The British Skin Foundation sat down with Advanced Nurse Practitioner (Dermatology) to learn more about when a person would be seen by a Nurse Practitioner, treatment plans and resources for extra help.

Emmanuel Toni, Advanced Nurse Practitioner Dermatology 

What does a dermatological nurse do, how do you become one, and what does it allow you to do?

A dermatology nurse refers to a qualified nurse who works in dermatology. You need to have a degree in Nursing. To practice at a more advanced level you often need a master’s degree and to be able to prescribe which requires a lot of hard work and exams. 

There are lots of different parts to a dermatology nurses’ job such as some work in skin cancer clinics helping look at moles with specialist equipment like a dermatoscope, helping to complete or independently completing biopsies while some might help with phototherapy (a special sunbed used to treat some skin conditions). Some might help with drug monitoring for certain conditions. Often, we are the main point of contact for patients and help educate and treat patients. 

Do you have any particular areas of interest? 

My area of interest is medical dermatology which includes skin conditions like eczema, psoriasis, and acne. 

When would a person experiencing a skin issue be referred to you?

As I work inside a hospital, often the patients that are referred to see us are patients whose topicals (that is creams) might not have worked and so they might require further treatment and specialist input. 

What is the general format of a consultation with a dermatological nurse?  

It often depends on the level and centre you are being seen in and the purpose of the consultation. Often, we take a history and a holistic assessment of your overall health so we can sign post you to resources that might be helpful.

Do the patients you see tend to struggle with their mental health as a result of their skin condition? 

Absolutely. Skin conditions are incredibly challenging to live with and can be very traumatic.  It is widely accepted throughout dermatology that many skin conditions have a negative impact on mental health.

Are your patients open about the mental and emotional impact their condition has upon them? 

Unfortunately, despite a huge push on social media, there is still a lot of fear and stigma around mental health that prevents some people from opening up about their mental health. We try and challenge people to be open with us however, sometimes it can take time to build this trust but when you do, we will always help you as best we can. 

Do you have any tips to help people get the most out of their appointment with a dermatological nurse? 

Do not be afraid to ask questions. Be open and honest. If you find that you don't put on your creams as they feel uncomfortable, please tell us. We often have lots of alternative options and advice that could help make it much easier for you. 

Will all the patients you see be given the same treatment plan?

No. Each treatment plan will be tailored to the patient based on their skin, the condition, their preference and supply. 

Do you have any advice for people whose skin is affecting their mental wellbeing? 

You are absolutely not alone. The majority of people will be affected by a skin condition at some point in their life. If your mental well-being is declining, contact your dermatology centre or your GP. Your GP might refer you to a dermatology centre if your skin condition is having a significant impact your mental wellbeing. Finally, find a support group of people in a similar situation. 

How distressing are skin conditions for the patients you see? 

Having a skin condition can be incredibly traumatic. In hospital we tend to see the very severe cases where creams have not worked and understandably, this causes a lot of distress which is why we screen for anxiety and depression at every appointment.  

Where can patients go to get extra help?

There are lots of resources available to anybody who needs extra help in the community. Talking Therapies in the community are available for self-referral. Your GP should be able to sign post some local resources. Alternatively, your local dermatology clinic might be able to sign post you to charities such as the British Skin Foundation, Psoriasis Association, Changing Faces, Alopecia UK, National Eczema Society. All of which have fantastic advice and guidance on their websites. 

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