OTC Update Summer 2025 by GreenX Publishing

Dealing

SKIN CARE

Protecting

A wild catch

Good for your heart1, brain2 and vision2

Natural fish oil in the form of free fatty acids which the body can easily absorb and use. In BioActive Omega-3 , the omega-3 is combined with vitamin B12 and folic acid to support your energy levels3 and immune3 system. The pure fish oil comes from free range fish that are caught in deep seas.

Each capsule contains 500 mg of fish oil with 65% omega-3 fatty acids. The small capsules are easy to swallow.

1. DHA/EPA contribute to the function of the heart. 2. DHA contributes to the maintenance of normal vision and normal brain function. 3. Folic acid (vitamin B9) and vitamin B12 contribute to the reduction of fatigue and tiredness and to the normal function of the immune system. * The beneficial effect is obtained with a daily intake of 250 mg EPA and DHA ** The beneficial effect is obtained with a daily intake of 250 mg DHA

GETTING SET FOR SUMMER

Welcome to your summer issue of OTC , which we have packed full of articles of practical interest.

In this issue, pharmacy counter assistant Michelle Lyons beautifully describes how at the counter, you build relationships with customers, get to know their personal stories, and take a few steps with them along their journey to wellness.

Pharmacists are among the most trusted healthcare professionals. This is consistently shown in public surveys — last year’s poll showed a 96 per cent public trust in pharmacists, 1 per cent behind nurses, and 1 per cent ahead of doctors.

This deep trust in pharmacists is, by extension, a vote of trust in pharmacy counter staff. As Michelle points out in her article, it takes time to build a sense of trust with customers, but they do rely on you for advice, guidance, product recommendations, and even occasionally a bit of simple human contact.

Michelle also notes that to do our best for customers, we

need to be as up-to-date as possible on the best products and advice for common injuries, cuts, sprains, and all those other everyday presentations at the counter.

With that in mind, this issue contains articles on Infant Health, Dental Care, Irritable Bowel Syndrome, Bone Health, and Sports Injuries.

Regarding the latter, as the warmer weather takes hold this summer, you will have plenty of opportunity to dispense advice and recommendations to the countless customers who limp in with muscle strains and general aches and pains.

Assuming the good weather continues — a dangerous assumption, I know — there is also a feature on preventing skin cancer that will be useful to you. Prevention is always better than cure, as we know.

Also, don’t forget to try our Crossword Quiz at the back of the magazine and be in with a chance to win €50.

All-in-all, a packed issue that we hope you will find interesting and informative.

pat@greenx.ie

National and international news in healthcare and research

08: FEATURE

Working at the pharmacy counter opens up windows into customers’ lives

10: BONE HEALTH

The need for good bone health at all stages of life and the importance of vitamin D

14: DENTAL CARE

Common dental problems can cause bigger issues if they are not addressed

19: SPOR TS INJURIES

Exercise is important, but brings with it some strains and sprains

24: IBS

Symptoms, treatment and management of IBS

27: INFANT CARE

Giving the little ones the best start in life

32:

SKIN C ANCER

An overview of this devastating disease

36: PRODUCT NEW S

Product and industry healthcare news

40: QUIZ

Test your knowledge and win €50

41: CROSSWORD

Exercise your ‘brain muscles’ with our fun crossword

EDITOR

Pat Kelly

pat@greenx.ie

SUB - EDITOR

Elaine Walsh

elaine@greenx.ie

MANAGING DIRECTOR

Graham Cooke

graham@greenx.ie

CREATIVE DIRECTOR

Laura Kenny

laura@greenx.ie

ADMIN

Daiva Maciunaite

daiva@greenx.ie

Top Floor, Ebony House, Main Street, Wicklow Town Wicklow

OTC UPDATE is produced by GreenCross Publishing Ltd. as a supplement to Irish Pharmacist

GreenCross Publishing was established in 2007.

The contents of OTC UPDATE are protected by copyright. No part of this publication may be reproduced, stored in a retrieval system, or transmitted in any form by any means – electronic, mechanical or photocopy recording or otherwise –whole or in part, in any form whatsoever for advertising or promotional purposes without the prior written permission of the editor or publishers.

Front cover design: Laura Kenny. Additional imagery: iStock.com

DISCLAIMER

The views expressed in OTC UPDATE are not necessarily those of the publishers, editor or editorial advisory board. While the publishers, editor and editorial advisory board have taken every care with regard to accuracy of editorial and advertisement contributions, they cannot be held responsible for any errors or omissions contained.

BLOOD PRESSURE: PUBLIC URGED TO CHECK ‘SILENT KILLER’

The public have been urged to have the ‘silent killer’ of blood pressure checked, following worrying results from a recent survey.

The legendary GAA commentator Marty Morrissey lost his father and grandfather to heart attacks and said their deaths fuelled his acute awareness of cardiac health, as he backed the Irish Heart Foundation’s ‘Before Damage is Done’ campaign.

“Sometimes we’re a bit careless about it, ‘ah, we’ll be grand’,” said the RTÉ Gaelic Games correspondent from Quilty, Co Clare.

“But we do need to be far more aware of our own health. You are the best judge of anything that is wrong with you, so don’t dismiss it — because your body is telling you something, and sometimes we ignore it or don’t want to know about it.

“In the GAA world, we have black cards, red cards and yellow cards. If you get the yellow card, you take the warning.

“When you get your blood pressure checked, and it’s high, that’s your chance to take the warning and do something about it. Sometimes people don’t get any warning.

“Once you’re over 50 you need to be getting everything checked.”

Mr Morrissey, whose dad Martin died of a sudden heart attack in 2004, was speaking as new research by the national stroke and heart charity showed a drop in understanding of the risk of stroke and heart disease from untreated high blood pressure.

A recent online survey of 1,000 people, by Core Research, reveals just 49 per cent had their blood pressure checked in the last six months, compared to 57 per cent in November 2023.

Only 67 per cent believe untreated blood pressure creates a high risk of stroke (down from 78 per cent in 2023), while 64 per cent believe there is a high risk of heart disease (down from 72 per cent in 2023).

In addition, the data shows public knowledge has fallen in relation to how

untreated blood pressure can lead to dementia or kidney disease, as well as damaging the heart and other organs.

Worryingly, 29 per cent of people believe the signs of high blood pressure are obvious, yet it is a silent killer.

Blood pressure checks are a vital tool in measuring how effectively the heart pumps blood around the body.

