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1 FEBRUARY 2017 AN INDEPENDENT SUPPLEMENT DISTRIBUTED IN THE GUARDIAN ON BEHALF OF MEDIAPLANET WHO TAKE SOLE RESPONSIBILITY FOR ITS CONTENTS PSYCHOLOGICAL IMPACT How can your skin affect your mental health P2 KEEPING IT NATURAL Find out about the benefits of organic skincare P4 FIND MORE ONLINE Read anti-aging tips from the skincare experts Your Skin HEALTHAWARENESS.CO.UK Gráinne McCoy, BBC s Apprentice star and make-up artist talks about the impacts of skin issues and offers her advice P5 PHOTO: ANNA NIGHTINGALE PHOTOGRAPHY SKIN NOURISHING DEAD SEA SALTS NOW with Colloidal Oatmeal Moisturising Softening Soothing

2 2 HEALTHAWARENESS.CO.UK AN INDEPENDENT SUPPLEMENT BY MEDIAPLANET MEDIAPLANET IN THIS ISSUE READ MORE ON HEALTHAWARENESS.CO.UK Skin cancer Prevention is the best method and understanding the risks is crucial p4 Eczema Dr Carsten talks about new treatment breakthroughs in eczema p6 Inspiring others Katie Piper talks about the psychological effects of burns and scars and the support available Why we all need to be mindful of the skin we re in The psychological impact of skin diseases must not be underestimated, says Dr Anthony Bewley, Consultant Dermatologist with Barts Health NHS Trust and member of the British Association of Dermatologists. Skin really matters. A report from the British Association of Dermatologists found that about 90 per cent of patients with skin disease have a significant amount of psychological issues associated with their condition. We know there is a close connection between the brain and the skin; and that distress, lack of confidence, anxiety and/ or depression can exacerbate skin disorders. In turn, skin disorders can exacerbate psychological issues. And so a self-perpetuating, vicious cycle is created. Tragically, a number of children commit suicide every year and 12 per cent of them do so primarily because of their skin diseases; plus we know that around 300 people choose to end their life every year, rather than live with their psoriasis. Help is at hand We cannot, and must not, underestimate the psychological strain that skin diseases can cause. For too long, patients have visited Dr Anthony Bewley Consultant Dermatologist, Barts Health NHS Trust and member of the British Association of Dermatologists their healthcare professionals to be told: It s only eczema or It s just your skin. Firstly, when a condition is minimised in this way, the patient is immediately disempowered. Secondly, research shows that patients who live with skin diseases find it every bit as traumatic as those who live with life-threatening illnesses. Then there are the secondary effects: for example, itching skin leads to sleep disturbance, which can take a heavy psychological toll. Thankfully as this campaign focusing on such conditions as eczema, psoriasis and skin cancer makes clear there are now a number of resources and treatments for patients with skin diseases. Plus, healthcare professionals are getting the message that living with skin conditions can have psychological consequences. This is as it should be. It s time that everyone started thinking differently about the skin they re in. Follow Please recycle Project Manager: Leila Samadi Business Development Manager: Henry Worth Head of Production: Faye Godfrey Digital Content Strategist: Chris Schwartz Social Media Coordinator: Jenny Hyndman Managing Director: Carl Soderblom Sales Manager: Alex Williams Designer: Oscar Fadeli Mediaplanet contact information: Phone: +44 (0) Epaderm Making happy skin part of the family Epaderm is a range of highly effective and award winning emollients for eczema, psoriasis and dry skin conditions. The Epaderm range is fragrance, colouring and SLS * free,making it kinder to sensitive skin and suitable from birth onwards. Ideal for long term moisturisation Readily absorbed and ideal for daytime use *SLS is an abbreviation for Sodium Lauryl Sulphate. Visit today for more information on eczema management Mölnlycke Health Care, Unity House, Medlock Street, Oldham, OL1 3HS. Telephone: The Mölnlycke Health Care and Epaderm trademarks, names and logotypes are registered globally to one or more of the Mölnlycke Health Care Group of companies Mölnlycke Health Care. All rights reserved. UKWC0272


4 4 HEALTHAWARENESS.CO.UK AN INDEPENDENT SUPPLEMENT BY MEDIAPLANET INSIGHT Keeping it natural: the benefits of organic skincare PhD cosmetic scientist Pauline Hill says that everyone can benefit from the use of well-formulated skincare and even more from wellformulated organic skincare. Why is organic skincare better than non-organic? All skincare should be scientifically validated to demonstrate its effectiveness. Well-formulated, clinically tested organic skincare has the advantage of providing the skin with all it needs to be healthy without any extraneous materials that the skin does not recognise. Given our daily exposure to extraneous chemicals in our air and daily lives, it s advantageous to find ways to reduce our bio burden. Who uses organic and what s in the products? Anyone who wants to take conscious care of themselves and be proactive in what goes on their skin. Many products have plant-derived active ingredients that have been shown to be beneficial to the health of the skin, such as organic oils to provide the omega fats, and organic plant extracts high in vitamins and minerals. Is organic skincare environmentally responsible? Yes. Organic products contain high levels of organic ingredients that have been produced by sustainable agriculture; they promote a healthy lifestyle; and they actively avoid chemicals that are environmentally damaging. Are we getting the message about