1. Emollients - what you need to know Barbara Page Dermatology Liaison Nurse Specialist NHS Fife November 2013

2. Skin facts and functions promoting healthy skin – skin integrity emollient therapy explore the variety of emollients

4. Skin Facts ……. the largest organ of the body weighs approx 2.5 kg covers area approx 2 sq metres contains over 1 million nerve endings has ability to regenerate itself cell renewal takes approx 28 days two main layers - dermis & epidermis

5. Functions of the skin barrier temperature control sensory vitamin D synthesis communication & display

6. Promoting Healthy Skin……. the basics of skin care emollients…… emollients…...

7. Allergens H ealthy Skin Water © 2001 Elliott/Cork/Cork

8. Loss of Skin Barrier allergens/irritants/infection into skin - skin reacts © 2001 Elliott/Cork/Cork Loss of water Loss of fat

9. Internal and External Factors Skin General Health Central Heating Cold Sun Trauma Heredity Factors Infection Chemicals/ Allergens/ Irritants Stress Ageing Drugs Lifestyle Hormone Change Pollution Infestation Nutrition Fluid intake

10. Emollients play a vital role in the management of skin disease definition and function classification when to apply how to apply which emollient

11. Emollients Emollients are oils that spread easily on the skin, providing partial occlusion that hydrate and improve the Stratum Corneum Rawlings A.V. et al., Dermatologic Therapy, Vol. 17, 2004, 49-56

12. Emollient……definition and function medical term for moisturiser safe simple effective steroid sparing intrinsic anti-inflammatory action

13. Emollients also help to………… replace water lost from the skin lubricate the skin reduce scaling seal the Stratum Corneum

14. Classification of emollients…. Lotions / Gels contain more water and less fat than creams Creams contain a mixture of water and fat Ointments contain very little water

15. Classification cont……………… Bath oils clean and hydrate - trap water in skin Soap substitutes not astringent - not alkaline - do not dry out the skin

16. Emollients…..when to apply as frequently and liberally as possible ideally - 3 times per day after bathing when the skin is still moist

17. Emollients….how to apply effectively bathing generously but gently do not rub vigorously - may cause itching or irritation smooth emollient along arms, legs and body following the natural hair growth

18. Emollient ……… the choice paramount importance cosmetic acceptability essential compromise between efficiency and cosmetic acceptability

19. Which emollient ? The very best emollient for any individual is……………. the one they prefer

20. Emollient base……... Important point to remember……… use a cream base for moist/wet skin use an ointment base for dry/cracked skin

21. Quantities of emollient For an adult with dry or compromised skin bath additives 300mls per month creams or ointments 2000gr per month

22. Emollient chart

24. What not to use on the skin Aqueous Cream Emulsifying Ointment Olive Oil

25. Useful web sites www.pcds.org.uk www.dermnetnz.com www.nhsfife.scot.nhs.uk/skinintegrity www.nhsfife.scot.nhs.uk/skincare www.bad.org.uk www.bdng.org.uk www.sdns.co.uk www.eczema.org www.pathways.scot.nhs.uk/dermatology

26. Thank you Questions ?