Rash Decisions

Mental Health (Part 3) - Mind-skin connections

In this third instalment of our series on mental health and the skin, we, Dr George Moncrieff and Dr Roger Henderson, are joined once again by special guest Professor Anthony Bewley, a distinguished authority in the field of psychodermatology. 
In this episode, we delve into the fascinating world of mental health conditions that manifest through the skin. Drawing from Professor Bewley's wealth of experience, we’ll explore conditions such as the obsessive compulsive disorder, trichotillosis and body dysmorphic disorder, shedding light on the complex psychological factors underlying these dermatological manifestations, that are expressed through the skin.
As the episode progresses, we’ll reflect on the key takeaways from this series on mental health and the skin and how treating both the psychological and the dermatological aspects leads to a more comprehensive and rapid resolution. Tune in and join us for an insightful summary on managing mental health implications linked to skin disease, in primary care. 
Thank you to our kind sponsor AproDerm, who provide a comprehensive range of quality emollients designed for the management of dry skin conditions, including eczema, psoriasis and ichthyosis.  
To simplify the process of finding the most suitable emollient for each patient, they have developed a remarkable solution: the AproDerm Emollient Starter Pack. This pack conveniently combines all four of their emollients in a single prescription, enabling patients to identify their ideal emollient more efficiently, aiding both compliance and adherence.  
Find out more: https://aproderm.com/aproderm-emollient-starter-pack/   
LI: https://www.linkedin.com/company/fontus-health-ltd/  
Got some feedback for us? Please rate and review Rash Decisions to help us keep creating educational podcasts for you.  
Is there a dermatology topic you’d like us to explore? Email us at info@aproderm.com, and we’ll do our best to cover it. 
The views expressed in this podcast are of Dr George Moncrieff and Dr Roger Henderson. Fontus Health has not influenced, participated, or been involved in the programme, materials, or delivery of educational content. 

Mental Health (Part 2) - How skin conditions impact the minds of your patients

This episode contains some eye-opening statistics revealing the staggering toll the likes of atopic dermatitis, rosacea, acne, psoriasis and alopecia areata take on an individual's mental wellbeing. 
BUT, the episode doesn’t just shed light on the problem. Dr George Moncrieff and Dr Roger Henderson have enlisted the help of Professor Anthony Bewley, a world authority on psychodermatology, to help them break down the barriers to initiating vital conversations around mental health in primary care.
They also discuss the golden rule of psychodermatology - to treat the skin, and the psychosocial comorbidities, at the same time and as early as possible along with the impact this has on patient outcomes.
Discover how you, a primary care healthcare professional, can become a beacon of hope for these individuals, by integrating mental health support into dermatological care. 
Thank you to our kind sponsor AproDerm, who provide a comprehensive range of quality emollients designed for the management of dry skin conditions, including eczema, psoriasis and ichthyosis.  
To simplify the process of finding the most suitable emollient for each patient, they have developed a remarkable solution: the AproDerm Emollient Starter Pack. This pack conveniently combines all four of their emollients in a single prescription, enabling patients to identify their ideal emollient more efficiently, aiding both compliance and adherence.  
Find out more: https://aproderm.com/aproderm-emollient-starter-pack/   
LI: https://www.linkedin.com/company/fontus-health-ltd/  
Got some feedback for us? Please rate and review Rash Decisions to help us keep creating educational podcasts for you.  
Is there a dermatology topic you’d like us to explore? Email us at info@aproderm.com, and we’ll do our best to cover it. 
The views expressed in this podcast are of Dr George Moncrieff and Dr Roger Henderson. Fontus Health has not influenced, participated, or been involved in the programme, materials, or delivery of educational content. 

