Eczema (young people)

What help can I get from medical professionals for eczema?

Young people visited medical professionals for a range of things, like:

getting a diagnosis of eczema
treatment for eczema on a particular part of the body like the scalp or genitals
advice and treatment for eczema which develops an infection
to get treatments like emollients, steroids or phototherapy and advice about how to use them
information about alternative and complementary therapies (e.g. homeopathy)
an allergy test, to find out about triggers to avoid or for lifestyle advice (e.g. diet and sleep)
check-ups – e.g. to see if treatments are working or have side effects
a referral – for example, a GP (General Practitioner – doctor) can ‘refer’ to a dermatologist (skin specialist doctor)
mental health help for dealing with the emotional and psychological side of eczema
a ‘fit note’ (or a ‘sick note’) for time off or other special arrangements with your work, school or university, such as getting extra time in exams.

The main sources of medical professional help used by the young people we spoke to were:

GPs and GP-clinic nurses
Dermatologists and dermatology nurses (healthcare professionals specialising in skin)
Pharmacists

Some young people saw just one kind of medical professional for their eczema. Alice’s eczema has always been treated by GPs. Other people have seen different types of medical professionals about their eczema and compared experiences between them. Pharmacists helped Laura find a weak steroid to buy over-the-counter (without a doctor’s prescription), but she says that GPs can give stronger steroid treatment. She adds that “it's even better if you could be referred and speak to a dermatologist”. Himesh prefers seeing dermatology nurses and finds there’s usually less of a wait to see them than for dermatology doctors.

Katie-Lauren was unsure about what medical help she would get when she moved to university.

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Age at interview: 19

Sex: Female

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I was worried about not being able to see my doctor because I didn't know whether I could sign up to a doctors here. I didn't really know much about it. But obviously there’s a medical centre, which is a part of the university. I was worried about getting prescriptions and seeing a dermatologist. But they’ve referred, like the nurse here has referred me to a dermatologist closer. So I’m going to see what this ones like, third time lucky.

Yeah.

Yeah it’s just I was worried about not getting the same support here that I got at home. But in a way, I get more support here, because there’s a bigger variety of people and a lot more people’ve got eczema than I actually thought, because at school, it seemed like it was just me and one other girl. And we didn't really talk that much so it’s not like I could talk to her about it.

Dermatology nurses helped Cat understand how best to use emollients (moisturisers).

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Age at interview: 24

Sex: Female

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So the nurses are quite good, they’ve obviously got a bit more time so they sort of talk to you if you’ve got any sort of worries or issues, but I wouldn’t say I've sort of overly sort of had like many in-depth conversations with them, but they're sort of quite good at just sort of giving you a bit more sort of information and sort of stuff that may be sort of dermatologists sort of look over, and GPs, so they're quite a good sort of knowledge hub.

What sort of things have nurses spoken to you about that GPs and dermatologists have skimmed over?

Some of it's just like technique, like techniques, like ways to sort of apply creams and things like that that you don’t really, you're like ‘well you put it on, how difficult can it be?’ [laughs] “Arr no, well if you do it like this and this and this, then it's actually sort of better” – things like that, that they don’t, like dermatologists don’t really have the time; well they probably wouldn’t think to sort of do or how like what's the best order to do stuff in, and things like that.

Could you say a bit more about what the nurses have said about techniques for applying creams?

Yeah so things like you follow like the hairline down, rather than up against, that was one of the key things. And like putting on the shower gel before you get in the shower, which I'd never thought to do [laughs] before, which I don’t always do cos I don’t have the time to sort of sit there for five minutes and do that. But yeah, so you sort of put it on and then it absorbs into your skin or something, and then you sort of get in and wash it off rather than just sort of putting it straight on and it coming straight off again. So things like that that I hadn’t really thought about.

Most people hadn’t talked to pharmacists about managing eczema, but a couple found it helpful. Sometimes other healthcare professionals helped with eczema, even though the person was seeing them for other reasons.

Himesh talks to his uncle (a pharmacist) to get information and advice on eczema treatments like Protopic.

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Age at interview: 17

Sex: Male

Age at diagnosis: 10

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Oh yeh like every now and again the dermatologist nurse would offer me like this new treatment, new creams or, or some sort of surgery or treatment kind of thing. So I’ll obviously go back to my uncle and he will explain to me properly what, what the ups and downs are what the, stuff like that basically, and so yeh. So he is quite handy I guess if I missed out any key information I guess on the day, so yeh.

