The Pharmaceutical Journal
Vol 270 No 7237 p259
22 February 2003

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Dermatologist calls for pharmacist prescribing to reduce GP visits

Pharmacists should be able to prescribe effective medicines for skin complaints, Dr Allan Marsden, consultant dermatologist and president of the British Association of Dermatologists, told the All-Party Parliamentary Group on Skin last week.

"Pharmacists are very much in the front line. I would like them to have a good knowledge of dermatology and I would like [dermatologists] to make an input to their training", he said. He believes that this would be an important step towards increasing self-reliance among patients and would help to reduce the number of visits to GPs for skin problems.

Reviewing progress in dermatology over the past 30 years, Dr Marsden said many problems remained to be tackled. He pointed out that the incidence of scalp ringworm is increasing, particularly among Afro-Caribbean children in inner cities.

He added that treatment of atopic eczema has been "a relative failure". Minority ethnic groups tend to be severely affected and adults with atopic eczema still face problems of stigmatisation and occupational discrimination. "Steroid phobia" continues to be a problem and he pointed out that he spends a lot of time explaining the safety of topical steroids and assuring patients that they will not develop horrifying side effects.

On the topic of acne, Dr Marsden said: "Roaccutane (isotretinoin) has been too effective — no one researches acne any longer." He added that since 1998 there have been case reports of suicide, depression and long-term cheilitis with Roaccutane, but there is still considerable pressure to prescribe the drug. The incidence of acne is now increasing among older females, possibly relating to the discontinuation of oral contraceptives, and antibiotic resistance is emerging in propionobacterium acnes, he said.

He went on to say that long waiting lists have been a problem in dermatology for many years. At present there is one dermatologist per 130,000 people and the estimated requirement is one per 80,000.