Mental Health (Part 1) - Psychodermatology and your patients

“…the skin is not just the skin. Underneath the skin, there is a person, who is really suffering.” Professor Anthony Bewley.
In 2020, the 'Mental Health and Skin Disease' report produced by the All-Party Parliamentary Group on Skin highlighted that 98% of individuals with skin disease reported an impact on their wellbeing, despite this, only 18% received effective professional help. 
The report stated that skin disease can adversely impact on all aspects of someone's life, from schooling, self-esteem, career choices, to social, sexual, and leisure activities.  
We are honoured to be joined by Professor Anthony Bewley on our latest podcast to discuss this report, in which we’ll be covering: 
How we, as healthcare professionals, can, within 4 minutes, get our patients to talk to us about whether their condition affects their mental health 
The reasons why Professor Bewley believes that only 18% of individuals seek professional help for their mental health 
How psychodermatology has improved in the UK  
What the Cumulative Life Course Impairment is and its importance in dermatology 
In today’s modern world where body image expectations can be both significantly and adversely affected by unrealistic social media expectations and where mental health is less of a taboo topic, this episode is definitely one that needs to be heard.  
Thank you to our kind sponsor AproDerm, who provide a comprehensive range of quality emollients designed for the management of dry skin conditions, including eczema, psoriasis and ichthyosis.  
To simplify the process of finding the most suitable emollient for each patient, they have developed a remarkable solution: the AproDerm Emollient Starter Pack. This pack conveniently combines all four of their emollients in a single prescription, enabling patients to identify their ideal emollient more efficiently, aiding both compliance and adherence.  
Find out more: https://aproderm.com/aproderm-emollient-starter-pack/   
LI: https://www.linkedin.com/company/fontus-health-ltd/  
Got some feedback for us? Please rate and review Rash Decisions to help us keep creating educational podcasts for you.  
Is there a dermatology topic you’d like us to explore? Email us at info@aproderm.com, and we’ll do our best to cover it. 
The views expressed in this podcast are of Dr George Moncrieff and Dr Roger Henderson. Fontus Health has not influenced, participated, or been involved in the programme, materials, or delivery of educational content. 

Rosacea (Part 2) – Getting treatment right first time

“...when you then see the patient who comes in [with] rosacea and they [have] then got the broken capillaries, the blood vessels starting to appear. It's not that my heart sinks when I see those, compared to a patient with simple background flushing, but I start thinking, we're in for a slightly trickier time here to start pulling them back.” Dr Roger Henderson. 
In this episode, your hosts, Dr George Moncrieff and Dr Roger Henderson discuss the treatment options available across the rosacea spectrum. From how to treat simple flushing and background redness through to ocular involvement and Rhinophyma.  
With over 70 years' combined experience in primary care, listen in to learn from these two expert GPs as they share their knowledge and practical tips on rosacea treatments.  
This episode includes: 
Discussing lifestyle changes and trigger avoidance with your patients 
The importance of emollients as part of a daily routine 
The variety of treatment options available, both on the NHS and privately, when to use them appropriately, including anti-inflammatory and camouflage products, as well as laser therapy  
The association between Demodex mites and rosacea 
The various ocular manifestations and their treatment options 
The advances of rhinophyma debulking 
But, be warned, by the end of this podcast, you might just be walking around with the same thoughts as George... “...I see a lot of people walking around the streets who've still got very nasty inflammatory papulopustular rosacea. I'm just desperate to talk to them because, I know we've got such effective treatments.” 
Thank you to our kind sponsor AproDerm, who provide a comprehensive range of quality emollients designed for the management of dry skin conditions, including eczema, psoriasis and ichthyosis.  
To simplify the process of finding the most suitable emollient for each patient, they have developed a remarkable solution: the AproDerm Emollient Starter Pack. This pack conveniently combines all four of their emollients in a single prescription, enabling patients to identify their ideal emollient more efficiently, aiding both compliance and adherence.  
Find out more: https://aproderm.com/aproderm-emollient-starter-pack/  
LI: https://www.linkedin.com/company/fontus-health-ltd/  
  
Thank you for listening. We hope you find this podcast interesting and helpful. Please leave us a review or email info@aproderm.com with any feedback on this episode or suggestions on dermatology topics that you would like to hear about in future podcasts.  
The views expressed in this podcast are of Dr George Moncrieff and Dr Roger Henderson. Fontus Health has not influenced, participated, or been involved in the programme, materials, or delivery of educational content. 

Rosacea (Part 1) - The best pub quiz question ever!

