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British Association of Dermatologists launches psychological support website

Today the British Association of Dermatologists (BAD) launches Skin Support (www.skinsupport.org.uk), a Department of Health funded website providing psychological support for people with skin conditions.

The website brings together, and links to, patient information leaflets, support groups, self-help materials and help-lines.

Prior to the Skin Support website, support materials and services directed specifically at skin disease patients were sporadic and disparate, and those that did exist were not always easy to find or access. While there are both patient support groups, centred on individual skin diseases, and also mental health charities, until now there has been no centralised hub that provides coordinated resources, appropriate to people with problems that go beyond their skin and are psychological or psychiatric – this is role that Skin Support fills.

Skin conditions are the most frequent reason for people to consult their GP. It is not just the physical symptoms that affect sufferers’ lives – diseases that are visible, disfiguring or long-term can carry a multitude of psychological and social effects, including isolation and depression. In the UK, psoriasis alone is linked to 300 suicide attempts annually. A British Association of Dermatologists’ survey in 2011 revealed that 85 per cent of patients indicated to their dermatologist that the psycho-social aspects of their skin disease were a major component of their illness.

Furthermore, stress, as well as being a frequent side effect of skin conditions, is also known to actually cause and exacerbate skin disease. Therefore psychological and self-help interventions can be crucial not only for easing mental distress but also for improving many of the physical symptoms of the skin disorder.

Dr David Eedy, President of the British Association of Dermatologists said: “Skin diseases can have a devastating impact on people’s mental and emotional wellbeing, and the benefits of support on both mental health and physical symptoms are well known in medical circles. However, few dermatology departments have access to local liaison psychiatrists and their associated services, so self-help can be a vital tool for patients. The problem is that finding self-help materials can be difficult – patients don’t know where to look and resources are available across so many different websites. The beauty of the Skin Support website is that it brings together lots of content in one easy to navigate place, and it tailors the materials to people’s individual skin disease and any physical impairment this may involve.

“A report produced by the All Party Parliamentary Group on Skin in 2013 showed that there is under provision of psychodermatology services. Whilst a website can in no way replace this kind of specialist care, it is a good starting point and will be of enormous benefit to clinicians as well as patients.”

Dr Andrew Thompson is Reader in Clinical Psychology at The University of Sheffield and a practising NHS Clinical Psychologist, and he was a member of the advisory panel associated with the development of the website. He said: “Skin conditions can have a significant psychological impact on people and it is well acknowledged that access to psychological intervention and even to good quality evidence based self-help is limited. Consequently the Skin Support project is an important development as it is unique in providing people with skin conditions with information about emotional and social issues associated with dermatological conditions. People visiting the site can also download self-help materials that have been written by qualified clinicians, such as myself, and have been either tested in the NHS or in research. We also hope that the site will encourage people to seek further help from their GP or Dermatologist if needed”

Members of the public with skin conditions have also provided testimonials for the website:

"Enduring skin conditions tend to cause you to be self-conscious, and lack confidence, even when the condition is under control. It is good to know that there are different, recognised methods which can be used to overcome this."
Susan Welch, 62, Surrey

"Emotional support is something that was really missing for me, my condition caused me to have a lot of dark days, it’s good to think beyond just physically managing my skin."
Sally Hooker, 52, Essex

"On particularly tough days, when it’s hard to stay positive, I can really see the benefit of the self-help materials on Skin Support."
Abi*, 28, Berkshire

"The blotchy skin I have with mast cell disease can be embarrassing but being able to share my problems with other sufferers has been a great help."
Gerry Newnham, 68, Hertfordshire

*Abi has asked for her surname not to be used
-ENDS-

Notes to editors:

Contact: Matt Gass, Communications Officer, British Association of Dermatologists. Email: matthew.gass@bad.org.uk, telephone: 020 7391 6084.

The Department of Health Innovation, Excellence & Strategic Development Fund awarded the British Association of Dermatologists (BAD) a three-year grant to enable them to develop an online hub for psychological support specifically targeted at skin disease patients.

