Treatment 1: The people (health professionals, skin camouflage and support groups)

Professionals involved in the treatment of skin disease
The parents of a new-born baby with a congenital skin condition or a person who
acquires a skin disease later in life may be confronted by a wide range of health
professionals. In this section we list the professionals that a skin disease patient
may meet at some point during their health consultation, and briefly describe the
role they play.
As will be seen, the problems associated with skin conditions can be many
and varied and a wide range of health professionals can be involved in the
treatment process.
Dermatologists
These are physicians who specialise in dealing with skin conditions which require
medical treatment. The conditions that dermatologists work with include acne,
psoriasis, eczema, vitiligo, urticaria and some skin cancers. They often prescribe
conventional medical treatments such as steroid creams, tablets, lotions and
sessions of ultraviolet light therapy and can give good advice to patients and
parents of children with skin conditions on good management of the skin. Since
they tend to specialise in the physiological aspects of the skin, some dermatologists
do not always appreciate the psychological aspects that can be associated with the
condition – and this is where psychologists and psychiatrists can come in.
Psychologists
Psychologists are non-medical professionals who are trained to help people to deal
with emotional and behavioural problems. The training they receive is based ona past knowledge of psychological theory and often includes specialised clinical
training, althoughnot always.Psychologists oftenworkwithindividuals or families
and, inthe case of skindisease, theyhave beenshowntohave achieved considerable
successwith both adult and child skin disease patients. Since skin disease can often
affect an individual’s body image, self-esteem and quality of life, psychologists
can work with skin disease patients to help them to develop new ways of coping
with their condition so that the patient’s body image, self-esteem and quality of
life improve.
Psychiatrists
Psychiatristsaredoctors, likedermatologists,but insteadof specialisinginskin, their
speciality is in working with people who experience mental illness. For example,
psychiatrists may be called upon to work with patients who have delusions of
problems that don’t actually exist. A common condition is that of delusions of
parasitosis where the sufferer believes that their skin is infested with parasites.
These patients often present to psychiatrists with scarred lesions on their arms
where they have attempted to remove the ‘parasites’.
Nurses
Almost everyone is aware of the role of nurses in looking after the needs of
patients in hospital. Nurses are often involved with the consultation and treatment
aspects of skin disease. There are other ways that nurses can be involved in the
care of those with skin diseases. Nurses often have daily contact with patients
and their families during hospital treatment and so may be the first professional
to be aware of the distress involved with the condition. They have experience
of multidisciplinary treatment, in that they are medically trained, but are also
experienced in counselling skills and so can be the first to offer help to patients.
Nurses have wide experience of the psychological and physical aspects of skin
conditions, because they see somany people on a daily basis, and so they are often
able to recognise patient’s reactions to their skin disease and so can be aware of
who may benefit from psychological referral.
Health visitors
These specialist health professionals work closely with the family doctor and are
involved in the care of people in the community. They are often involved in the
care of babies and young children, although their work can include people of any
age. These nurses can be especially useful in offering advice to parents who may
be experiencing feeding or sleeping problems with their children. They are also
involved in monitoring the development of the children and their skin disease.Because health visitors have regular contact with parents and the family home,
they often find that they are involved in helping the parents to cope with the
emotional adjustment that comes with the birth of a baby with a skin disease.
Genetic counsellors
These are doctorswhohave a specialist knowledge of particular congenital diseases,
including skin disease. Their job is to give families information on the reasons that
particular congenital conditions occurredandwhat the chances are of the condition
appearing in the family in future generations.

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