"What do Rembrandt, the Hollywood actor W. C. Fields and the former president Bill Clinton all have in common?"
The answer is rosacea, and in this first episode on this common skin condition, your hosts Dr George Moncrieff and Dr Roger Henderson explore how to identify rosacea in your patients, giving you clarity on the clinical presentations to avoid potential misdiagnosis.
They will also cover:
How to differentiate rosacea from acne
Rosacea in skin of colour
The different subtypes in the rosacea spectrum and their severities
The link between rosacea and eye symptoms, including how to work with opticians to help identify the condition quicker
The impact rosacea has on a patient’s quality of life
The importance of understanding different triggers to help patients effectively manage their condition
Rosacea affects around 1 in 10 people in the UK and can have a huge impact on their self-confidence and mental health. So, tune into this 20-minute episode, which is jam-packed with nuggets of wisdom from our hosts, allowing you to confidently help your patients manage their rosacea.
Thank you to our kind sponsor AproDerm, who provide a comprehensive range of quality emollients designed for the management of dry skin conditions, including eczema, psoriasis and ichthyosis.
To simplify the process of finding the most suitable emollient for each patient, they have developed a remarkable solution: the AproDerm Emollient Starter Pack. This pack conveniently combines all four of their emollients in a single prescription, enabling patients to identify their ideal emollient more efficiently, aiding both compliance and adherence.
Find out more: https://aproderm.com/aproderm-emollient-starter-pack/
LI: https://www.linkedin.com/company/fontus-health-ltd/
We hope you find this podcast interesting and helpful. Please leave us a review or email info@aproderm.com with any feedback on this episode or suggestions on dermatology topics that you would like to hear about in future podcasts.
The views expressed in this podcast are of Dr George Moncrieff and Dr Roger Henderson. Fontus Health has not influenced, participated, or been involved in the programme, materials, or delivery of educational content.

Acne (Part 2) - Best treatment, zero scarring

As Dr Roger Henderson aptly puts it, “...The one thing guaranteed to make my heart sink, if I'm walking down the high street, is to see someone with acne scarring... Because you know that, that was preventable.”  
In this insightful episode, your hosts Dr George Moncrieff and Dr Roger Henderson discuss acne treatments, emphasising the crucial importance of preventing acne scarring. 
From topical retinoids to isotretinoin, this episode equips healthcare professionals with essential knowledge and patient-centric approaches to addressing acne. You’ll learn:  
The essential information-gathering process at the onset of a consultation, laying the groundwork for selecting the most suitable treatment option(s). 
Insights into what treatment choices are available, how they work, who they are suitable for and what the benefits are.  
Proactive measures for the prevention of acne scarring, alongside an overview of scar types and management strategies. 
When to refer for isotretinoin and what you, as a primary care clinician can do to help the process of referral go smoothly. 
Acne management in patients with skin of colour and how it differs. 
Whether you're a seasoned healthcare professional or a budding practitioner, this episode offers invaluable perspectives and practical insights into acne treatment.  
Thank you to our kind sponsor AproDerm, who provide a comprehensive range of quality emollients designed for the management of dry skin conditions, including eczema, psoriasis and ichthyosis.  
To simplify the process of finding the most suitable emollient for each patient, they have developed a remarkable solution: the AproDerm Emollient Starter Pack. This pack conveniently combines all four of their emollients in a single prescription, enabling patients to identify their ideal emollient more efficiently, aiding both compliance and adherence.  
Find out more: https://aproderm.com/aproderm-emollient-starter-pack/   
LI: https://www.linkedin.com/company/fontus-health-ltd/  
Got some feedback for us? Please rate and review Rash Decisions to help us keep creating educational podcasts for you.  
Is there a dermatology topic you’d like us to explore? Email us at info@aproderm.com, and we’ll do our best to cover it. 
The views expressed in this podcast are of Dr George Moncrieff and Dr Roger Henderson. Fontus Health has not influenced, participated, or been involved in the programme, materials, or delivery of educational content. 

Acne (Part 1) - The full monty!