The British Association of Dermatologists is the central association of practising UK dermatologists. Our aim is to continually improve the treatment and understanding of skin disease.

Website: www.bad.org.uk
Twitter: @HealthySkin4All
 

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One in five women with a vulval health condition contemplate self-harm or suicide

One in five patients with a condition affecting more than 300,000 women in the UK have considered suicide or self-harm, according to a survey of women with vulval health conditions released today.

Vulval health conditions are common in the UK, with a conservative estimate suggesting that 1 in every 100 women in the UK suffers from Lichen Sclerosus. This is just one of a range of vulval disorders and affects 63 per cent of the respondents to this survey.

The survey conducted by the British Association of Dermatologists (BAD), together with the Association of Lichen Sclerosis and Vulval Health, showed the extent of the social, professional and emotional damage that vulval health conditions can have on lives.

44 per cent of women with a vulval condition surveyed stated that it was difficult to access medical treatment for their condition. Reasons for the difficulties experienced included misdiagnoses, waiting times, not knowing who to speak to and embarrassment at seeking treatment.

Further to this, 89 per cent of those surveyed said that their condition had affected their emotional and mental wellbeing, 42 per cent said that it had affected their social life, 79 per cent said that it had affected personal relationships, and 39 per cent said that it had affected their work life.

The severity of this impact should not be underestimated. 22 per cent had suicidal thoughts or thoughts of self-harm. 17 per cent felt that their condition had been responsible for the break-up of a relationship, partnership, or marriage. 63 per cent felt that their condition had prevented, or made difficult, romantic or sexual relationships. One respondent said her condition made her feel “less of a woman”, another that she felt like “a freak”.

Many of the respondents said their condition made everyday tasks difficult, unpleasant, or impossible, including:

• Walking: 38 per cent
• Urinating: 50 per cent
• Wearing underwear or trousers: 60 per cent
• Engaging in sexual activities: 84 per cent
• Sleeping: 36 per cent

Dr Karen Gibbon of the British Association of Dermatologists said, “Embarrassment, emotional trauma, and physical pain are common themes amongst women with vulval health conditions. It’s important that women are able to talk about vulval conditions without fear of stigma. Greater awareness and education around vulval health will not only help mitigate emotional distress but will also help women get the treatment they need sooner.”

Dr Nevianna Tomson, Consultant Dermatologist said, “Vulval health conditions can be difficult for people to talk about, but it’s important that we overcome that discomfort. It shouldn’t be necessary for women across the country to suffer in silence. For many of these conditions there is no cure, but there are treatments that can help and there is a heavy psychological burden which we can lessen.

“Women should not be trapped inside their own heads thinking that they are less of friend, partner, employee or woman because of a condition. Being able to talk openly about health is the first step to improving the lives of patients and helping them get access to treatment.”

Fabia Brackenbury of the Association of Lichen Sclerosis and Vulval Health said, “I have been living with lichen sclerosus for over 20 years. It was a contributing factor to the loss of my 30 year marriage. The challenges never end. You go into old age with this condition. A woman deserves an Indian Summer, not a Winter of Discontent.

“A much higher profile needs to be established for vulval disease, not only amongst medical professionals but also researchers and the media. My own campaign for awareness started well with media interest but over the years has been dropped in favour of other health issues.

“Those who suffer, long to enjoy the high profile that is seen in other conditions, and none more so than those with vulval cancer. So many women have told me that at least if they had breast cancer, they could talk to people about it.

“If awareness equality was possible, women would feel more able to come forward and seek help. Awareness and education for everyone is essential if we are to improve the lives of the small girls who are diagnosed as young as two years old with lichen sclerosus and who will live a life sentence of shame, despair and uncertainty.

“We live in an unequal world where some people's health issues are more important than others and this is the root of much suffering for those who struggle for recognition.”

-Ends-
Notes to editors:
For more information, please email: john.major@bad.org.uk

Interview opportunities available with Dr Karen Gibbon, Dr Nevianna Tomson and Fabia Brackenbury. For more information contact john.major@bad.org.uk

Vulval health conditions include, but are not limited to, Lichen Sclerosus, Vulval Cancer, Vulvodynia, Lichen Planus, Ulcers, Cysts and Lichen Simplex. None of these are sexually transmitted diseases.

