Most people with vitiligo are self-conscious about their appearance, specifically if the white patches show on their face, neck or hands, which may make them reluctant to seek help. There are two specific areas in which the pharmacist can provide information: the appropriate utilization of sunscreens and the use of skin camouflage products.
Sunscreens absorb or reflect ultraviolet radiation before it reaches your skin layer. However, many sunscreens offer better protection against UVB (short wavelength UV radiation) than UVA (longer wavelength). Because vitiliginous skin is particularly vunerable to sunburn, there are many of sunscreens on the National Health Service, but a majority of individuals with treatment for vitiligo do not know this. These items appear in appendix 7 from the British National Formulary (borderline substances) in fact it is from the patient’s interest being informed that sunscreens needs to be used and can be obtained on prescription.
In case a sunscreen has become prescribed, it really is beneficial to make sure that the person is told how, and just how often, to use it. Sunscreens should be applied liberally and even for good protection, they must be reapplied approximately every hour if the person is outside over a sunny day. However, this could be a problem when the wearer also uses skin camouflage products.
It is also beneficial to make certain the person is happy with the sunscreen selected with the general practitioner – no sunscreen is beneficial to a patient if it is not used. For youngsters of school age, roll-on sunscreens are particularly useful because they are often self-applied with little spillage or embarrassment. Indeed, they may well be considered a “cool” item to have in one’s school bag. Many GPs and patients will never be aware tinted sunscreens can also be viti1igo on prescription. These will provide both colour and sun protection for the depigmented patches and therefore are particularly helpful for children, or for anybody who desires to disguise the patches but would not feel at ease using skin camouflage.
Should somebody with vitiligo request assistance in choosing from your vast range of non-prescribable sunscreens available, they ought to be advised to make use of one containing both UVA and UVB protection. With regards to everybody with vitiligo, whatever their ethnic origin, their vitiliginous skin must be treated as type 1 skin (always burns, never tans), that is typical of men and women with fair skin, light eyes and freckles. They therefore require a sun protection factor of 25 or above. Considerations when recommending products include comfort of application, staying power, absorption and stickiness.
Should a patient report that he / she always burns, no matter what sunscreen is used, the pharmacist should discover how this product is being applied. Additionally it is vital that you inquire if the sufferer has taken drugs for almost any other condition so that you can rule out any drug-induced photosensitivity. Enquiries about any “health” products being taken will also be useful because a number of herbs can cause photosensitivity. By way of example, many individuals usually do not realise that for those who have vitiligo, herbal products for example St John’s wort is capable of doing more harm than good.