The Pharmaceutical Journal
Vol 271 No 7258 p95
19 July 2003

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A good training source for pharmacy staff

'Vitiligo: understanding the loss of skin colour', 2nd edition, by Marion Lesage. Pp 157. Price £15. London: The Vitiligo Society; 2002. ISBN 0 9530325 1 5

Vitiligo affects around 1 per cent of men and women in all ethnic groups. The depigmentary skin condition, characterised by milky-white patches, is disfiguring but receives little publicity, and general practitioners may treat it as something the patient must learn to live with. Specialist treatments do exist but camouflage and high factor sunscreens are the mainstay of routine management. Pharmacies are therefore well placed to play a role.

This practical book would be a good training resource for pharmacy staff. Armed with the information it contains, anyone working on the beauty or medicines counter should be able to offer practical advice on products, and point customers towards sources of further help.

The first chapter describes what vitiligo is, and some of the triggers, and how it can develop. Chapter two looks at conventional treatments such as topical steroids and PUVA with psoralens and skin bleaching, and chapters three and four cover complementary treatments and diet.

Chapter five highlights, in a tactful way, what people should expect from their doctors and what to do if this does not happen. Doctors can prescribe sunblock, sunscreens and camouflage products for vitiligo, but not all of them are aware of this. Chapters six and seven cover the products themselves, with a wealth of practical advice on use.

Chapters eight, nine and 10 address the concerns that parents may have, and the psychological impact of looking different, and chapters 11 and 12 provide an update on what is happening research-wise. There is also a list of chemicals that may be implicated in the onset of vitiligo.

The book ends with a comprehensive list of camouflage practitioners, product manufacturers and support groups plus a series of personal stories. As these show, vitiligo can have a huge impact on a person's confidence and self esteem. Men as well as women may use ordinary cosmetics to cover patches, and be unaware of what they can obtain on prescription. Research suggests that awareness of vitiligo in pharmacies is low, and staff response variable. This book could help make things better.

Imogen Savage

Dr Imogen Savage is lecturer in patient safety, School of Pharmacy, University of London