The British Association of Dermatologists is the central association of practising UK dermatologists. Our aim is to continually improve the treatment and understanding of skin disease.

The British Association of Dermatologists’ Vulval Health Survey 2015 was completed by 325 women suffering with vulval health conditions. For details of the full survey contact: John.Major@bad.org.uk

Dr Karen Gibbon is a consultant dermatologist who works both in the NHS for Barts Health NHS Trust and privately in Essex. She runs specialist vulval clinics for girls and women of all ages. She is also a member of the clinical services unit at the BAD.

Dr Nevianna Tomson is a consultant dermatologist who works both in the NHS for West Suffolk Hospital and privately. At NHS West Suffolk she is the lead clinician for vulval disease. More about Nevianna can be found here: www.suffolkskin.co.uk

Fabia Brackenbury is the founder of the Association for Lichen Sclerosus and Vulval Health. She has been living with Lichen Sclerosus since 1994.

Other patient support groups for vulval health include the Vulval Pain Society and the British Society for the Study of Vulval Disease (BSSVD)
 

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Charities and medics call for parliamentary inquiry into NHS staffing crisis

Thirteen national groups representing doctors, nurses and patients are calling for a government inquiry into the chronic lack of doctors working in dermatology, following responses to Freedom of Information data released today that highlight staff shortages and variations in waiting times.

In a letter to Dr Sarah Wollaston MP, Chair of the House of Commons Health Select Committee, the organisations urge the Committee to review a decision by Health Education England not to allow for an increase in the number of trainee doctors in the specialty.

The signatories, which include the All Party Parliamentary Group on Skin, British Association of Dermatologists, Royal College of General Practitioners (RCGP), British Dermatology Nursing Group, as well as charities including DEBRA, Changing Faces, National Eczema Society and Psoriasis Association, cite newly released Freedom of Information (FOI) figures obtained by one of the co-signing groups, Dermatology Council for England.

Two-thirds (66 per cent) of trusts responding to the FOI request reported that they had consultant dermatologist vacancies. However, Health Education England (HEE) is funding just 177 specialty training places in dermatology in 2014/15, a reduction from the previous 178 posts. This means that with fewer trainees coming up through the ranks to replace retiring staff, there will be no scope to increase Consultant numbers.

Steps taken by trusts and CCGs to try to alleviate the void in consultants are themselves problematic, and no substitute for increased consultant numbers achieved through increased training posts.

71 per cent of trusts said they were using locum consultants to maintain services. Furthermore, while locums are meant to be a short-term solution to temporary staff shortages, 52 per cent of trusts employing locum consultants have had them in post for between one and four years, while 19 per cent had employed individual locums for more than four years.1

Recent reports have disclosed that the NHS paid £3.3bn last year for temporary agency staff, compared to £1.8bn in the past three years.
Almost half of trusts employing locums (48 per cent) were employing at least one that was not on the specialist register. In the UK, this register indicates when a doctor has completed training to the standard required to become a consultant.

The data also exposes the detrimental impact on waiting times and patient care For trusts with vacancies, the average waiting time for urgent referrals, but not subject to the two-week waits for cancer, was seven weeks, with urgent waiting lists as long as 19 weeks reported.

Half (104) of the CCGs who responded were commissioning community services staffed by GPs with a Special Interest in Dermatology (GPwSI). GPwSIs are GPs who have additional training and experience in a particular specialty, in this case dermatology. These services are often set up to try to alleviate the pressure on consultant dermatologists and increase the access to dermatological expertise within the community setting.

However, at least 29 per cent of these services were using GPs who did not fully comply with NHS guidance on good clinical practice for the provision of such a service.