“The research shows an unfortunate fall off in the level of understanding of the serious consequences of hypertension or high blood pressure,” said Janis Morrissey, Director of Health Promotion, Information and Training with the Irish Heart Foundation.

“High blood pressure is among the leading risk factors for heart disease or stroke and premature death worldwide. For most people, it is symptomless, yet there may still be a misconception that symptoms are necessary to indicate it.

“That’s why it is vital to get your blood pressure checked at your GP or local pharmacy, before damage is done.

“A quarter of people having strokes are under age 65 and are still of working age, so it can have devastating consequences not only for someone’s health, but also on their quality of life and financial independence if they are forced to stop working.”

Dr David McConaghy, ICGP/HSE Integrated Care Lead for Prevention, said: “The Irish College of General Practitioners supports this campaign to raise awareness about blood pressure and encourages people to attend their GP practice for a cardiovascular review.”

Susan O’Dwyer, Head of Governance and Pharmacy Services with the Irish Pharmacy Union, said: “We support this important campaign to encourage people to get their blood pressure checked with the aim of detecting high blood pressure before damage is done. Pharmacies nationwide offer blood pressure testing and many also offer 24-hour blood pressure monitoring. Speak to your local pharmacist to learn more.”

For more information, visit irishheart.ie.

NEW RESEARCH REVEALS THAT FEAR OF WORSENING ASTHMA SYMPTOMS IS STOPPING NEARLY HALF OF PEOPLE WITH ASTHMA FROM GETTING ACTIVE

The Asthma Society of Ireland is calling on people across the country to reclaim their health and confidence through movement, as part of its 2025 Asthma Awareness Week campaign, Active for Asthma. Launching new survey data and a panel of expert voices, the Asthma Society is encouraging people with asthma to reach out for personalised, expert advice — and get active safely.

“Asthma can be unpredictable and, at times, frightening — we hear that all the time from the people who contact us,” said Eilís Ní Chaithnía, CEO of the Asthma Society of Ireland. “But with the right support, asthma doesn’t have to control your life. Our Active for Asthma campaign is here to shift the narrative — to show that exercise isn’t off-limits. In fact, it can be part of the solution. We want people to feel confident, informed, and supported to move their bodies safely — to embrace the benefits of physical activity.”

New findings from a survey conducted among 500 people with asthma in April 2025 show the scale of the issue:

 43% of people living with asthma say fear of triggering symptoms is a significant barrier to exercise.

 41% said they’ve reduced physical activity over time due to their asthma.

 20% frequently stop exercising due to symptoms.

 8% have stopped exercising altogether because of their asthma.

“These figures are worrying but not surprising,” Ní Chaithnía continued. “For too long, there has been a misconception that asthma and physical activity don’t mix. And if you’ve ever been left gasping for breath — or even hospitalised — from exercise, it’s only natural to fear doing it again. But the evidence is clear: Regular movement, done safely, strengthens your lungs, reduces inflammation, and can

alleviate the mental toll of having a chronic disease.

“That’s why we’ve introduced a new, free service on our Adviceline, connecting people with a Senior Physiotherapist who can provide personalised guidance on staying active with asthma. We’re here to support every step of the way.”

Supporting the campaign is Olympian and asthma ambassador Derval O’Rourke, who has lived with asthma throughout her sporting career.

“I know what it’s like to second-guess yourself before training,” O’Rourke said. “But I also know that staying active has helped me manage my asthma, not worsen it. This campaign is about empowering people — whether you’re walking around the block or aiming for a marathon, the support is there.”

Everyone who signs up for Active for Asthma receives a free 30-minute consultation with a physiotherapist and access to practical resources, including:

 Safe, personalised exercise plans.

 Breathing techniques to manage symptoms and anxiety.

 Medication advice for active lifestyles.

 Guidance for returning to activity after a flare-up.

“Asthma is one of the most common

chronic conditions in Ireland, yet it’s often misunderstood,” said Professor Patrick Mitchell, Respiratory Consultant at Tallaght University Hospital and Trinity College Dublin.

“People with asthma should be able to participate fully in exercise — even competitive sport — with proper management. If symptoms appear during or after exercise, it may be a sign that the asthma is not well controlled, not that activity should be avoided.

“We know that regular activity, done safely, can actually reduce symptoms and improve lung function. That’s why the right education, support and treatment are so important.”

Ireland has one of the highest asthma rates in the world, affecting one-in-10 people — around 450,000 individuals — with a lifetime prevalence of one-infive. Yet too many remain unsure where to turn for guidance.

“Knowledge changes lives,” said Ní Chaithnía. “One call to our Adviceline can help someone go from fearing a walk, to training for a race. We’ve seen it time and again. That’s why we’re asking people to pick up the phone, take the first step, and use this campaign as a turning point.”

The Asthma Society is also urging people to take on a physical fundraising challenge in 2025 to support vital services and raise awareness.

“My wife and children have asthma, so I’ve seen first-hand how important support like this is,” said Aodhan Boyle, who is running both the Berlin and Dublin Marathons in the space of five weeks this September and October to raise funds. “This campaign is not just about getting active — it’s about giving back so others can breathe easier too.”

To sign up, donate or get involved, visit www.asthma.ie.

Image: iStock.com/ RgStudio

LINKS BETWEEN SPORT- RELATED BRAIN INJURY AND DEMENTIA EXAMINED IN NEW STUDY

Retired high-performance contact sports athletes are being asked to participate in a ground-breaking research study investigating the links between sport-related brain injury and dementia risk in later life.

The RESOLVE study, led by researchers in Trinity College Dublin, will also explore how to reduce dementia risk through lifestyle changes, such as managing blood pressure and implementing exercise programmes.

The research team is looking to recruit 360 contact-sports athletes from the disciplines of rugby, soccer and Gaelic games, who are retired from high level competition and aged between 40-to-59.

It is the first time this type of research has been conducted at such a large scale in Ireland, and it will also be one of the largest international longitudinal studies of the brain health of mid-life contactsports athletes.

“Scientists already know that experiencing a sport-related brain injury (TBI) during your lifetime increases the risk of dementia in later life by around 3-to-15 per cent. However, we don’t fully understand how sport-related TBI impacts cognition and brain health in mid-life, prior to the development of dementia symptoms,” explained Principal Investigator of the study Lorina Naci, Professor, School of Psychology, and the Global Brain Health Institute.

The research team will undertake detailed clinical, cognitive, physical and lifestyle assessments of the participants at the initial visit, and again after two years. The results will be compared to those of 700 control individuals. This will identify who is at greatest risk of TBI-related dementia, and how to intervene early to reduce dementia risk in athletes and the wider population.

