The pharmaceutical Approach:
Today, at least 15% of the population consult a GP each year with skin disorders, including skin allergies. (Reference 1) About 20% of young Britain's are now estimated to suffer from eczema alone, and it is on the increase. (This compares to just 5% 50 years ago) In adults, the prevalence is slightly lower, but also on the increase. (Reference 2)
Recommendations of first line treatments for common skin disorders, for the practice of dermatology in primary care are in place. New outline guidelines for the management of common skin disorders from the Primary Care Dermatology Society (PCDS) have been made available. However, the principals of treatment, i.e.: emollients, topical steroids, antibiotics, antihistamines, bandaging / wet wraps have not been changed over the last 30 years or so.
The average time for an appointment with a GP is only 8 Minutes and a large element of “try it and see” is involved in finding the best sorts of emollients, strength of steroid and other medical support treatments. This can take several appointments and some weeks or even months to get the right treatment balance which provides the patient with relief and improvements of the skin disorder.
Unfortunately, today’s patient is very impatient and more often than not expects instant cure.
Furthermore, poor patient compliance, inappropriate selection and insufficient use of emollient types may have led to an over use of steroid creams. Today’s patients seem to object to the liberal use of steroid creams, they have heard about certain side effects and have also been made aware that emollient creams routinely given may actually cause them more harm than good. (Reference 3) They don’t like to take antibiotics for everything and they have not got the time or the ability to apply wet wraps / bandaging and find them totally uncomfortable, restrictive and inhumane, something they can do without.
Today’s patients feel that the pharmaceutical approach in treating common skin disorders, particularly for most cases which are of mild severity, is unsatisfactory and is not providing the hoped for relief and they actively look for alternatives.
The non pharmaceutical Challenge:
Today, most Britain’s do not believe anymore that they have the best health-care system in the world, although government health experts keep saying that it is.
Equally, patients do not assume anymore that the pharmaceuticals the doctor’s prescribe are unquestionably better than the alternative or complimentary medicines. This is supported by the fact that the European Union (EU) is estimated to have spent the equivalent of 6 billion dollars on plant - based pharmaceuticals in the year 1995 alone and today it is more than double that figure. Therefore, one of the major challenges is to transcend the assumptions that are made by certain doctors, the advertising and promotion of the drug companies and the narrow and restrictive drug approval processes used in the UK. Particularly in the light that the so called advances in orthodox (Pharmaceutical) treatments have had little or no impact in stemming the tidal wave of common skin disorders.
Could it be that we simply do not know which information is correct and therefore feel confused as to which way to turn?
Alternatives do work for millions of people - but often doctors have little or no knowledge of alternative medicines and therapies. To be fair, many doctors are stretched to the limit, often working an exhausting schedule and under tremendous pressure. They have enough trouble keeping pace with the constant flow of information in the medical journals about “new” orthodox treatments.
Also, new product information is continually being sent to doctors by the pharmaceutical companies who are all to eager to increase their market share in the lucrative prescription drug market. However, the winds of change are beginning to blow in a more positive direction.
Some doctors and other practitioners of conventional medicine may be sceptical about alternative therapies, but many others for example take dietary supplements themselves. In a survey of 181 cardiologists in the USA, nearly half were regularly taking antioxidant vitamins (C&E), which are linked with the prevention of cancer and heart disease. A smaller percentage of doctors (37%) routinely recommended antioxidants to their patients. A study of 665 dieticians in Washington State found that nearly 60% of them took some kind of nutritional supplement either daily or occasionally. (Reference 4) Lets be honest, might the figure for the UK be similar?
Some doctors in the UK now openly admit that conventional medicine and alternative therapies can work in tandem for the well-being of their patients, whilst many others are still closed to the concept of alternative and complimentary medicine. Increasingly though, more and more local health authorities are offering alternative therapies on the national health.
Some patients are actually asking their doctor questions about the side effects of drugs and are suggesting natural remedies which they have discovered as beneficial to their health. Patients everywhere are sick of being sick and are desperate to find alternatives and / or complimentary treatments.