The letter to the Health Select Committee, the body responsible for examining the work of the Department of Health, also refers to an independent report last month into the collapse of a dermatology service in Nottingham due to lack of staff and poor commissioning decisions. The report highlighted the need for Health Education England to review the funding available for dermatology training posts - a call to action that the Health Select Committee is being asked to consider, either within the context of dermatology specifically or as part of a larger review of the NHS’ workforce planning capability.

President of the British Association of Dermatologists Dr David Eedy said: “We hope this FOI data will prompt the Health Select Committee to look into the illogical decision by HEE to reduce our trainee numbers. Trusts are struggling to cope and efforts being made to bypass the need for consultants are clearly failing. Relying on locums is not a viable solution, and not just owing to the greatly increased cost to the NHS. Many locums may have trained abroad where clinical standards and guidelines differ widely from those in the UK, but the public are simply being told they are seeing a consultant, which is grossly misleading.”

The Dermatology Council for England is auditing all 209 CCGs and 54 trusts, chosen at random from each of the regions covered by NHS England’s former area teams. This interim report is based on responses received to date, from 204 CCGs and 38 trusts. Figures will be updated when the final responses have been received and processed.

Dr George Moncrieff, GP and Chair of the Dermatology Council for England said: “This report describes a dermatology service in meltdown. There has been an insidious over-dependence on expensive locums, many with foreign qualifications or not even on the specialist register, with alarming consequences.

“Sadly, after years of neglect to their teaching and training in dermatology, we cannot turn to General Practitioners to provide the solution. GPs have had, at most, just one or two weeks teaching in dermatology during their entire time at medical school. The Deaneries responsible for specialist training for these future GPs, provide virtually no further formal dermatology training. That is extraordinary when skin disease is such a large part of the everyday workload of a GP and results in about 15 per cent of the entire workload of a GP.

“Worryingly, the inevitable time lag between making effective changes and establishing a suitably qualified Primary Care workforce and adequate numbers of appropriately qualified dermatologists, will be measured in decades. This report demonstrates a service that has decayed relentlessly over the last ten years. It is imperative that we act now to address this crisis.”

-Ends-

Notes to editors:

For more information please contact: Nina Goad, Head of Communications, British Association of Dermatologists: comms@bad.org.uk
Tel: 0207 391 6094. Website: www.bad.org.uk

*The full results of the FOI requests will been available to view on both the Dermatology Council for England and APPGS websites: http://www.appgs.co.uk/dermatology-council-for-england-releases-foi-report-july-2015/

** The full signatory list for the letter to the Health Select Committee is as follows:
Sir Paul Beresford MP, Chair, All Party Parliamentary Group on Skin
Dr David J Eedy MD, FRCP, President, British Association of Dermatologists
Professor Nigel Mathers, Honorary Secretary, Royal College of General Practitioners
Dr Stephen Kownacki, Chairman, Primary Care Dermatology Society
Karen Stephen, President, British Dermatological Nursing Group
Margaret Cox, Chief Executive, National Eczema Society
Claire Mather, Director Healthcare, Membership, and EB Community Support, DEBRA
Dr George Moncrieff, Chair, Dermatology Council for England
Helen McAteer, Chief Executive, Psoriasis Association
James Partridge, Chief Executive, Changing Faces
Fred Frederiksen, Vitiligo Society
Nigel Scott, Herpes Virus Association
Julie Halford, Hyperhidrosis UK

1 Many trusts employed more than one locum for different lengths of time, as such the percentages given will not total 100%.

The British Association of Dermatologists is the central association of practising UK dermatologists. Our aim is to continually improve the treatment and understanding of skin disease.
 

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Increase in hair dye and fragrance allergies in children

A study due to be presented at the British Association of Dermatologists annual meeting in Manchester today has found  a substantial shift in the allergens causing skin reactions in children over the last decade, with some allergies becoming less common and with others, including to hair dye ingredients, on the rise.

The study involved 500 UK children tested for potential contact allergies (skin reactions following contact with a substance*) between 2005 and 2014, and replicated a previous study, also of 500 children, between 1995 and 2004, to see the changes that have occurred in the frequency of contact allergy and the allergens responsible over the past ten years. The study was conducted by dermatologists from Leeds Teaching Hospitals NHS Trust.