“We aim to find new ways to measure TBI-related dementia risk, and to identify changes in lifestyle that could reduce this risk in contact sports athletes and

the wider population, some 20-30 years before symptoms, such as memory loss and confusion, develop,” Fiona Wilson, Professor in Physiotherapy, School of Medicine, and Co-Principal Investigator on the study, added.

Player and welfare representatives from several sporting bodies, including Rugby Players Ireland, Football Association of Ireland, Professional Footballers Association of Ireland, Ladies Gaelic Football Association and Gaelic Athletic Association, are collaborating with the research team on the recruitment of participants for the study.

Luke Keaney, former Donegal Football Player and member of the Gaelic Players Association, commented: “I’m honoured to be part of the retired athlete brain-health programme. As a retired athlete, I hope my

experiences will contribute to the learnings of the programme and lead to positive change. My aim is to improve the overall wellbeing of retired athletes worldwide, through acting as the athletes’ voice.”

The RESOLVE study, ‘Dementia Risk in formEr profesSiOnal athLetes and protectiVE’ factors in mid-life’, is funded by a recent €1.3 million Frontiers for the Future Programme Award from Taighde Éireann – Research Ireland to Professor Lorina Naci, from the School of Psychology, and Professor Fiona Wilson, from the School of Medicine, Trinity College Dublin.

To find out more about the study and how to sign up as a participant, please see the RESOLVE website here: www.theresolvestudy.org

Email: Preventdementia@tcd.ie.

FOUR - IN - FIVE WOMEN EXPERIENCE ‘BABY BLUES’

To mark Maternal Mental Health Awareness Week last month, mental health charity Turn2Me called on families across Ireland to be vigilant and compassionate when supporting new mothers. According to the HSE, four-in-five women experience some form of ‘baby blues’ after childbirth — but around one-in-seven women go on to develop postnatal depression, a more serious and long-lasting condition.

The first few weeks and months after giving birth can be an overwhelming emotional rollercoaster. Hormonal changes, sleep deprivation, and the huge responsibility of caring for a newborn can impact mental health in profound ways.

“Too often, postnatal depression is misunderstood or dismissed,” said Fiona O’Malley, CEO of Turn2Me. “The ‘baby blues’ is more common than not in new mothers and postnatal depression can linger

and worsen if not addressed. Knowing the signs and how to support a loved one is vital.”

7 COMMON SIGNS OF POSTNATAL DEPRESSION:

1. Persistent feelings of sadness or hopelessness.

2. Apathy: Lack of interest or joy in activities once enjoyed.

3. Excessive guilt or feeling like a ‘bad mother’.

4. Difficulty bonding with the baby.

5. Changes in appetite or sleep (beyond typical exhaustion).

6. Irritability, anger, or anxiety.

7. Thoughts of self-harm or harming the baby (which requires immediate help).

THREE WAYS TO SUPPORT A LOVED ONE WITH THE ‘BABY BLUES’:

1. Listen without judgement.

Allow her to express her feelings openly. Don’t try to ‘fix’ things — just be present

and supportive.

2. Offer practical help.

From cooking meals to watching the baby so she can sleep, small acts of kindness make a big impact.

3. Encourage professional support.

Gently suggest talking to a GP or using services like Turn2Me if her symptoms persist beyond a week.

Turn2Me is encouraging new mothers and their families to prioritise mental health. The charity offers up to six free professional counselling sessions to anyone over 18 living in Ireland.

Sessions are available online through Turn2Me.ie and are fully confidential.

“Support, empathy and timely intervention can make all the difference. No one should suffer in silence.” O’Malley added.

LET’S BE REAL

TAKE THE TALKING STICK WHILE GETTING YOUR SCRIPT

BEING IN THE PHARMACY MEANS BEING PART OF A REAL COMMUNITY, WRITES MICHELLE LYONS

Aquiet day, with not much to do — these are the best kind of days, when we can get to know our patients. It usually starts off small, with a curious look of ‘who is this new person giving me my medication?’ The acknowledging grin, the polite

‘hello’, and the courteous ‘goodbye’. Conversations start short and small. Over time, as the weeks progress, those short hellos and quick goodbyes become countless words and deep-dive chats. Slowly, it flows to why they are there, what is in the bag, and how much they fear what is in the bag. We open up about

our day, what’s in our heart, and how we play. Friendships blossom, and those monthly scripts turn into daily trips.

SOCIAL OUTLET

Truth be known, the pharmacy is the social outlet for many older folks. They don’t really need anything, they really

just need someone to chat to. I suppose as we grow older, our social networks decline. The people we once went to bingo with, had tea with and watched the footie with, have all dwindled.

Most of their outings have been planned around collecting their pension, doing their food shop, or even something as simple as collecting their monthly tablets. The need for human interaction is what brings the most vulnerable people out of their homes and into the pharmacy each week.

These little visits mean so much, for both ourselves and our patients. The lessons in history for us, and the trips down memory lane for them. Not only do we learn about their lives and their families, we hear about their ailments.

barred’ kind of chats. We admit what we know, and what we don’t know. We help the patients who don’t know how to use electronic mail, help them set up an account and teach them, so that they can mail for their future scripts. They help us to avoid starving, dropping in the biccies and the cakes for the tea later! A little appreciative gesture.

With the blossoming friendship comes the questions about how to treat their insecurities, the pride we hold on to that we’re not ready to let go of yet. ‘Which product can I use to stop the hair falling out?’ ‘What colour is the best to hide these roots?’

These questions create a deeper bond between each of us, but also put the fear of God in us — that, heaven

THE LESSONS IN HISTORY FOR US, AND THE TRIPS DOWN MEMORY LANE FOR THEM

We learn about their symptoms, their reasons for their visit to the doctor (eventually). We learn about the diagnosis and the treatments they’re undertaking. Work becomes school again, always learning something new, either about people or medicine. Most important lessons we’re learning are that the human spirit is resilient, and it costs nothing to be kind.

COMFORTING WORDS

As we get closer, we recognise each other’s ways — when there’s a little less pep in the step, the downward smile, when the day isn’t going so well. We’re there with the comforting words from a friend, lifting each other up, putting the smile back on our faces and hope back in our hearts.

We have all the chats, the ‘no-holds-

forbid — we recommend something that doesn’t work! Could you imagine: One wrong recommendation could ruin months of friendly testing to see if we know and trust each other or not!

That’s why we need to be schooled on all products that come into our store, making sure we know what suits each specific person, especially now that summer is coming. More sun means more skin to protect!

