Millions of people across the US are affected by skin conditions, with symptoms ranging from the purely cosmetic to the downright excruciating. These conditions can be lethal in some cases. Skin conditions can indicate deeper problems – for instance, patients suffering from psoriasis are at a higher risk of developing associated comorbidities such as diabetes, chronic pulmonary disease, rheumatic disease, and renal disease.
Many patients with skin issues tend to experience sleep disruptions, suffer from anxiety, and fall into patterns of social isolation. For example, for those battling melasma, eczema or psoriasis, psychological symptoms pack a one-two punch, triggering stress that can exacerbate the conditions.
These factors can further undermine a patient’s ability to function well in social situations, school, or at work, which is likely to exact an emotional and financial toll for patients and the society at large.
When seeking medical care, dermatological patients increasingly face two main challenges:
1. Access to Treatment Options
The challenges of accessing treatment options don’t necessarily end after seeing a dermatologist – getting the prescribed treatments can be equally difficult. Given the innovations in dermatological therapies, it is particularly unfortunate to experience these challenges.
While traditional dermatological treatments such as phototherapy or topical agents are still used, advances over the past few years, such as small molecule inhibitors and other biologics, offer more effective options.
However, some of these modern health plans may require prior treatment authorization, prolonging the time a patient has to spend in discomfort and potentially avoid social settings such as the workplace. The process may involve step therapy (also called step edits), which requires a patient to first try traditional treatments before receiving an innovative therapy.
2. Access to Specialists
Health care providers play a pivotal role in diagnosing a patient’s skin condition and identifying the treatment options that are most likely to be effective. However, it has become more difficult to access medical specialists due to:
• Shortage of skin specialists
• Coverage limits
• Narrow health plan networks
The Holistic Approach to Skin Treatments
As a result of the profound and far-reaching effects of dermatological treatments, a holistic approach could be essential in dealing with skin disorders. Given the social and psychological factors associated with skin diseases, an empathetic approach is important. This may involve using some topical preparations to treat common skin issues.
The following topical preparations can be used to treat skin disorders.
Ointments such as petroleum jelly contain very little water and are oily. They are most appropriate when the skin needs moisture or lubrication. While they can be greasy, messy, and difficult to wash off, they usually deliver active ingredients into the skin better than creams.
They are also less irritating than creams, lotions, gels, and solutions for open wounds such as ulcers or erosions. Ointments work most effectively when applied after dampening the skin with water or after taking a bath.
These are the most commonly used preparations. They are emulsions of oil in water and are easy to apply. When rubbed into the skin, they appear to vanish and are relatively non-irritating.
These are suspensions of finely powdered and dispersed material in a base of oil and water. Although they are considered less effective and of lower potency than creams, ointments, and gels, lotions have several beneficial effects. They can be easily applied to hairy skin, and are particularly useful for drying or cooling oozing or inflamed lesions, such as those caused by athlete’s foot (tinea pedis), jock itch (tinea cruris), or contact dermatitis.
These are aerosol preparations that contain liquids stored under pressure. A propellant is used to dispense the mixture into the skin. They are often used in hair-covered areas as they contain an alcohol base that is rapidly absorbed into the skin to give a soothing effect.
These are liquids in which a drug is dissolved – the most common include plain water, propylene glycol, alcohol, and polyethylene glycol. They are used especially for scalp disorders such as seborrheic dermatitis or psoriasis.
Rather than moisturizing the skin, solutions tend to have a drying effect, which is useful for wet and oozing skin disorders. Solutions can irritate, particularly when those containing propylene glycol and alcohol are applied to open wounds. The two common solutions that are often used as soaks are Domeboro solution and Burow’s solution.
These are alcohol-based or water-based substances that are thickened without fat or oil. Gels are most effective for conditions requiring slow absorption, such as scalp psoriasis, acne, and rosacea. They are quite irritating on diseased skin and open wounds.