In both studies 27 per cent of the children (133 in 1995 to 2004 and 134 in 2005 to 2014) tested positive to one or more contact allergy. However, where they differed in their results most significantly was in regards to the causes of these allergies. In the 1995 to 2004 study 33 per cent of these children had a nickel allergy and 18 per cent presented with an allergy to a fragrance. Between 2005 and 2014 these two allergens remain the most common, however, there was a sharp fall in the number of nickel allergies, down to 18 per cent.

Despite the fall in nickel allergies the total percentage of children with allergies remains static because more children are becoming sensitised to other substances, some of which did not even feature in the original study, including various hair dye ingredients. It is thought this might suggest increasing use of hair dyes in children, and may also be due to black henna tattoos which contain a high concentration of para-phenylenediamine (PPD). Use of these tattoos just once can make people react to PPD in other products at a later date*.

After metals and fragrances, the next most common allergens were:

Allergen                                              Frequency         Common Uses
Para-phenylenediamine (PPD)          16 per cent         Hair dye ingredient
4-aminophenol                                    8 per cent          Hair dye ingredient
Aminoazobenzene                              7 per cent          Dye ingredient
Disperse orange 3                              7 per cent          Textile dye ingredient
Para-toluenediamine sulfate (PTDS)  7 per cent          Hair dye ingredient
Methylchloroisothiazolinone and
methylisothiazolinone
                                                           6 per cent          Preservative commonly used in cosmetics and many everyday household objects.

The authors of the study hypothesised that the reason for the fall in nickel allergies may be down to the European Union Nickel Directive, implemented in December 1994. The Nickel Directive limits the amount of nickel that can be used in products that come into prolonged contact with the skin. This impact of this would not be instantaneous but rather would likely show over time as new generations are less exposed to the metal, as although some people are predisposed to certain allergies others become sensitive to new substances through exposure over time.

In fact, in 2013 dermatologists raised concerns about the UK’s new five pence and ten pence coins which are nickel-plated, rather than being made of a nickel alloy, worried that people would be unnecessarily sensitised to nickel by long-term exposure through these coins.

Dr Vanessa Smith of Leeds Teaching Hospitals NHS Trust and one of the authors of the study, said: “It’s important to track the rates of allergy in children in the UK, and to recognise the underlying allergens, this can help guide policy makers and manufacturers as to potential public health risks.

“Our results suggest that efforts to curb the rates of nickel allergies have been a success and that these policies should continue. However, it’s clear that some of the highest rates of allergy amongst children are due to hair dye ingredients such as PPD. This is perhaps a sign of children using hair dyes and getting black ‘henna’ tattoos at younger ages, both of which can cause sensitivity to PPD.”

Matthew Gass of the British Association of Dermatologists, said: “Contact allergies can be very severe and can have a devastating effect on people’s lives. Nickel has been a common allergy for a long time and so it’s good to see that this study has shown that rates are falling. However, more efforts need to be made to make people aware of the sensitising properties of other common substances.”

-Ends-
Notes to editors:

* The study specifically looked at contact eczema, which is separate to immediate-type allergy, e.g. to foods.

Study details: Allergic contact dermatitis in children: trends in allergens, 10 years on. A retrospective study of 500 children tested between 2005 and 2014 in one U.K. centre
V. Smith, S. Clark and M. Wilkinson
Leeds Teaching Hospitals NHS Trust, Leeds, U.K.

If using this study, please ensure you mention that the study was released at the British Association of Dermatologists’ Annual Conference.
The conference will be held at Manchester Central from July 7th to 9th and is attended by approximately 1,300 UK and worldwide dermatologists.

For more information please contact:  Matthew Gass, Communications Officer, mobile 07837734620 during conference week, 0r 0207 391 6084 from Friday 10th, or email: comms@bad.org.uk , Website: www.bad.org.uk

*‘Black henna’ temporary tattoos are generally not made from henna but high concentrations of PPD.  This use of PPD is illegal in the EU, however black henna tattoos are often available abroad.

