From Mr L. Furniss, MRPharmS, and others
SIR,—We were interested to read your report on a letter sent by the Skin
Care Campaign to chief executives of primary care groups about the use of aqueous
cream (PJ, September 2, p325).
We would like to add the following comments regarding the use of emollients.
Choice of any therapy should consider safety, efficacy and cost-effectiveness
and should be individualised to the patient. With respect to emollients, there
is a lack of good quality evidence comparing preparations, and patients should
use the cheapest one that is effective, cosmetically acceptable and which they
are prepared to use regularly.1
Regarding the consistency of the product, individuals will obviously have different
preferences. As a result we also suggest hydrous ointment BP, cetomacrogol cream
BP, white soft paraffin 50 per cent/liquid paraffin 50 per cent and emulsifying
ointment BP as options with varying consistencies. We would be interested in
receiving information on patient satisfaction with aqueous cream at the address
below.
We would also welcome any details of the “substantial” numbers of
people who are sensitised to aqueous cream; recent information confirms that
aqueous cream is suitable for many patients with dry skin.2
We entirely agree with the recommendation to encourage prescribing sufficient
amounts of emollients to patients.1
We were disappointed at the simplistic approach to recommending emollients that
was implied in the report, ie, that “pharmaceutical advisers to PCGs are
inappropriately recommending aqueous cream as the emollient of choice because
it is cheap”.
In summary, we will continue to promote the principles above to our general
practitioners and will continue to suggest aqueous cream as a suitable option
in the initial management of patients with dry skin.
Lee Furniss
Janet Cree
Sarah Taylor
Ian Tritschler
Prescribing Advisers to Primary Care Groups,
Camden & Islington NHS Health Authority,
110 Hampstead Road,
London NW1 2LJ
References