Survey: Only half of primary care physicians aware of Complete Emollient Therapy for managing patients with eczema

The results of a new survey have found that only half of primary care practitioners are aware of Complete Emollient Therapy (CET) as a principle for managing patients with dry skin/eczema. Furthermore, two thirds (64%) believe more education is needed to improve emollient use by patients with eczema.

The survey of 500 primary care practitioners (250 GPs and 250 practice nurses) which was carried out by Cetraben also found inconsistency in the advice given to patients on the use of emollients, despite their important role in the management of eczema. Just 38% of primary care practitioners advised their patients on how to apply their emollients (in the direction of hair growth and avoid rubbing) and only 73% gave instruction on how frequently to use it, yet emollients should be applied several times a day to keep the skin hydrated.

In addition the survey found two thirds (67%) of healthcare professionals believe roughly four in 10 of their patients apply their emollient incorrectly, with just 4% feeling confident the majority of their patients are using it correctly.

The results of the survey are worrying as around one quarter (24%) of the population present to their general practitioner in the UK each year with a skin problem, and the correct use of emollients can not only help control dry skin conditions, but also prevent flares of atopic eczema and may lead to a reduction in referrals and improve quality of life.

Regular communication between healthcare professionals and patients on emollient preferences and correct use could improve adherence. The survey found that 30% of community nurses discuss emollient preferences at every consultation compared to just 18% of GPs.

Emollients have an important role to play in the treatment of several dry skin conditions, and although they are widely prescribed in general practice in the UK, they are often not prescribed in sufficient quantity for optimal effects.

The CET regimen consists of the regular use of emollients, including ointments, creams, lotions and bath oils. To maintain an effective CET regimen, people with eczema should be advised to:

• Apply emollients in generous quantities all over the skin, including unaffected areas
• Apply emollients as liberally and frequently as possible. They are best applied when the skin is moist but they can and should be applied at other times. Ideally emollients should be applied every 4 hours or at least 3 to 4 times per day
• Apply thicker emollients, such as an ointment, at night time or to complement emollients during the day

The use of CET and emollients is supported by professional bodies and NICE. The Primary Care Dermatology Society and the British Association of Dermatologists state that: ‘continual treatment with Complete Emollient Therapy (combinations of cream, ointment, bath oil and emollient soap substitute) will help provide maximal effect’, and NICE guidance states that emollients are the mainstay of treatment for mild flares of atopic eczema.

Thornton and Ross, manufacturers of Cetraben, is committed to improving education on the management of dry skin conditions including atopic eczema. It has developed several resources for healthcare professionals and patients to help achieve this aim.