skin cancer? Instances of skin cancer are rising in the UK, so it s important that the public understand the latest advice regarding prevention and early diagnosis. By Tony Greenway Some people are very receptive to information about skin cancer, says Dr Nick Levell, consultant dermatologist and member of the British Association of Dermatologists. Usually, they re the ones who have had personal experience of it. Other people can be harder to reach. The trouble is, says Levell, so much health advice is given out on a regular basis that it can be fatiguing and confusing. People have trouble filtering the information they receive, he admits. Take skin cancer. One day they ll read that vitamin D in sunlight is good for you. The next, they ll read that too much sunlight is bad for you. (The fact is, says Levell, that too much of anything is bad for you.) The stark reality, however, is this: instances of skin cancer are growing in the UK. According to figures from Cancer Research, malignant melanoma incidence rates have increased by 360 per cent in Britain since the late 1970s. Growth in skin cancer is linked to the increase in holidays abroad, says Levell. It s also linked to the ageing population. As we get older, our chances of developing skin cancer rise... so that s a difficult message to get across to young people who think: OK: I ll worry about it later, then although young adults are at risk of melanoma. What are the risks? There are many types of skin cancer, but it s easier to think of them under two headings: melanoma and non-melanoma. Melanoma can spread to other organs in the body and be fatal; while non-melanoma is common, particularly in older people, and develops slowly. Signs to look out for are moles which change shape or bleed, or any changes on the skin that grow steadily bigger. Watch for anything that is different or new, says Levell. The increase in skin cancer is having an DON T LET THEM TOAST THIS SUMMER USE YOUR LOAF Children spend half their childhood at school, where they are outdoors every day during peak UV hours and whilst some sun is good for us, over-exposure to UV is a serious health risk and the primary cause of the UK s most common and fastest rising cancer. UV damage is accumulative, irreparable and burning as a child can dramatically increase a persons risk of developing the disease in later life. PREVENTING SKIN CANCER THROUGH EDUCATION Developed by national skin cancer charity Skcin, the Sun Safe Schools National Accreditation Scheme is the UK s most comprehensive FREE, ONLINE RESOURCE to assist primary schools in; creating a suitable sun safety policy; communicating with parents to gain support and raise awareness within the wider school community; educating pupils on the importance of sun safety, to influence behaviour and ultimately, save lives. SUN SAFE SCHOOLS NATIONAL ACCREDITATION SCHEME Education is key to preventing over 85% of all skin cancer and melanoma cases. Help us, help our future generations by getting your school to register and take part. For further information and to view our extensive range of resources, please visit:

5 AN INDEPENDENT SUPPLEMENT BY MEDIAPLANET MEDIAPLANET 5 Gráinne teaches an apprenticeship in skincare Dr Nick Levell Consultant Dermatologist and member of the British Association of Dermatologists impact on the NHS. Patients need to see consultants who can make an accurate diagnosis about their condition as quickly as possible, but there are only around 800 dermatologists in the UK, says Levell. And that does put a huge strain on the Protect your skin. Skin cancer is on the rise in the UK - prevention is key Photo: Unsplash Lotte Meijer system. Which is why it s so important to get messages across about prevention and the importance of early diagnosis. We have to find ways to deliver health education without patronising or talking down to people, says Levell. How can I protect myself? Covering up with light clothing is the most effective way to decrease your risk if you are going out in the sun; but if you do want to expose your skin, use a high-factor sunscreen. Try to stay out of the sun when its rays are strongest, however, and avoid getting sun burnt. If you are losing your hair, then it s a good idea to wear a hat in the sun, says Levell. If you have fair skin, blue eyes, fair hair or red hair, or freckles, then these are all factors which bring risk particularly if you have someone with skin cancer in your family. Make-up artist Gráinne McCoy, star of The Apprentice, shares skincare advice and says that, when it comes to enhancing natural beauty, less is more. What impact can skin problems have? Skin problems need to be spoken about more as it s a massive subject that affects a lot of people. I do many masterclasses and meet young girls who have nothing good to say for themselves because of their skin, even if they only have a couple of spots. Have you been affected by any skin issues? I haven t although I did go on a detox about six months ago which resulted in a layer of scaly redness and burning breaking out on my face. To get rid of it I drank loads of water because the main problem was the dryness of my skin. Do people take care of their skin properly? Not enough of them! I m super-focussed on my skin. I put on layers of oil, serum, and moisturiser before I go to sleep until I m shining! But you need to keep it hydrated to ward off wrinkles. What skincare advice do you have? Women buy concealers and don t ask how to apply them, which makes skin problems even more visible. So use light, feathery movements with a brush. And remember: you don t need to plaster on a thick layer of foundation. You can enhance your beauty with a more natural look.