The British Association of Dermatologists is the central association of practising UK dermatologists. Our aim is to continually improve the treatment and understanding of skin disease.
 

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Smoking worsens acne scarring, study finds

It is well known that smoking has a negative impact on the health. Now new research, presented this week at the British Association of Dermatologists’ Annual Conference in Manchester, will reveal that it may worsen skin scarring in people with spots.

Smoking is known to cause changes to the skin, such as wrinkles, but this is the first study to suggest there may be a link between smoking and acne scarring.

A team of dermatologists from Harrogate conducted a study of 992 people with acne vulgaris (the most common type of the disorder) referred to a hospital dermatology department over an eight year period.

At the first appointment, each patient’s skin was examined and the severity of their acne and any scarring noted. Lifestyle factors that might affect the skin were also recorded, including smoking.

Scarring was noted in 91 per cent of patients but was not more common in smokers. However, a higher percentage of moderate to severe scarring, rather than mild scarring, was noted in those that smoked. Over half (53.7 per cent) of smokers showed moderate to severe scarring compared to just over a third of non-smokers (35 per cent). This appeared to be independent of acne severity.

Dr Raman Bhutani, one of the study’s authors, said: “The correlation seen between smoking and severity of facial scarring could suggest that smoking can increase the severity of scarring in a susceptible person with acne. Further work is required to confirm this finding and to understand the mechanisms by which this may occur.”

Nina Goad of the British Association of Dermatologists said: “Acne affects a huge proportion of the population, with 80 per cent of teenagers affected at some point. While for most people the disorder will eventually clear, some are left with scarring which can be for life. This can be hard to treat and can make people feel self-conscious and affect their self-esteem. We already know that smoking is bad for our health, so perhaps this latest finding will provide an extra impetus for people to quit.”

Acne occurs when the sebaceous (oil-producing) glands are particularly sensitive to normal blood levels of certain hormones, causing the glands to produce an excess of oil. The build-up of oil creates an ideal environment in which acne bacteria, known as Propionibacterium acnes, can multiply. At the same time, the dead skin cells lining the pores are not shed properly and clog up the follicles, producing blackheads and whiteheads.

The study team are conducting a study to understand how acne is treated across the UK. Please consider answering a short questionnaire via this link https://www.surveymonkey.com/s/Acne_treatment_survey_patient

-Ends-
Notes to editors:

If using this study, please ensure you mention that the study was released at the British Association of Dermatologists’ Annual Conference.
The conference will be held at Manchester Central from July 7th to 9th and is attended by approximately 1,300 UK and worldwide dermatologists.

For more information please contact: British Association of Dermatologists Communications Team, 0207 391 6096 or Nina Goad, Head of Communications, mobile 07825567717 during conference week, or email: nina@bad.org.uk, Website: www.bad.org.uk

Study details: Exhibition poster P56, Smoking and scarring severity in acne, R. Bhutani, P. Kadiyala, E. Fryatt and A.M Layton; Harrogate District Foundation Trust, Harrogate, UK.

The British Association of Dermatologists is the central association of practising UK dermatologists. Our aim is to continually improve the treatment and understanding of skin disease.
 

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Sunbed use starts at age 12, study finds

A study due to be presented at the British Association of Dermatologists annual meeting in Manchester this week has found that the average age at which young people start using sunbeds is just 12 years old.

The research, involving 755 secondary school pupils from across Ireland, is the country’s largest study ever undertaken looking at avoidable skin cancer risk factors among the 14-18 age group.

The aim was to assess sunburn history, sun-protection habits (including sunscreen use), sunbed usage rates and attitudes towards sun and sunbed exposure among teenagers.

Eight per cent of respondents had used sunbeds, increasing to 11 per cent in the capital city, Dublin. Worryingly, six per cent had used sunbeds over 25 times in the previous year.

The average age of sunbed use was 16.2 years, with the average age of first sunbed use being 12.9 years. The youngest age of reported use was, shockingly, seven-years-old.