SUNSHINE AND POLLEN

Getting the legs out means getting the tan out for most of us ladies. We need to know that we need we have our skin care in the same bottle as the tan, so that would be reaching for the St Tropez to keep us hydrated and silky smooth, as well as lookinglike a golden goddess! Keeping the sun cream out of the

eyes of the keen golfer, runner, cyclist, all the outdoor enthusiasts, is just as important, so we’re handing the La Roche Posay Anthelios skin fluid out with confidence, knowing we’ve done the très important research.

Once we have everyone on the outside protected from the sun, looking their best, we have to try fight against the pollen — the arch nemesis of most of the population, from babies to the elderly. We need to use every strategy we’ve learned to protect ourselves, from antihistamines, nasal sprays, eye drops, barrier balms, to hoovering the house at night after we’ve closed our windows.

The holiday-goers asking for what they need, the go-to’s to be holidayready, their survival kits! Rehydration tablets, travel sickness, anti-sickness, and don’t forget the diarrhoea tablets — no-one wants to get caught out with a dodgy tummy.

COMMUNITY

Telling us all the stories of where they are going, to the reasons why they chose the place, and the excitement of it all. Going to see members of their family they haven’t seen in so long — it feels like we’re going along with them. And when they return, showing us picture after picture of their adventures, putting faces to the names we’ve heard about for so long.

We find ourselves dancing at their weddings, sharing the celebrations of their children’s christening, or giving condolences to their family members.

“Community: A group of people living in the same pace or having a particular characteristic in common.”

That’s the word they chose to describe pharmacies in our areas. Community pharmacies — and there’s no better description, because that’s what we become — a little community, supporting each other, caring for one another in all aspects of our lives.

Customers becoming friends, friends that become family. ●

BONE HEALTH AND VITAMIN D

MAINTAINING BONE HEALTH AND ADEQUATE VITAMIN D LEVELS ARE ALMOST SYNONYMOUS. BOTH ARE INTERCONNECTED AND INCREDIBLY IMPORTANT TO A PERSON’S MENTAL AND PHYSICAL HEALTH

damage such as a broken hip or shoulder. A lack of vitamin D can have

consequences for skeletal integrity at any stage of life, it can also have a negative impact on bone development and growth in key life stages, such as childhood and

increase the risk of breaking a bone from a fall later in life. Fatigue has also been associated with a deficiency in vitamin D.

To keep their bones healthy, a person needs sufficient calcium, as well as a plethora of other vitamins. They also need vitamin D to help their body absorb the calcium. Protein is also very important in maintaining muscle, which is an intrinsic part of bone health.

Bone is a major store of calcium and phosphate, and every cell in the body including those in the heart, nerves, and muscles requires calcium. Vitamin D also helps to regulate cell growth and the immune system, and it is essential for the absorption of calcium, increasing the body’s ability to absorb the mineral by 30-80 per cent.

There are a number of conditions that affect bone development in children, rickets being the best-known. It causes bone pain, poor growth and soft, weak bones that can lead to bone deformities. While the condition was common in the past, it almost disappeared in the West due to better nutrition. However, in recent years, in Ireland there has been

In Ireland, it is estimated that 300,000 people suffer from osteoporosis and that one-in-four men and one-in-two women over 50 will develop a fracture due to the condition during their life. Women lose bone density rapidly in the first few years after menopause and are more at risk of osteoporosis than men, particularly if they start menopause before the age of 45 or if they have had their ovaries removed. It is estimated that, on average, women lose up to 10 per cent of their bone mass in the first five years after menopause. Osteoporosis can also affect men, younger women, and children. Many other factors can also increase the risk of developing osteoporosis, such as taking high-dose steroid tablets for more

THERE ARE A NUMBER OF CONDITIONS THAT AFFECT BONE DEVELOPMENT IN CHILDREN, RICKETS BEING THE BEST- KNOWN

an increase in the number of cases of rickets. The HSE also notes that studies have shown that adults in Ireland have low levels of vitamin D, with an Irish study also identifying an association between lower levels of vitamin D and inflammation in older adults.

Another well-known bone condition is osteoporosis, which weakens bones, making them fragile and more likely to break. Calcium and vitamin D are an essential part of the prevention and treatment of osteoporosis, particularly in housebound people and elderly people in nursing homes. The most common injuries in people with osteoporosis are a broken wrist and hip fracture. However, breaks can also happen in other bones, such as in the arm or pelvis. Sometimes even a cough or sneeze can cause a broken rib or the partial collapse of one of the bones of the spine.

than three months; heavy drinking and smoking; having a low BMI; and not exercising regularly.

VITAMIN D AND CALCIUM

We all pray for glorious sunshine, and with good reason. As well as putting most people in good form, we also get vitamin D from sunshine, as it is formed in the body in response to sun exposure. Unfortunately, getting outdoors in Ireland can be easier said than done. With Ireland’s northern latitude, and, at times, unappealing weather, getting enough vitamin D through sunlight alone can be a challenge for people of all ages. As the HSE states, between October and early March sunlight is not strong enough to make vitamin D, but it can be found in a number of foods. However, the Irish Osteoporosis Society warns in Ireland 74 per cent of adults, and 88 per cent

of primary school children, get less than half of the recommended daily amount of vitamin D.

There is a range of foods with high levels of vitamin D, such as oily fish, red meat, liver, egg yolks, and some breakfast cereals. Calcium is also essential, as well as a plethora of other vitamins, to keep bones healthy. Sources of calcium in food include milk, cheese, and other dairy foods. Protein is also very important in maintaining muscle, an intrinsic part of bone health.

There are also many over-the-counter vitamin supplements available from respected brands to help meet daily requirements. These include Centrum Advance Multivitamins & Minerals

Centrum Advance is a daily multivitamin supplement packed with essential nutrients such as vitamin D and zinc to help support a person’s nutritional needs. A complete daily multivitamin formulated with individual vitamins and minerals, including all essential vitamins, it helps to support daily energy release and normal immune function, and also assist in the body’s metabolism of macronutrients. It is also high in vitamin D.

Another one of the Centrum products is Centrum MultiGummies Energy Release. It comes as a delicious gummy, specifically formulated with vitamin B6 to help reduce tiredness and fatigue, and is sure to be popular with kids.

For men and women, there are also specifically designed products. Since men have higher requirements for some nutrients compared to women, the nutrient levels have been adjusted in Centrum Men to help support their health and wellbeing. Centrum Men contains vitamins B6 and B12, which support normal energy yielding metabolism, while magnesium contributes to maintaining normal muscle function.