A growing number of medical professionals believe that future health-care will demand the successful integration of conventional and complimentary or alternative healing methods. As fast as medical science forges ahead into the future of on-line diagnosis, gene therapy and laser surgery, older, gentle modes of healing are acquiring renewed appeal. In many countries that boast state -of - the - art medicine, for example, nearly half the population claims to be using some form of non-conventional therapy.
Of course it would be foolish to ignore the life-saving achievements of modern medicine, and many of us have cause to be grateful for the latest drugs and skills of medical specialists. But the future of health-care involves practitioners of all approaches working hand in hand and that includes treating common skin disorders and becomes apparent when we look at the causes and trigger factors of common skin disorders.
The Cause of Common Skin Disorders:
The body, when healthy, maintains a state of balance, or equilibrium, in which all systems, including the skin, function smoothly. What undermines healthy and resilient skin, is an imbalance.
There are several main causes which can play a part individually or several causes come together and others which are consequential causes, ie: poor diet, immunological deficiencies, environmental pollution and toxins, unremitting stress, lack of rest, low levels of physical activity, persistent psychological conflicts, pessimism and hostility for example.
The Trigger Factors of Common Skin Disorders:
Structural trigger factors:
Are external irritants, which can provoke contact skin disorders and can work in tandem with internal causes. ie: soaps, detergents, perfumes, cosmetics, wool, synthetic fibres, leather, nickel, rubber etc,,
Biochemical trigger factors:
Are allergic skin reactions to a wide variety of external and internal irritants, allergens, which involves the immune system, triggering inflammation of the skin ie: nuts, citrus fruits, cows milk, kiwi fruits, food additives, wheat etc,,
Psycho-social trigger factors:
Are emotional tension and stress, higher levels of anxiety, hostility and neurosis, ie: embarrassment and lack of confidence, bullying, unacknowledged stress, bereavement etc,,
Recommendation:
It is therefore suggested that the GP and dermatologist when treating common skin disorders works in tandem and involves other practitioners such as nutritionists, psychologists etc,, and also gets as much information as possible himself about alternative and complimentary ways to treat common skin disorders. There is sufficient information available for example in complimentary and alternative health magazines, natural product magazines on the internet, at complimentary and natural health-care exhibitions etc,,
It is a wrong policy to allow only pharmaceutical companies to display (promotional) leaflets for patients (about their products) in GP’s practices and the dermatology sections of hospitals, very often masked as “unbiased” educational literature for sufferers of skin disorders.
The only way forward is not to be “narrow minded” and implement complimentary and alternative therapies combined with or based on medical science, in other words integrated medicine to practice the best treatment options.
These ideas are confirmed by the case studies preseted here:
| Case study 1 on a non pharmaceutical treatment of eczema. | ||
| Patient: 4 and a half years old. Eczema from 9 weeks old, continuous treatment with 1% hydrocortisone cream, occasionally 2.5% strength, plus 2 types of prescribed bath oils and three types of prescribed emollient creams. Regular check ups four times a year with GP. | ||
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Picture 3 and 4 were taken 1month after treatment only with a natural colloidal skin therapy spray, free from steroids, hydrocortisone and other pharmaceutical ingredients.
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For further free information on the above case, plus other case histories, including the treatments used in those cases, please click here and look at our registered users articles in the consultation room.
References:
Royal College of General Practitioners. Morbidity Statistics from General Practice. Fourth National Study 1991 - 92. London.
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Kay J, Gawkrodger DJ, Mortimer MJ, Jaron AG. The prevalence of Childhood atopic eczema in a general population J Am Acad Dermatol 1994; 30: 35-9
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BBC. “warning over child eczema cream.” Published 2003/11/28
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“Guide to Vitamins, Minerals and supplements” Dr Anne Walker, Dr Alan Lakin, University of Reading, Dr John Cormack GP and regional (Essex) press secretary for the BMA. Readers digest publication 2000.