Could you give me an example of the sorts of things, conversations you’ve had with your uncle where he’s been sort of able to fill you in on some of that information?

Okay so recently I had a conversation with him regarding this new cream that’s called Protopic that was offered by my dermatologist nurse, she said it would probably improve the redness of your skin. And it was different because I thought it was, I thought it was a steroid but my uncle explained it’s not a steroid so you can use as much, as much of it as you want, but yeh. So I started using it basically and sort of kind of, I kind of saw improvements in places but before I try creams or any new treatment I kind of test it out on my skin first so I’d put a bit of it, I’ll apply a bit of it on my arm for a day or so and see how it goes and then use it or not use it after that, so yeh.

It wasn’t until a doctor at a sexual health clinic asked Georgia about the eczema on her face that she felt it was taken seriously.

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Age at interview: 20

Sex: Female

Age at diagnosis: 4

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And it wasn’t until, which was the funniest thing, I went to see a doctor in a sexual health clinic, just to pick up like some regular contraception or something like that. And it had, my eczema had actually been quite good that day, I was feeling quite confident, cos it was summer and it usually picks up during the summer. I don’t know if it’s because of my, sort of my mental disposition, it picks up because it’s lighter or something like that. And yet all I had was a little bit of dry skin above my eye. And I’d gone in and he hadn’t, he wasn’t the doctor who was supposed to have seen me. It was supposed to have been someone else. But by chance he’d been called in. And we spoke about other things I’d been there for and he picked up on my skin and asked what was wrong with my eye. And I just said, “Oh, it’s just a bit of dry skin. I suffer from eczema from time to time and it’s cropped up.” And it was weird how somebody who was not in that field of work could pick up on it and just thought it wasn’t right that my skin was like that. It shouldn’t have been dry, it shouldn’t have been as prominent or red or... You could see I was itchy because it was quite warm in the room and I was sweaty a little bit and that irritates my skin. And he just said, “How many doctors have you seen?” And I tell, I told him I’d seen about, I think about seven in the past year and a half about it and none of them had done anything properly about it. And I think within about twenty minutes he decided that he was going to write off for a referral to a dermatologist and within about a month I’d seen somebody about it.

And I think that was the biggest turnaround point for me. And it kind of made me lose a bit of faith in some of my doctors because they weren’t, didn’t take me seriously as a patient. I mean I haven’t got anything about the, against the NHS or anything like that. I just felt like I wasn’t taken seriously. Which obviously makes you lose a bit of faith and a bit of confidence in not only yourself, because you don’t feel as though your problem is serious enough, but also because it didn’t feel like they’d picked up on it properly. So I think when I, when that happened, it, I really felt like it was going to turn around and it would be getting better soon because he’d picked up on it and I’d be referred to a dermatologist. Which is what I’d been asking for ages.

Himesh learnt that he had eczema when he was admitted to hospital for an infection at age 10/11.

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Age at interview: 17

Sex: Male

Age at diagnosis: 10

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I think I had an infection first so I ended up in the hospital and one of the doctors said, I think they said “This is due to your eczema” and I was, obviously I, I didn’t know I had eczema at that time until the doctor said, so yeh I think that’s when it started.

Hmm. How did you feel when the doctor said that?

I didn’t know how to feel because I think at that point I didn’t know what eczema was, if that makes sense, so yeh.

And what happened next, did the doctor explain a little bit about it?

Yeh explained like you have a skin condition for it, you’ll have to put creams and stuff, which I didn’t mind at the time because I thought that’s alright, if that makes sense, but as you, you know, get used to, to the routine and stuff it gets kind of annoying I guess ‘cos it take up a lot of time, so yeh.

Hmm. Hmm. So what did you think the symptoms might have been because you said you had an infection, was that a skin infection?

Yeh it was I think because I probably scratched myself that’s why something probably went into my immune system and then it triggered an infection which was really bad because I had to stay overnight in the hospital. I think that infection I had to have medicine through my veins I think it was, so yeh it was pretty bad as I’d never experienced anything like that, I used to be a really healthy kid really so yeh.

For more about getting medical help, see also the sections on repeat visits to medical appointments and what makes for supportive doctors/nurses.