6 6 HEALTHAWARENESS.CO.UK AN INDEPENDENT SUPPLEMENT BY MEDIAPLANET MEDIAPLANET INSIGHT PSORTing out personalised treatment for psoriasis A consortium of dermatologists, pharma companies and patients is carrying out personalised treatment research in order to benefit people with psoriasis. New treatments offer breakthrough for severe eczema By Tony Greenway Psoriasis is a chronic skin condition affecting more than one million people in the UK. It can appear anywhere on the body at any age, causing both physical and psychological trauma, and is not always easily treated. In fact, a treatment that works for one person does not necessarily work for another: and that s a big problem. It means that some patients have to live with the condition and the physical and psychological distress it causes for a long time before finding effective relief. Personalised treatment The National Institute for Health and Care Excellence (NICE) and The Scottish Intercollegiate Guidelines Network (SIGN) have set out treatment pathways for psoriasis which are useful but rigid, amounting to treatment on a trial and error basis. However, PSORT a consortium of dermatologists, pharma companies and psoriasis patients is working to cut down on the long and arduous treatment process that some patients with the condition currently undergo. In 2013, PSORT was given 5 million by the UK Medical Research Council and an additional 2 million from industry partners to conduct research into personalised treatments for psoriasis that will directly benefit people with the condition. PSORT s aim is to find the right treatment, first time, for every patient, says Carla Renton, Information and Communications Manager at The Psoriasis Association. To do that, it is developing tests to understand the kind of psoriasis each individual has. This means treatments that won t work can be immediately ruled out so that a focus can be placed on the ones that will. While the research is only just beginning and any findings are some way in the future, targeted medicine would offer obvious cost savings for the NHS, says Renton. And, from a patient perspective, it would have a positive impact on their mental wellbeing and quality of life. Patients with severe eczema have been given hope of a breakthrough with biologics a new class of drugs which reduce inflammation and break the itchscratch cycle. It s human nature: if you develop an itch on your body, you scratch. For eczema patients, scratching only brings temporary relief and, ultimately, a worsening of their condition. The hallmark of eczema is a vicious cycle of itching and scratching, which drives the disease process, says Dr Carsten Flohr, consultant dermatologist at St John s Institute of Dermatology at Guy s & St Thomas NHS Foundation. Eczema commonly starts in early life and affects up to 20 per cent of children and over 5 per cent of adults. When mild, it s characterised by itchy, scaly and inflamed skin. In its more severe form, patches on the body can be left weeping, crusted or even bleeding. Sleep loss because of the itching is frequent, and patients are often socially withdrawn and more likely to develop anxiety and depression. The initial problem is a lack of moisture in the skin, often due to a gene mutation that makes the skin barrier more leaky and results in skin Dr Carsten Flohr Consultant Dermatologist and member of the British Association of Dermatologists dryness virtually from birth. As a second step, the skin becomes inflamed, which triggers the itching. Once the itch-scratch cycle has been established, skin infections are a common problem, as pathogenic bacteria introduced through the scratching colonise the eczematous skin and drive the upregulation of the immune system further. What are the causes? Although eczema often affects those who are genetically predisposed, environmental factors also play a major part. For instance, hard domestic water can contribute to the skin barrier breakdown, says Flohr. Other environmental factors that have been linked to eczema include exposure to allergens (such as house dust and foods) and extremes of temperature and UV light. Soaps and detergents may also act as irritants to the skin and contribute to the skin barrier damage. Treatment options Treatments vary. For those with a mild-to-moderate form of the condition, a topical steroid cream in the form of hydrocortisone, for example can be prescribed, along with emollients to moisturise the skin. Removal of irritants, as well as recognising if foods or other allergies contribute to flare-ups, is also important, in particular in patients with more severe eczema, says Flohr. For patients with severe eczema, a new class of drugs known as biologics offer a breakthrough. This is a very exciting time, says Flohr. Biologics target specific pathways of the immune system involved in eczema, and the first few trials that have been published are very promising, but they compared this new treatment to placebo and so far only enrolled adults. We now need similar studies in children and research that directly compares biologics with the established tablet treatments we use for severe eczema. It will still take a while before these new medicines will enter routine NHS clinical practice. MULTI - AWARD WINNING NATURAL SKINCARE 100% NATURAL FOR SKIN PRONE TO ECZEMA, PSORIASIS AND DERMATITIS Suitable for adults, children and babies FREE UK POSTAGE USE CODE: FREEP

