There are a number of dry skin conditions which are prone to inflammation, such as eczema in its various forms, and psoriasis.
The term eczema, or dermatitis, describes a range of related dry skin conditions where there is damage to the skin barrier. These include atopic eczema, contact dermatitis and varicose eczema. In such cases the skin is dry and often inflamed or itchy. Scratching can cause further damage to the skin and aggravate the inflammation.
The causes of the different types of eczema are varied, and for atopic eczema there may also be a genetic link. Factors in the environment can make the eczema worse (called trigger factors).
‘Flares’ or ‘flare-ups’ can occur in atopic eczema, characterised by areas of inflammation where the skin is often hot, red and may also be itchy. Flares are often due to a trigger, and it is important to try to recognise what these triggers are so that they can be controlled. Common triggers are:-
Dry skin, which is lacking in oils, allows too much water to leave the skin. Emollients can help to replace the missing oils, to help trap moisture in the skin, and provide a protective layer on the skin preventing further water loss.
Scratching should be avoided, if possible, as it damages the skin even more and initiates a cycle of itching and scratching which causes inflammation, making the eczema worse.
By carefully looking after the skin and regularly using simple treatments such as emollients and anti-inflammatories, it is possible to reduce the impact of eczema for most people.
Anti-inflammatories such as topical steroids are often prescribed during flare-ups. These are topical treatments (applied to the skin) which contain a steroid to reduce inflammation and help improve the condition. Regular use of emollients can help to increase the time between flare ups and can help reduce the amount of topical steroids required.
Psoriasis is an inflammatory dry skin condition that causes skin cells to grow, or mature, too quickly. In healthy skin, this process usually takes between 21 and 28 days, but only a few days for psoriatic skin. This leads to a build-up of immature skin cells, causing red, dry inflamed areas of skin that are covered in silvery scales. These become uncomfortable, and can easily crack and bleed.
It is estimated that psoriasis affects between 2 and 3% of the UK population, which is over 1.5 million people. Psoriasis can start at any age, but commonly begins in the late teens to early 30s, or between the ages of 50 and 60.
There are many treatments for psoriasis and your GP or nurse will be able to recommend an appropriate therapy for you.
Treatments include topical therapies, such as steroids or Vitamin D analogues to help reduce the inflammation. Emollients are widely prescribed for patients with psoriasis and they can be used alongside other treatments. Emollients help to soften scales, keep the skin supple, reduce the dryness and improve the appearance of the skin.
Anti‑inflammatory: A treatment used to reduce inflammation
Emollients (medical moisturisers) are key to treating dry skin. However, for those whose skin is prone to inflammation, an additional treatment is often required, either during ‘flares’ or sometimes for longer, if the condition is not adequately controlled using emollients alone.
Anti‑inflammatory treatments such as topical steroids are effective, but their use may be limited, especially when used long term, over large areas of skin, or on sensitive parts of the body, and when used by children and the elderly.
Emollients and topical steroids are often prescribed to be used together to treat both dryness and inflammation. When used together, each treatment should be applied separately and allowed to be absorbed before the next is applied (in line with the in-pack leaflet or as advised by the prescriber or pharmacist). Emollients are commonly used in large quantities, whereas topical steroids should be used sparingly (as advised by the prescriber or pharmacist), and only on areas of active inflammation.
Adex Gel combines an emollient and anti‑inflammatory together in a single product. Adex Gel is very convenient to use, making it easy to establish a treatment routine.
Adex Gel can be used routinely where additional anti‑inflammatory action, in addition to the emollient action, may be beneficial.
Adex Gel can be used on the face and is suitable for adults and children over 1 year of age.
Emollients are key to the routine treatment of dry skin. However, for those whose skin is prone to inflammation, additional treatments may be required, in addition to the emollient, either during ‘flares’ or long-term, because the condition is not adequately controlled using emollients alone.
Additional treatments are typically topical corticosteroids (sometimes just referred to as steroids) or immunomodulators (also referred to as calcineurin inhibitors). Effective though these agents are, their use may be restricted, especially if used long-term, on large areas of skin, on sensitive areas, and when used by children or the elderly.
Topical corticosteroids are available in a variety of different potencies. Patients may sometimes be required to use a range of different strengths of topical corticosteroid, when the severity of the condition changes, as well as for different parts of the body. It is always important to ensure that the correct product is being applied to the correct part of the body.
Immunomodulators are sometimes used instead of topical corticosteroids, such as on the face or for children. However, use of immunomodulators is normally short-term.
Advice should be sought from the prescriber as to the appropriate use for each prescribed treatment.
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