • Darea as the skin is very sensitive
se a body brush to exfoliate the back • Uand other hard to reach places not use a body exfoliating product • Dtooexfoliate the face as this will be too harsh
inse with lukewarm water, followed by • Rcooler water to close the pores f the customer’s skin becomes • Iexcessively dry or irritated after
exfoliation, advise them not to scrub so hard, to cut back on how often they exfoliate and explore the possibility that they may be allergic to the products they have used.
Moisturising Customers should use body moisturiser once a day. Exfoliation is drying to the skin, so the skin must be hydrated. The most important thing to remember is to moisturise every single time they get out of the shower or bath. It is important to seal in the moisture after bathing or showering as quickly as possible. The quicker this is done, the better the skin will look and feel. And if the moisturiser of choice is body oil, it’s actually best to apply it to damp skin. There is a wide choice when it comes to hydrating moisturisers for the body. The three most popular types are: Body butters. These are good for intense, long lasting moisture. They are perfect for the long cold winter when skin is prone to dehydration. Formulated to be the thickest moisturiser, the consistency does seem almost butter
•
38 Counterskills
Skin
Body lotions containing alpha or beta hydroxy acids are ideal choices because these acids continue to remove dead skin cells.
Moisturising tips
he areas of the body that are most • Tprone to dryness are the lower legs, arms, sides and thighs. Taking the time to address those trouble spots and adequately moisturise from the neck downward requires more effort, but by doing so will pay off as the skin maintains its youthful luster longer
for lotions that have antioxidants • Linook them. Antioxidants can help to
like. Most body butters will last up to 24 hours, making them great for areas of the body where the customer won’t be able to reapply on a regular basis during the day. They are also great for extra dry areas of the body such as the feet, knees and elbows
otions. These are by far the most • Lpopular moisturiser because of the
ease of application. They are usually dispensed with a pump or in a squeeze tube.
ils. Oils are a great multi use beauty • Oproduct. Use it in the bath to soften
the skin, or apply straight out of the shower to damp skin. Oils soak in when applied, leaving the skin moisturised and smelling great. While oils can be a bit pricier than lotions, the bottle will last much longer.
eliminate free radicals and they can also work to stimulate the growth of new skin cells. Some of the best antioxidants include resveratrol, pomegranate, and even green tea
ome moisturisers are higher priced. • SThey command this price by saying that they actually have collagen in them. While collagen is an essential part of skin health, adding collagen to a product does not provide results. These molecules of collagen are too large to even pass through the skin, so they are basically useless. Avoid paying more for these products as you search for the best body moisturiser
o find a moisturiser that will be the • Tmost beneficial, consider your skin
type. Use a water based product if you have normal or oily skin, an oil based moisturiser for dry or mature skin, and a product free of fragrances and dyes for sensitive skin.
Counterskills 39
Skin
Section 5: Healthy skin Seasonal changes Your customers’ skin care needs may change to reflect the relevant season. In summer the air is dry and hot and there may be a lot of sunshine. In winter, there are cold winds, central heating and very cold temperatures. Here are a few hints and tips for you to give your customers to help them decide how best to manage their skin care regime throughout the year: When the seasons change, customers may notice their skin type changes as well. Winter is the time where someone with oily skin might notice their skin turns a bit normal, or those with normal skin might consider their skin is suddenly dry. Advise customers to take note of what their skin is like as the weather turns cold or warm to see if they need to change their skin care products. If they are not sure whether their skin needs different products, they should seek advice
•
s summer holidays approach customers’ • Athoughts might turn to the beach, sunbathing and wearing swimming costumes or bikinis. Exfoliation is a perfect first step before tanning, waxing or simply rejuvenating winter weary skin
the summer, fruity body cleansers are • Ianpopular. The customer should make
sure that their summer choice isn’t going to dry out their skin when the dry, cold weather comes. A body cleanser that is soap free as well as hydrating, such as a creamy body wash would be a good winter alternative
40 Counterskills
ily based scrubs are good for winter • Obecause the customer gets the exfoliating benefits with the extra bonus of hydrating oils
customers to hydrate their skin • Aondvise a daily basis. The best time to apply
their lotion is right after they have dried off after a shower or bath
unscreen is essential in summer but • Sshould be applied in winter too. Use a
moisturiser with an SPF 15 as a minimum. In summer reapply with a facial sunscreen throughout the day as needed
dvise customers to remember their feet! • ACustomers’ feet are going to be stuck inside their shoes/boots for some months over winter. If they continue taking care of them and exfoliating them on a regular basis, they will have no problem popping back on their sandals when the time comes. Plus, having nice feet will make them feel good.