“Now many patients of mine do believe that acne, is acne, is acne. But one of the things I have learnt, over too many years of treating them, is that there's a massive range of presentations, including the 'no need to treat, so mild', to the... specialist referral level with horrendous scarring, which I think we've failed, if we get to the scarring point...  
So, there's this massive sort of A to Z range, isn't there?... We've got to treat each patient as they sit in front of us rather than just lumping everyone with acne into the same boat.” Dr Roger Henderson 
From barely-there blemishes to the severe and scarring, learn why acne is not just 'acne'. Drawing from years of clinical experience, Dr Henderson along with his co-host Dr George Moncrieff emphasise the importance of a bespoke management approach to acne and recognising each patient's unique needs. 
In today's discussion, our experts explore everything from genetic predispositions to lifestyle influences.  
Listen along to learn:  
How increased sebum production and bacterial colonisation lead to acne development. 
The roles of diet, combined oral contraceptives and stress in acne. 
Insights into identifying potential triggers for acne, including the use of anabolic steroids.  
The significance of considering conditions such as polycystic ovarian syndrome (PCOS) and adrenal hyperplasia in the diagnostic process, urging vigilance in clinical assessment. 
Tune in to transform your understanding of the causes of acne and enhance your patient care. 
Thank you to our kind sponsor AproDerm, who provide a comprehensive range of quality emollients designed for the management of dry skin conditions, including eczema, psoriasis and ichthyosis.  
To simplify the process of finding the most suitable emollient for each patient, they have developed a remarkable solution: the AproDerm Emollient Starter Pack. This pack conveniently combines all four of their emollients in a single prescription, enabling patients to identify their ideal emollient more efficiently, aiding both compliance and adherence.  
Find out more: https://aproderm.com/aproderm-emollient-starter-pack/   
LI: https://www.linkedin.com/company/fontus-health-ltd/  
Got some feedback for us? Please rate and review Rash Decisions to help us to keep creating informative educational podcasts for you.  
Is there a dermatology topic you’d like us to explore? Email us at info@aproderm.com, and we’ll do our best to cover it. 
The views expressed in this podcast are of Dr George Moncrieff and Dr Roger Henderson and Fontus Health has not influenced, participated, or been involved in the programme, materials, or delivery of educational content. 

Topical Steroids (Part 2) - Everything you wanted to know but were too afraid to ask!

“Somebody with moderate atopic eczema has nine flares a year, each of those flares, perhaps needing topical steroids for two to five weeks at least. So, they're barely stopping the topical steroids.” Dr George Moncrieff 
Already you can see how patients can very easily, and unintentionally, be prescribed topical steroids long-term, which they are neither intended for, nor licensed for. The impact of this is discussed in this episode, by your hosts Dr George Moncrieff and Dr Roger Henderson. They will also guide you through incidences where topical steroids can be a cause for concern and how to overcome these. Our learned colleagues will cover: 
How topical steroids affect the skin, including the impact of their pH on our all-important acid mantle. They then dive deeper below the surface to look at how topical steroids compromise the granular activity in the stratum granulosa and the impact of this on our skin barrier. In addition, they look at how topical steroids can thin the skin along with their potential systemic effects, including suppression of the hypothalamic-pituitary-adrenal axis and the immune system 
Where you absolutely would not want to be using a topical steroid 
The impact of long-term topical steroid use and tips on how to prevent this, from a simple patient audit to looking at alternatives 
How in the short-term, topical steroids might seem to be the most cost-effective option, but in the longer term, how alternative solutions reduce real costs. 
Thank you to our kind sponsor AproDerm, who provide a comprehensive range of quality emollients designed for the management of dry skin conditions, including eczema, psoriasis and ichthyosis. 
To simplify the process of finding the most suitable emollient for each patient, they have developed a remarkable solution: the AproDerm Emollient Starter Pack. This pack conveniently combines all four of their emollients in a single prescription, enabling patients to identify their ideal emollient more efficiently, aiding both compliance and adherence. 
Find out more: https://aproderm.com/aproderm-emollient-starter-pack/ 
LI: https://www.linkedin.com/company/fontus-health-ltd/ 
Thank you for listening. We hope you find this podcast interesting and helpful, please leave us a review or email info@aproderm.com with any feedback on this episode or suggestions for what you would like to hear about in future podcasts. 
The views expressed in this podcast are of Dr George Moncrieff and Dr Roger Henderson and Fontus Health has not influenced, participated, or been involved in the programme, materials, or delivery of educational content. 