Centrum Women contains key vitamins and minerals to help support the specific nutritional needs of adult women. It contains calcium, which

supports the maintenance of normal bones as well as iron and folic acid, which contribute to normal blood formation. Vitamins B6 and B12 help reduce fatigue.

There is also Centrum Advance 50+. It is a high-quality micronutrient supplement made for men and women over the age of 50, specifically developed to help meet the changing needs that come with age.

Pharmaton is another trusted brand. It has numerous products, including Pharmaton Advance Fizz Multipack, high in vitamins A, C, and D, which all help to support the immune system.

Pharmaton Vitality 11 capsules

bones. Another product is Pharmaton Immuno10, which is high in vitamin B-complex with added vitamin D. Another well-known brand, Seven Seas, has a range of supplements to promote bone and joint care. This range supports an active lifestyle focusing on the health of a person’s bones, cartilage, muscles, and connective tissue. All these products start with omega-3 and glucosamine plus the addition of chondroitin, calcium, and turmeric. One of these is Seven Seas JointCare Supplex & Turmeric, which has been specifically formulated to support an active lifestyle. It supports cartilage, bones, muscles, and connective tissue.

muscles. The advanced levels of vitamin D3 in Caltrate help maximise calcium absorption and maintain healthy bones. Another product is Solgar Vitamin D3 tablets. This supplement may be beneficial for those at risk of vitamin D deficiency, including people aged 65 and over or those who are not able to spend time outdoors.

Sona , another trusted brand, also provides supplements including Sona D 1000. This provides vitamin D3, which is important for the maintenance of normal bones and teeth, cell division, and normal muscle function.

VITAMIN

D3 IS IMPORTANT FOR THE MAINTENANCE OF NORMAL BONES AND TEETH, CELL DIVISION, AND NORMAL MUSCLE FUNCTION

are also available. These are a multivitamin, mineral, and ginseng supplement. Each capsule contains standardised ginseng extract G115 with vitamins A, B group, C, D, E, nicotinamide, folic acid, biotin, and minerals iron, calcium, copper, magnesium, zinc, and selenium.

Pharmaton Vitality 11 helps relieve daily fatigue associated with a busy, hectic lifestyle, and ill-balanced or deficient nutrition. It contains ginseng G115, which works by enhancing mental and physical performance. Pharmaton capsules are suitable for adult men and women but not for children.

Meanwhile Pharmaton Kiddi is suitable for children aged three and older. It contains a unique blend of vitamins and minerals with added L-lysine, it is specifically designed to support stronger immunity and stronger

One of the most famous supplements is Seven Seas Cod Liver Oil . It is rich in omega-3 fatty acids and is also a reliable source of important nutrients, including vitamins A and D.

As regards effervescent tablets, there is Berocca Immuno Effervescent Tablets. These are packed with 11 vitamins and minerals, including high-strength vitamin C, vitamin D, vitamin A, vitamin B9, zinc, copper, iron, and selenium, which help support the immune system. Each tablet also contains vitamins B6 and B12 to help support energy release and reduce tiredness and fatigue, as well as vitamin E, an antioxidant, to help protect cells from oxidative stress.

Caltrate 600+D3 tablets provide a high level of vitamin D3 to help maximise calcium absorption and support healthy bones, joints, and

Vitabiotics Osteocare is scientifically developed to complement a person’s dietary intake at any age. Based on the latest research, it is developed with an optimum level of vitamin D3. It provides 100 per cent of a person’s calcium, zinc, and copper requirements. It also contains calcium and magnesium, Vitabiotics Wellbaby Vitamin D Drops have been carefully developed for infants aged four months to five years.

Nutri Advanced Vitamin D3 supports a healthy immune system as well as healthy bones, muscles, and teeth. It is designed to offer an easy way to supplement with vitamin D.

Revive is another trusted range. Revive Active is a super supplement with 26 active ingredients, including 11 vitamins, seven minerals, and six amino acids all in one sachet. Taken once a day, its ingredients include vitamins B6, B12, C, and D, minerals copper, zinc, and selenium as well as amino acids such as L-arginine, laurine, citrulline, and 150 mg of CoEnzyme Q10. These ingredients are scientifically selected to support adults from 35 years of age. It reduces fatigue and supports the immune and nervous systems.

Probiotics are also available. One of these is BioGaia Protectis Baby Drops with vitamin D. As well as supporting a baby’s gut health from the very first days of life, it also supports a baby’s immune system and is the most researched probiotic for infant colic. ●

DENTAL CARE AT THE COUNTER

COMMON DENTAL HEALTH PROBLEMS CAN CAUSE BIGGER ISSUES UNLESS THEY ARE TREAT QUICKLY AND EFFECTIVELY

Dental health is something that can be taken for granted, but its importance cannot be overstated. Eating sugary treats and skipping brushing teeth can all take a toll on our teeth, until suddenly, we get the exquisite agony of a toothache.

Poor dental health can seriously impact a person’s general health, and among common oral health problems are bad breath, gum disease and cavities, to name just a few. Worryingly, oral diseases also share common risk factors with chronic diseases such as heart disease, obesity, and diabetes. The role of the community pharmacy in promoting and maintaining dental health is increasingly important.

One of the most common dental problems is gum disease. It is a consequence of a build-up of plaque on the teeth and around the gums. Plaque is a sticky substance that contains bacteria that can be harmful for gums. It is estimated that around 80 per cent of Irish people have some form of gum disease. Fortunately, it is treatable, and the earlier it is treated, the more effective the treatment is.

It can be caused by many factors, but poor oral hygiene is the most common cause of the build-up of plaque. Smoking, age, and diabetes can also increase the risk.

GUM DISEASE

The initial symptoms of gum disease can include red and swollen gums and bleeding gums after brushing or flossing teeth. This stage of gum disease is called gingivitis, which if left untreated can develop into periodontitis, which can, eventually, cause tooth loss. Symptoms of

this can include halitosis, loose teeth, and gum abscesses.

Tooth decay is another problem. Often caused by having too much sugary food and drink and not cleaning teeth and gums, early treatment can help stop it from worsening. It may not cause any symptoms at first, but if it gets worse it can lead to problems, such as a dental cavity. Patients should be advised to see their dentists as quickly as possible if they experience a dental pain.

