Author: Dr Monika Saha: Skin Deep in COVID19

Dr Monika Saha - consultant dermatologist and amateur food critic

As Covid 19 swept onto British shores and invaded the NHS in tsunami style, we all got ready, we acted on our clinical instincts and the united force of the NHS kicked in. As a consultant dermatologist, 20 years out of acute medicine, it was time to dig out the stethoscope, bone up on ecgs and get ready for the wards, albeit it a little nervously. We wanted to do our bit and support our frontline friends and colleagues. I saw my anaesthetist buddies in blues take the pressure on long shifts and march in day in day out, night in night out, exhausted mentally and physically. Lots of WhatsApp jokes were going around saying ‘don’t worry the dermatologists, the radiologists, the geneticists are coming’…..slightly tongue in cheek, made us laugh. Medic humour is as black as it gets. Many of my dermatologist friends were called on to be second consultant on call (luckily partnered with a real medic), or as junior doctors on elderly care wards (time for reverse mentoring), or for breaking bad news, or basically an extra pair of sensible hands. I did giggle picturing my dermatologist friend running a ward round with a mask, clinically concurring with everything the FY1 said and trying to ask the right questions; ‘ have they passed flatus?’ ‘ are they off legs?’ ‘is that skin rash covid perniosis?’. Under our dermatology armour there is a type A medic lying beneath honestly.

The skin wellbeing clinic for staff was one way we could help our colleagues. They came in exhausted with dry cracked hands and war wounds from PPE, seeking solace in emollients and a quiet dermatology clinic room. The stories I heard brought me to tears and fury behind my mask. I had the mask on for 2 hours, but to wear these masks for 12 hour shifts is unbearable, suffocating and sweaty. A huge shout out to the ITU nurses. I think restoring a person’s skin and taking that pain away helped take the edge off a little. They left a little lighter mentally and heavier with free creams.

There are so many creams out there but for you medics, I would advise non-perfumed creams if you like a lighter option but apply frequently or ointments for pure grease. Do carry a tube in your blues and reapply every few hours, your skin needs hydration all day. A little tip at night is to go for a greasy ointment, hydromol ointment or similar and get some cotton gloves or cover with cling film and let it soak in for intensive hydration. And, of course, our favourite weapon of choice: ‘steroid cream’, if you have active dermatitis, you can buy Hydrocortisone or Eumovate cream OTC, but often hand dermatitis needs something stronger that needs prescribing by your friendly dermatologist or GP. Try find a little time in the evening to look after your skin and let those cracks heal, whilst watching ‘Killing Eve’ or ‘Homeland’. Netflix and a good curry have the power to heal.

In a global crisis the power of collaboration should not be underestimated. These are gamechangers which may change the way we do medicine forever. Mercedes F1 and UCL and the production of CPAP devices in record time, Burberry and the production of NHS gowns, AI technology and medicine to help decipher the right drugs and vaccines against Covid19 and in Dermatology, the cosmeceutical industry and production of hand sanitisers and emollients for NHS staff. I have been amazed by the pace, the ingenuity and the results of these partnerships. I am a big believer that medicine needs to learn and strengthen from other industries.

Covid19 may have broken our world for now but it has also exposed our strengths, our unity, our humour and the unfailing power of the NHS.