Use hand cream throughout the year. In summer your customers’ hands can dry out due to the heat and in winter, cold air can chap and make skin on the hands feel sore. Moisturiser should be applied frequently to the hands as they are the areas of skin which come into contact with the elements more than others.
Skin
ACTIVITY Please read the scenario below. A woman of about 30 comes into your pharmacy. She says that she would like help choosing some new skin products. She has never bothered before but her friend has just started using a skin care regime and has suggested she do the same. When you ask her what type of skin she has she says that it is oily. Write in the box below what you would advise as a skin care regime to this customer.
my r we ans
Ask your Pharmacist to review your answer and discuss it with you if required. Counterskills 41
Skin
Product recommendations
Kleenex
Key attributes:
• Kleenex
Facial Cloths – softer than cotton wool pads, cleanse skin better than cotton wool ®
• Kleenex
® Eye Make Up Removal Wipes – gently and effectively remove eye make-up including waterproof mascara
• Kleenex
Facial Cleansing Wipes – extra gentle quilted wipes which effectively remove make-up and suitable for sensitive skin ®
• Kleenex
® Shine Absorbing Sheets – powder free oil blotting sheets which dab away any excess oil keeping make-up intact
• Plus, these products are made from Ecoform with natural fibres, so they have a lower environmental impact than standard wipe material too.*
*excluding Shine Absorbing Sheets
Why recommend?
•
good skincare regime is essential for A any woman. Not only is it refreshing and invigorating to cleanse your skin, but also removes the make-up that blocks your pores and the dirt and germs that build up on your skin throughout the day.
42 Counterskills
Skin
Section 6: Check your understanding
Complete the following multiple choice questions on skin. Ask your Pharmacist to check your answers.
ACTIVITY
Question 1 Dandruff is caused by:
A) Not brushing your hair properly B) A build up of dead skin cells on the scalp C) Washing your hair too frequently Question 2 Hair loss affects around:
A) 80% of men and 20% of women B) 70% of men and 50% of women C) 90% of men and 50% of women
Counterskills 43
Skin
Section 6: Check your understanding
Question 3 The main cause of acne is:
A) Not washing enough B) Over sensitive oil producing glands C) Eating too much fatty foods Question 4 Impetigo is most commonly found on the:
A) Face B) Tummy C) Feet Question 5 Dry skin should be treated with:
A) Vaseline B) Exfoliating products C) Emollients
44 Counterskills
Skin
Question 6 Eczema is also known as:
A) Dermatological itch B) Dementia C) Dermatitis Question 7 Atopic eczema is:
A) The least common form of eczema B) The most common form of eczema C) Only experienced in adults Question 8 When cleansing your face it is important to:
A) Choose the right cleanser for your skin type B) Make sure that you buy the most expensive cleanser you can afford C) Always use soap
Counterskills 45
Skin
Section 6: Check your understanding
Question 9 A clay/mud mask is suitable for customers:
A) With dry skin B) With oily or combination skin C) Who are looking for a boost of radiance Question 10 A humectant rich cleanser:
A) Reduces water content in the epidermis B) Increases the amount of oil in the epidermis C) Increases water content in the epidermis
46 Counterskills
Skin
Look out for the next Counterskills workbook from Alliance Healthcare covering Women's Health Available May 2012
training
skills May -June 2012
COUNTERSKILLS training programme
Womens Health urinary tract disorders
6
workbook
thrush contraception
skill builder:
sexual health
advising confidently
pre menstrual syndrome
using WWHAM
menopause
activities & assessment merchandising aid
Supported by:
Queries relating to Counterskills should be directed to
[email protected] or 0203 044 8964 Content developed by: ©2011 Scientia Skills Limited Copyright in the whole and every part of the workbook belongs to Scientia Skills Limited (“the Owner”) and may not be used, sold, transferred, copied, adapted or reproduced in the whole or in part in any manner or form or in any media to any person without prior written consent of the Owner.
Counterskills 47
Planogram This planogram has been provided as a guide to help you optimise the sales opportunity on the skin category. For a full listing see the ‘Star Ratings’ document included with this workbook which contains essential, additional and supplementary brands within pharmacy.