When we have a toothache, pain relief can be essential. There are a range of

over-the-counter pain relief medications, such as Panadol, and Nurofen, which can be used to ease symptoms. Another one of the best known pain remedies for a sore tooth is clove oil and it has natural analgesic properties which help relieve the pain of toothache. It also has antimicrobial and antifungal properties which make it good to use on acne, warts, scars and parasites. There are a wide variety of clove oil brands in pharmacies. Its popularity is even acknowledged by Colgate, which has a lengthy article about it on its website, where it says that

eugenol, an ingredient within clove oil, provides pain relief. Eugenol is a natural anaesthetic and antibacterial agent, and it works well at reducing inflammation in the mouth. The company cited a 2015 study by the British Association of Oral and Maxillofacial Surgeons which showed that eugenol is much more effective than using another analgesic and doing nothing else. However, Colgate warns that while clove oil reduces the pain and swelling of a toothache, a dentist should be visited as soon as possible.

“Toothaches are usually caused by tooth decay, and the longer you delay before seeing a dentist, the worse the decay can become,” it said.

Advanced White Toothpaste. It promises whiter teeth in 14 days. Its active micro-cleansing crystals are clinically proven to gently polish and effectively whiten teeth and also help prevent new stains from adhering. It also freshens breath, fights cavities, and removes plaque.

There are also Colgate Baby and Kids Toothpastes for younger members of the family, which are perfect to help develop healthy young teeth. Colgate Cavity Protection Toothpaste contains fluoride, which is clinically proven to fight cavities on teeth surfaces and exposed roots. The liquid calcium formula helps to strengthen teeth and repair weak spots before cavities start.

EUGENOL IS A NATURAL ANAESTHETIC AND ANTIBACTERIAL AGENT, AND IT WORKS WELL AT REDUCING INFLAMMATION IN THE MOUTH

The HSE says that the best way to treat gum disease is by developing and maintaining good oral health. This includes brushing teeth with toothpaste, mouthwash, and flossing.

BAD BREATH

Bad breath is also a very common dental problem, which is often caused by a build-up of bacteria in the mouth. Bad breath can be embarrassing and cause awkward situations for people in their professional and personal lives. It can affect a person’s confidence and perhaps even mental health.

Fortunately, there are numerous well known and respected over-the-counter products, from electric toothbrushes to floss, that can help to freshen breath and protect teeth. Some of the best known products come from Colgate. Among its products is Colgate

Aquafresh Extreme Clean contains sugar acid protection from fluoride and germ-killing micro-active bubbles, helping to fight bad breath. Brushing twice a day with Aquafresh Extreme Clean Deep Action Toothpaste helps give every tooth a thorough clean. Containing five times smaller cleaning micro-crystals, Aquafresh’s unique foam gets between the teeth to help clean hardto-reach places that other toothpastes might miss. It provides a superior clean while still protecting tooth enamel. It also leaves the mouth feeling fresh with a minty flavour.

To help brighten teeth, there is also Aquafresh Extreme Clean Whitening Action Toothpaste. As teeth can become stained from exposure to things like coffee and red wine, toothpastes with whitening agents contain particles that polish teeth back to their natural

whiteness. Aquafresh Extreme Clean Pure Breath Action Toothpaste helps to neutralise bad breath for 80 per cent cleaner, purer breath.

Aquafresh Little Teeth toothpaste is specially designed by experts to provide gentle care for a child’s teeth to help ensure their adult teeth come through healthy and strong. Its formulation is highly effective at delivering fluoride to enamel surfaces and helping remineralise early enamel lesions, thereby strengthening little teeth from the inside out.

Another popular brand is Oral B. Included in its range is the Oral-B Pro-Expert Deep Clean Toothpaste

This uses dissolving microparticles active on surface stains for an outstanding deep clean. It delivers a unique cleaning sensation and has up to five times smaller microbeads than regular Oral-B ProExpert toothpaste. It contains stannous fluoride complex, a unique combination of ingredients, which targets and protects against issues such as cavities, plaque, gum problems, sensitivity, stains, bad breath, tartar, and enamel erosion.

There is also Arm and Hammer Advanced White Pro, which promises exceptional deep clean with teeth up to three shades whiter in six weeks with twice daily brushing.

Another tooth whitener is Pearl Drops Luminous Bright White Toothpaste. This promises that teeth will look instantly white after one use and up to two shades whiter after one week.

Another trusted brand is Crest. Crest

Complete is a deep clean paste. It delivers the stain-removing power of Crest with a breath-freshening effervescent mint flavour. It helps fight cavities, prevents tartar, and provides teeth whitening from cleaning action that helps to remove surface stains, all while helping to keep your breath minty fresh and ready for anything.

SENSITIVE TEETH

For sensitive teeth, there is Sensodyne toothpaste, which is recommended by dentists all around the world for both

sensitive teeth and acid wear. Sensodyne provides long-lasting protection for sensitive teeth. One of its products, Sensodyne Pronamel, helps to reharden tooth enamel. Tooth sensitivity is a condition that can develop over time, as a result of common problems such as receding gums and enamel wear. Most sufferers are between 20 and 50 years old. Tooth sensitivity can start to happen when dentine becomes exposed.

Sensodyne Daily Care Original provides daily care for sensitive teeth. With twice-daily brushing, Sensodyne Daily Care Original helps strengthen teeth, fights tooth decay and promotes gum health. Sensodyne Daily Care Original has been specially formulated for people with sensitive teeth. It provides all the benefits of a regular toothpaste.

Sensodyne Daily Care Deep Clean Gel is specially formulated for people with sensitive teeth as well as giving advanced cleaning and lasting freshness with foam burst technology. It provides lasting sensitivity care with twice-daily brushing, helps remove plaque, and provides all the benefits of a regular toothpaste.

The HSE also recommends regularly — preferably daily — flossing before brushing teeth. Flossing removes plaque and food particles in places where a toothbrush cannot easily reach. Colgate recommends using its Total Pro Gum Health Floss. This helps to reduce gum problems and tooth decay by removing plaque from hard-to-reach places. Also, it has been designed to slide easily between teeth. There is also Oral-B Essential Dental Floss. Gentle on fingers and gums, it provides advanced flossing action for a fresh, clean feeling. Its advanced, two-layered design provides superior strength, easy handling, and comfort.

MOUTHWASH

In terms of mouthwashes, there are a wide range of trusted products. Colgate Plax FreshFX delivers a pleasurable cooling sensation that lasts 10 times longer

than brushing alone. Colgate Plax is a clinically proven formula that effectively fights bacteria and provides 24/7 plaque protection, when used twice daily.

Another very popular mouthwash brand is Corsodyl. It is clinically proven to help treat the first stage of gum disease.

