Just the fact that I’m writing this blog suggests that talking to your GP may not be straightforward. If you have a GP you like and have trust in then the two of you are obviously doing very well already! But if not, then let’s think about what would help. I was a GP for 23 years, and during that time developed interest and experience in dermatology. I now work in specialist skin clinics. I’m hoping I can help you to help your GP give you great care.
Your GP needs to understand what it is like for you to live in your skin. If your skin is causing you a problem, it’s your GP’s job to work with you to find a solution. It can help to take a good friend or relative with you, someone who can act as another pair of ears to listen to the GP’s advice, and can maybe tell the GP their experience of how your skin problem affects you. Don’t worry how long all this will take, as the ten minutes typically allotted for each patient is only an average, and the GP will be skilled at giving each patient the time they need. Let the GP be the one to worry about time.
It is common for someone with eczema or psoriasis to feel that they’re not in control of their skin, but their skin’s in control of them. It may be that your sleep is affected by itching. Self-confidence may be low because your skin problem’s affecting areas that others can see, such as your face or hands. Your skin may be painful, and symptoms preventing you doing things at home or at work. You may feel that you don’t understand how to use products that have been prescribed for you. You may be feeling very low, or anxious, or unable to cope. Don’t play down how much your skin affects you; eczema or psoriasis is never ‘just’ a skin problem.
Take all your skin treatments with you, in a bag, or take a written list. This means the ones you get on prescription, and also ones you’ve bought yourself or borrowed from friends and family. Say which creams and ointments you like using, and any you don’t. Say if you are finding that the quantity of a cream or ointment that you get on a repeat prescription isn’t lasting long, as it’s reasonable to expect an item to last you at least one month. It’s OK to ask for several pots of products that you need to use in different places, for example a wash-cream for both home and work.
After hearing your story, and asking you questions, the GP should examine all the areas of the body that are affected. Do tell the GP if your skin problem affects ‘embarrassing’ areas, such as in the genital area or near the back passage. You can say if you’d rather not be examined, but it helps the GP to do so. Delicate areas of the body often need milder treatments than tougher areas of the body such as arms and legs.
Your GP may suggest treatment that involves several different creams and/or ointments. Make sure you’re clear about the order in which to apply them, and to which areas of the body. It’s OK to write this down while you’re with the GP, but better still if the GP gives you a written plan. Ask how soon you should expect an improvement, and when you should see the GP again for a review. Book that appointment before you leave the surgery, with the same GP if possible, if you found them helpful.
My final advice is to request to be referred to a specialist clinic if you still don’t feel able to manage your skin problem as well as you would like. If necessary, a new referral to a new clinic, if a previous referral didn’t help. And when you find the GP and/or specialist who helps put you back in control of your skin, tell them, as you’ll make their day too!