7 COMMERCIAL FEATURE A natural approach to healthy skin Irritants in soaps and antibacterial products can play a part in breaking down the skin s natural barrier. A more natural approach to skincare may help replenish it. By Tony Greenway The skin is a complicated organ says Karen Davis, Head of Pharmacy at Westlab, the UK mineral salts specialist. If healthy and well-nourished, it should work normally to form an effective barrier between us and whatever our environment throws at us. But when the skin is exposed to for example irritants in soaps or gels or air conditioning, it may not work as effectively and can dry out, she says. This is how eczema s itch-scratch cycle can begin. Unless moisture is replenished, the skin s natural barrier can break down and then the skin itself becomes prone to infection. The problem is, in our dayto-day lives we re exposed to many chemicals that can harm the skin. Strong soaps or antibacterial products can strip it of its natural moisture, says Davis. And while antibacterial products kill bad bacteria, they also kill the beneficial bacteria which help maintain that all-important natural barrier. To counter this, traditional dermatology advises application of emollient creams, which tend to include mineral oils. Mineral oil will make the skin feel better by treating the symptom, but it usually can t penetrate through the layers to give the skin the real nourishment it needs, says Davis. A more natural way to support a healthy skin A more natural way to support a healthy skin barrier is with products that include natural plant oils which encourage the skin to retain moisture barrier is with products that include natural plant oils which encourage the skin to retain moisture. Essential nutrients Salt bathing is popular for dry, itchy skins, as specialist salts are cleansing and soothing. Salts can be rich in natural barrierbuilding nutrients such as magnesium and other minerals, which are essential for skin health. Colloidal oatmeal, which has been used in herbal medicine for the last 100 years, can calm redness and itching, providing the skin with nutrition and moisture. Davis tips for healthy, hydrated skin include drinking lots of water, and eating a diet rich in natural oils and also probiotics (in food such as yoghurt) which help maintain the right balance of good bacteria in the gut. Eat a healthy, balanced diet with lots of fruit and veg, she says, and avoid too much sugar which can deplete the body of magnesium and probiotics. Lastly, if you are prone to eczema flare-ups, refrain from using shower gels and shampoos with sodium lauryl sulfate and soaps that include antibacterials so that the skin can be allowed to work naturally. Westlab Skin Nourishing Dead Sea Supersalts are available at larger Boots stores from 20th March and online now at Save Your Skin Skin conditions are the most common new 1 reason people go to their GP although effective treatments are available to reduce flare-ups. Eczema is also known as dermatitis, and is not contagious. 92% Sponsored by of GPs see a patient with a skin condition 3 a minimum of three times a week. Mon Tue Wed Thur Fri Sat Sun Eczema is the most common skin condition. It can flare up now and again - and inbetween times, causes skin to be itchy and dry 25% of the population is affected by inflammatory dry skin, with eczema 2 most prevalent in children. A study of a group of children found that emollients caused an 89% reduction in the severity 4 of eczema. Used every day, emollients may be all you need to keep mild to moderate eczema under control, and can reduce the need for 5 topical steroids. Emollients work by forming a film over the skin, trapping water and preventing excess evaporation. The greasier the emollient, the more effective it is. The use of a non-biological washing powder and avoidance of fabric conditioner can also help to reduce the itchiness 6 of the skin. E Emollients are moisturising treatments used by eczema patients that help the skin feel less itchy. They are not the same as cosmetic moisturisers. 1 Schofield, Grindlay, Williams (2009) 'SKIN CONDITIONS IN THE UK: a Health Care Needs Assessment', Centre of Evidence Based Dermatology, University of Nottingham, UK 2 Schofield (2007) 'Shifting Care Closer to Home: Dermatology', Department of Health 3 4 5,6 GP market research, Mölnlycke Health Care, 2016 Cork MJ, et al. 'Comparison of parent knowledge, therapy utilization and severity of atopic eczema...' British Journal of Dermatol. 2003;149: National Eczema Society To prevent future eczema flare-ups, patients are advised to keep using the emollient even if the skin has improved.