CB12 mouthwash with fresh mint flavour is also available. It fights the root cause of bad breath with a scientifically proven formula. There is also CB12 Sensitive, which fights the root cause of bad breath and protects sensitive teeth. It has three benefits in one mouthwash: It fights the root cause of bad breath for 12 hours, helps reduce teeth sensitivity, and

TOOTH SENSITIVITY CAN START TO HAPPEN WHEN DENTINE BECOMES EXPOSED

provides daily teeth strengthening with fluoride. CB12 Sensitive is alcohol-free and has a soft menthol flavour.

CB12 Boost gum is also available. It is a unique formula, sugar-free chewing gum with patented technology and double action. The unique combination of active ingredients protects users while offering instant refreshment with a fresh, minty flavour. During the day, CB12 Boost can be used whenever instant breath freshness is needed. CB12 boost is the perfect supplement to the CB12 mouth-rinse for truly fresh breath.

GRINDING

Teeth grinding, also called bruxism, is often related to stress or anxiety and there are over-the-counter measures that patients can avail of. Teeth grinding usually happens at night-time during

sleep and many sufferers are unaware that they grind their teeth. It can cause disturbed sleep and can also have a significant impact on dental health if left untreated. Bruxism can result in problems such as teeth fractures, abnormal tooth wear and gum recession, as well as headaches, earaches, jaw pain, jaw stiffness, and facial pain.

Fortunately, many people experiencing teeth grinding benefit from dental guards, which can be helpful to people who grind their teeth.

One of these is DenTek Professional Fit Maximum Protection Dental Guard. This custom-fit mouth guard is similar to guards provided by dentists but designed to be much more affordable. The guard creates a cushion of comfort between your upper and lower teeth. This professional fit dental guard can be moulded in two easy steps to individual teeth size and shape, providing a comfortable fit. This mouth guard includes a forming tray for a close-toprofessional fit at home and storage case when not in use.

Another One of these is Bruxeeze Night Guard For Teeth Grinding

The Bruxeeze Night Guard has duallayer technology — a soft inner layer for comfort, and a durable outer layer for protection against wear and tear caused by teeth grinding. It can be easily moulded at home in under five minutes, offering immediate and effective relief from teeth grinding symptoms.

For people with dentures, there are also a range of products from Fixodent. Fixodent PLUS promises unbeatable hold, with up to 88 per cent of the initial hold remaining at the end of the day. It provides a 10 times stronger hold versus no adhesive and keeps the dentures securely in place. It allows people to eat any kind of tough food due to its exceptional holding power. It acts as a cushion between gums and dentures, allowing for a customized fit. It is easy to apply in thin strips, thanks to the regular nozzle and is suitable for full and partial dentures. ●

Athlete’s Foot with just one application Treat

To maximise treatment outcome remind your customers to:

Apply LAMISIL ONCE to both feet

Spread evenly on toes, sole and sides of feet

Do not massage or rub

Do not wash feet for 24 hours

Unique, patented ﬁlm forming technology:

2.5 x

Enhances Terbinaﬁne penetration by 2.5 times***

Days 13

Creates a reservoir that prolongs the fungicidal e ect of Terbinaﬁne for up to 13 days**

Lamisil is a medicine containing Terbinaﬁne Hydrochloride. Always recommend reading the individual product leaﬂet before use. Lamisil ONCE is suitable for 18+ years.

*Ortonne, J P et al. “E cacy and safety of a new single-dose terbinaﬁne 1% formulation in patients with tinea pedis (athlete's foot): a randomized, double-blind, placebo-controlled study.” Journal of the European Academy of Dermatology and Venereology : JEADV vol. 20,10 (2006): 1307-13. doi:10.1111/j.1468-3083.2006.01807. Epub 2007 Apr 27. PMID: 17559730. **Kienzler, J-L et al. “Stratum corneum pharmacokinetics of the anti-fungal drug, terbinaﬁne, in a novel topical formulation, for single-dose application in dermatophytoses.” Current medical research and opinion vol. 23,6 (2007): 1293-302. Doi:10.1185/030079907X199664. *** Compared to Lamisil cream. Lamisil® OnceTM 1% cutaneous solution is a pharmacy only product. Marketing Authorisation Number: PL 50567/0016. Distributed in Ireland by Ocean Healthcare. Date of preparation: April 2025. For more information visit www.lamisil.ie

GETTING ON TRACK TO HEAL SPORTS INJURIES

EXERCISE IS CRUCIAL FOR GOOD HEALTH BUT CAN SOMETIMES LEAD TO MINOR INJURIES, MANY OF WHICH CAN BE DEALT WITH IN THE PHARMACY

From community games to fun runs to just getting out for a walk in the evening, everyone can enjoy and benefit from physical activity. It boosts physical and mental health, and helps people to make friends. And with so many of us now sedentary in front of our screens, it is more important than ever. It is recommended that adults engage in at least 30 minutes of moderate activity five days a week,

or 150 minutes a week. This can seem like a lot but there are many different ways in which a person can get active, such as joining a walking club or a five-a-side soccer team. There are also numerous wearable devices and apps to help achieve this.

According to the HSE small changes can make a big difference. And the health benefits are undeniable, reducing a person’s risk of developing up to 35 chronic diseases, including

cancer, heart disease, depression, and type 2 diabetes, to name just a few.

But there is a rogue’s gallery of sports injuries – runner’s knee, tennis elbow, and shoulder injuries are among the most common – which can leave people frustrated and in pain. They can also potentially ruin weeks and months of training in advance of ‘the big event’.

The community pharmacy can help treat these painful injuries, providing a range of over-the-counter (OTC) medications, as well as being an important signpost to other health services that can help repair and prevent injury. These can include, when appropriate, physiotherapists, yoga classes, and resistance training.

You can also offer advice about treating sprains and strains, such as ‘RICE’ therapy (Rest Ice Compression Elevate).

Sports injuries invariably can cause pain, whether it be a niggle or something which causes significant discomfort. But there is a range of OTC treatments for these injuries, including painkillers such as ibuprofen and paracetamol.

There is also an array of medical devices which can treat muscle pain, including deep tissue massage percussion guns, which work to relieve soreness and stiffness. TENS machines are also available from the community pharmacist and work to help ease aches and pains, including back and shoulder pain.

A sports supplement, creatine, is available in many pharmacies and sports shops. It increases muscle energy production rates and boosts performance in high-intensity activities like sprinting or resistance training. There is also some evidence that oral creatine might reduce the frequency of dehydration, muscle cramping, and injuries to the muscles, bones, ligaments, tendons, and nerves. Creatine is not just for weightlifters but is beneficial for team sports athletes, endurance athletes, and even those recovering from injuries, according

to one of the most popular brands, Optimum Nutrition.