Further to this, only 26 per cent of sunbed users had been given any advice prior to use and 66 per cent of users were left unsupervised.

The study also found that 91 per cent of students had been sunburned. Teenagers were twice as likely to apply sunscreen regularly while abroad on sunshine holidays, than to apply it during the summer months in Ireland, suggesting a lack of understanding that sunburn can occur at home as well as abroad.

42 per cent of sunbed users were male, and most teenagers used sunbeds in beauty salons (29.3%). 20 percent were spending 11 to 30 minutes at a time on sunbeds, a worrying figure since 20 minutes on a sunbed can be equivalent to spending four hours in the sun*.

86 per cent of sunbed users believed that a tan makes you more attractive; 81 per cent believed a tan looked healthy; 61 per cent thought that sunbeds are a good way to create a base tan before going on holiday; and 53 per cent believed sunbeds to be a good treatment for acne. Whereas 72 per cent of non-sunbed users believed a tan makes your more attractive; 70 per cent thought a tan looked healthy; 22 per cent thought it useful to create a base tan; and 18 per cent believed sunbeds to be a good treatment of acne.

Sunbeds are a group 1 carcinogen, with indoor tanning placing users at a 48 per cent higher risk of developing non-melanoma skin cancer. 72 per cent of interviewed sunbeds users were aware that sunbeds were harmful, suggesting that concerns over skin cancer are being outweighed by the desire to be tanned.

Miriam Fitzgerald, co-author of the study said: “Studies have shown that first use of a sunbed when aged under 35 years increases the risk of later developing melanoma by 75 per cent, so our findings that eight per cent of teenagers are using sunbeds is a worry. Even more concerning is that those who use sunbeds are starting, on average, at age 12. National legislation banning the use of sunbeds by persons aged under 18 years was introduced in 2014, four months after our study ended. We plan to revisit schools to assess whether the ban, once established, has any effect on the above results.

-Ends-
Notes to editors:

Study details: Ambient and sunbed ultraviolet radiation exposure: exposure rates, protection habits and attitudes of Irish teenagers aged 14–18 years before introduction of national sunbed legislation
M. Fitzgerald,1 S. Daly,2 D. McKenna,2 J. Bourke3 and A. Kelly3
1Mater Misericordiae University Hospital, Dublin, Ireland, 2Sligo Regional Hospital, Sligo, Ireland and 3South Infirmary Victoria University Hospital, Cork, Ireland

If using this study, please ensure you mention that the study was released at the British Association of Dermatologists’ Annual Conference.

The conference will be held at Manchester Central from July 7th to 9th and is attended by approximately 1,300 UK and worldwide dermatologists.

For more information please contact: Nina Goad, Head of Communications, 0207 391 6094 or mobile 07825567717 during conference week, or email: nina@bad.org.uk, Website: www.bad.org.uk

The British Association of Dermatologists is the central association of practising UK dermatologists. Our aim is to continually improve the treatment and understanding of skin disease.

*http://www.bbc.co.uk/newsbeat/article/21057439/newsbeat-guide-to-sunbeds-and-tanning
 

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Antibiotic usage for acne and skin infections is leading to drug resistant bacteria, doctors warn

Doctors are being warned to limit the use of antibiotics for the treatment of acne, amidst growing rates of antibiotic resistance in patients with the disorder.

For more than 40 years, antibiotic therapy directed against the acne-causing bacterium, Propionibacterium acnes, has been the mainstay of treatment for moderate (rather than mild or severe) acne. Commonly used antibiotics for acne include erythromycin, clindamycin and a group of antibiotics called tetracyclines.

This week, Dermatologists and Microbiologists from Harrogate will present findings at the British Association of Dermatologists’ Annual Conference in Manchester that may challenge this practice, while a study from King’s College Hospital in London will show growing rates of antibiotic resistance among all dermatology patients.

The Harrogate researchers measured the numbers of Propionibacterium acnes colonising the skin of 994 patients referred to the hospital Dermatology department between 2004 and 2013 and assessed what proportion of them were resistant to common antibiotics used to treat acne.