Topical Steroids (Part 1) - The Lowdown

“…we’ve been using topical steroids now for over 70 years, which means they've been around longer than paracetamol.  So, we know how to get the best results from them, and we know what to expect from them.” Dr George Moncrieff 
Or do we? 
Join our hosts as they unravel the essentials of prescribing topical steroids. Dr George Moncrieff and Dr Roger Henderson explore key topics, including: 
The anti-inflammatory action of topical steroids and how they work 
The topical steroids that are available to us, their various forms and their potencies 
Advice on how to effectively communicate with your patients to dispel misconceptions including careful use of ambiguous terms like "sparingly" and "cautiously." 
Working out how much topical steroid to prescribe by utilising the universal 5mm nozzle, combined with the fingertip unit measure 
Advising patients on frequency of application, the all-important question, what comes first, emollient or steroid?  and the importance of tapering down topical steroids  
Tune in to enhance your knowledge of topical steroids; achieving better outcomes for your patients and efficiencies for our healthcare system. 
Thank you to our kind sponsor AproDerm, who provide a comprehensive range of quality emollients designed for the management of dry skin conditions, including eczema, psoriasis and ichthyosis. 
To simplify the process of finding the most suitable emollient for each patient, they have developed a remarkable solution: the AproDerm Emollient Starter Pack. This pack conveniently combines all four of their emollients in a single prescription, enabling patients to identify their ideal emollient more efficiently, aiding both compliance and adherence. 
Find out more: https://aproderm.com/aproderm-emollient-starter-pack/   
TW: https://twitter.com/AproDerm 
LI: https://www.linkedin.com/company/fontus-health-ltd/ 
Thank you for listening. We hope you find this podcast interesting and helpful, please leave us a review or email info@aproderm.com with any feedback on this episode or suggestions for what you would like to hear about in future podcasts. 
The views expressed in this podcast are of Dr George Moncrieff and Dr Roger Henderson and Fontus Health has not influenced, participated, or been involved in the programme, materials, or delivery of educational content. 
 

Emollients (Part 3) - Emollients everywhere! Which one to choose?

“...Appropriate use of an emollient reduces overall health costs because the patient's eczema gets better, they have less appointments with doctors, they have less eczema, they're using less steroids, and in the paper that I showed not only were they using less topical steroids, they were using less antibiotics. So, it really is a win. You're using a very safe agent.” Dr George Moncrieff. 
In this third, and final, episode on the topic of ‘Emollients’, your hosts Dr George Moncrieff and Dr Roger Henderson highlight the importance of communication and collaboration between patients and their healthcare professional in order to use emollients to their full potential in the management of dry skin conditions. They will also cover: 
The importance of Complete Emollient Therapy and aiding patient compliance 
Ways to communicate with your patient to help them understand the pivotal role of their emollients 
Guidance on the appropriate emollient quantities that you should be prescribing to your patients 
How often you, as a healthcare professional, should be reviewing your patients progress after initiating therapy 
The difference between simple and sophisticated emollients and when to use them 
The importance of choosing the right container to avoid emollient contamination and product wastage 
Cost-effective emollients including the AproDerm Emollient Range 
The importance of prepayment certificates and discussing these with patients 
Effective emollient use is the key to managing dry skin and this episode equips you with the knowledge to confidently prescribe and educate patients on effective emollient use. Listen in to finely tune your emollient selection. 
Thank you to our kind sponsor AproDerm, who provide a comprehensive range of quality emollients designed for the management of dry skin conditions, including eczema, psoriasis and ichthyosis. 
To simplify the process of finding the most suitable emollient for each patient, they have developed a remarkable solution: the AproDerm Emollient Starter Pack. This pack conveniently combines all four of their emollients in a single prescription, enabling patients to identify their ideal emollient more efficiently, aiding both compliance and adherence. 
Find out more: https://aproderm.com/aproderm-emollient-starter-pack/ 
TW: https://twitter.com/AproDerm  
LI: https://www.linkedin.com/company/fontus-health-ltd/ 
Thank you for listening. We hope you find this podcast interesting and helpful, please leave us a review or email info@aproderm.com with any feedback on this episode or suggestions for what you would like to hear about in future podcasts. 
The views expressed in this podcast are of Dr George Moncrieff and Dr Roger Henderson and Fontus Health has not influenced, participated, or been involved in the programme, materials, or delivery of educational content.