The study, supported by a grant from the British Skin Foundation, revealed that up to 79.5 per cent of patients were colonised by bacteria resistant to erythromycin or clindamycin or both.

The proportion of patients colonised by tetracycline-resistant bacteria was lower (14.2 to 25 per cent), but did rise to 68.2 per cent one year (2011) for reasons that are currently unclear. Most patients were colonised by a mix of both resistant and non-resistant bacteria.

There is evidence to suggest that patients carrying antibiotic resistant Propionibacterium acnes may respond less well to antibiotic therapy used to manage their acne. It has also been shown that these resistant bacteria can be spread by direct contact from one person to the next.

A second study due to be released at the conference looked at the resistance to antibiotics of another bacterium, called Staphylococcus aureus, which is a common cause of skin infections. The researchers, from King’s College Hospital in London, found that 30 per cent of samples taken from general dermatology patients (rather than acne patients specifically) in 2014 were resistant to the antibiotic erythromycin compared to 17 per cent in 2007. 24 per cent of samples in 2014 were resistant to clindamycin, but it is not known if this is an increase from previous years.

Nina Goad of the British Association of Dermatologists said: “The growing resistance to antibiotics among skin patients generally and among acne patients more specifically, as highlighted by these two studies, is of concern. Antibiotics are important for treating skin infections, which are common in many skin diseases like eczema. Acne affects a huge number of people – 80 per cent of teenagers experience acne and while for most people it will disappear with age, for some it continues well into adulthood. If left untreated it can have a big psychosocial impact and cause scarring, so clearly this is a problem that needs to be managed.”

Consultant Dermatologist Dr Alison Layton from Harrogate, one of the acne study’s authors, explained: “Against a background of global concern about rising antibiotic resistance rates in major bacterial pathogens, GPs
may be unaware that resistance rates in skin propionibacteria are so high. These results highlight the need to use antibiotics judiciously when managing acne and to ensure that alternative effective agents are used, such that reliance on antibiotics is reduced whenever possible.”

Acne occurs when the sebaceous (oil-producing) glands are particularly sensitive to normal blood levels of certain hormones, causing the glands to produce an excess of oil. The build-up of oil creates an ideal environment in which Propionibacterium acnes can multiply. At the same time, the dead skin cells lining the pores are not shed properly and clog up the follicles, producing blackheads and whiteheads.

Dr Layton and the team in Harrogate are now conducting a study to understand how acne is being treated and are asking patients (via https://www.surveymonkey.com/s/Acne_treatment_survey_patient) and professionals who prescribe for acne (via https://www.surveymonkey.com/s/Acne_treatment_survey) to complete a survey to confirm this, so they can then provide relevant educational material to support improved treatment outcomes.

-Ends-

Notes to editors:

If using this study, please ensure you mention that the study was released at the British Association of Dermatologists’ Annual Conference.
The conference will be held at Manchester Central from July 7th to 9th and is attended by approximately 1,300 UK and worldwide dermatologists.

For more information please contact: Nina Goad, Head of Communications, 0207 391 6094 or mobile 07825567717 during conference week, or email: nina@bad.org.uk, Website: www.bad.org.uk

Study details:
1. A decade later, has the prevalence of skin colonization by resistant propionibacteria increased in our patients with acne? K.H. Kuet,1 C. Finch,1 E. Fryatt,1 A. Eady1 and A. Layton1,2
1Sheffield Teaching Hospitals NHS Trust, Sheffield, U.K. and 2Harrogate and District NHS Foundation Trust, Harrogate, U.K.
This study was supported by a grant from the British Skin Foundation: www.britishskinfoundation.org.uk

2. Trends in antibiotic resistance patterns of Staphylococcus aureus isolates from dermatology patients in the U.K. over 12 years. A. Sears, M. Rossabi, N. Desai, J. Wade, R. Hay and R. Morris-Jones
King’s College Hospital, London, U.K.

The British Association of Dermatologists is the central association of practising UK dermatologists. Our aim is to continually improve the treatment and understanding of skin disease.
 

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