Another well-known treatment is gently heating and cooling sports injuries, and there are a range of products to help. One of the bestknown brands is Deep Heat and Deep Freeze, which provide trusted pain relief via sprays, creams, and patches.

Deep Heat and Deep Freeze sprays are some of the most popular sports injury treatments available, and many athletes also use them as a preventative measure before events. Deep Heat Spray is a warming spray used on the

Another trusted product is Diclomel Max Strength 2% w/w gel from Clonmel Healthcare, which contains the active substance diclofenac. Diclomel Max Strength gel is indicated for the short-term, local, and symptomatic treatment of mild to moderate pain in acute strains, sprains, or contusions following blunt trauma. It is suitable for adults and adolescents aged 14 and over and is available from pharmacies nationwide in 100g and 50g pack sizes.

Another respected brand is ThermaCare heat wraps. These provide powerful, targeted, drug-free pain relief. ThermaCare heat wraps provide long-lasting pain relief associated with muscle tension, overexertion, strains, sprains, and arthritis.

YOU CAN ALSO OFFER ADVICE ABOUT TREATING SPRAINS AND STRAINS, SUCH AS ‘RICE’ THERAPY

skin and is recommended for the relief of pain in muscles, tendons, joints, bones, lower back and thigh pain, sprains, and strains. It can be used before and after exercise.

Deep Freeze Cold Spray delivers an instant burst of targeted cooling to sore areas, such as the back, neck, shoulders, legs, and feet. Deep Heat and Deep Freeze also come in patches, which can be worn under the clothes on the affected area, allowing a person to get on with their day.

There is also a range of creams and gels, including Deep Heat Pain Max Strength cream . This can be used before and after exercise and contains ingredients that provide pain relief plus heat. Deep Freeze Cold Gel provides fast-acting, soothing relief. It is also easy and convenient to use.

There are also Medicare Infrared Therapeutic Heat Plasters . These deliver penetrating heat that lasts up to 12 hours, stimulating local blood circulation and delivering deep, healing heat into the body. They provide natural heat therapy to aid in reducing aches and pains caused by conditions such as arthritis, rheumatism, and soft tissue injuries. They may also assist with the following conditions: Rheumatoid arthritis, osteoarthritis, and lumbar soft tissue injury.

Biofreeze products are also very popular, providing fast-acting, cold therapy treatment via spray, gel, and patches. Biofreeze can be directly applied to the skin to bring targeted and effective pain relief. Its cooling formula is backed by science and research, and nine out of 10 of patients say it lasts longer than a cold pack.

Another increasingly popular cream, particularly for athletes, is Ovelle Menthol & Wintergreen Cream . It is used for the symptomatic relief of muscular pains, lumbago, rheumatic pain, fibrositis, and strains.

Other OTC products include the Voltarol range. Voltarol Emulgel P brings targeted and localised relief from pain and swelling in muscles and joints.

Voltarol Emulgel P contains an antiinflammatory drug, diclofenac, which targets the source of pain, and has been used as a pain reliever for more than 30 years in Ireland. Diclofenac gets through the skin barrier as well as offering a cooling effect to ease the painful and red areas of the body. It provides a triple effect by relieving pain at source and reducing inflammation which helps speed up recovery.

Voltarol Emulgel Extra Strength gel can provide all-day relief from pain and swelling in joints and muscles, which can be caused by their overuse during physical activity.

Diclac Relief 1% gel is also a popular and trusted brand. It is an antiinflammatory gel used for pain relief and to reduce inflammation. Diclac Relief is suitable for use with injured or damaged joints, muscles, tendons, ligaments, and in local soft tissue bruising.

Epsom salts are world famous for easing muscle pain and soreness, and they are available in a host of products. These include soluble bath salts and gels.

Ultrapure Laboratories Epsom Salts Ge l with arnica is a natural, fragrance-free gel infused with aloe vera and designed to support natural muscle recovery. It is suitable for professional athletes, those doing endurance training, adults and teens suffering from muscle and joint pain, and people with no time or access to Epsom salt baths.

Ultrapure also has other muscle recovery products, including Ultrapure Laboratories Ice-Cold Menthol Gel. This is an intensive, sports recovery topical gel with menthol crystals (4% strength) for an instant ice bath-type cooling sensation. This fastabsorbing gel has a mild fresh menthol scent and is designed for on-the-go, targeted application.

There is also Ultrapure Laboratories Wintergreen Heat Rub, which is infused with natural extracts and rich oils, plus calming wintergreen oil and rosemary camphor oil.

Keeping hydrated during sport

and exercise is very important. If a person is dehydrated, sweat levels can decrease, body temperature rises, and a person could experience muscle cramps and dizziness. Dioralyte sachets can help restore a person’s natural fluid and body salt balance. There is also Electrosal blackcurrant from Clonmel Healthcare, which helps replace electrolytes. Another trusted product is O.R.S. Hydration Tablets , available in a variety of flavours. These effervescent tablets are designed to help replenish electrolytes and fluids lost through dehydration,

increasingly popular to help recover from and prevent injury. Physiologix Kinesiology Tape from Fleming Medical is constructed from a combination of elastic and cotton fibres and latex-free coating which allows adhesive properties. It is used to prevent injury, control edema, and for pain management. Being almost identical to human skin in both thickness and elasticity, kinesiology tape can be worn without binding, constricting, or restricting movement. The sports tape is ideal for neck strain, shoulder pain, tennis elbow, rib pain, wrist pain, runner’s knee, and a range of other injuries.

ATHLETE’S FOOT SHOULD BE TREATED AS SOON AS POSSIBLE WITH A SPECIALISED PRODUCT

ensuring optimal hydration whether a person is working out, travelling, or recovering from illness. Formulated with a balanced mix of glucose, sodium, and essential minerals, they dissolve quickly in water.

A plethora of supports, insoles, and tape products can also be found at the community pharmacist.

The Scholl Gelactiv Sport range is developed to effectively absorb shocks and help reduce excessive pressure from running or sports. It provides strong arch support for active feet, impact cushioning for heels, knees, and ankles, and a sole shape design for all day comfort.

There is also a range of knee, ankle, and elbow supports available from the pharmacy, including those available from well-known brand Elastoplast . Sports and kinesiology tapes are

As the name suggests, athlete’s foot can also be an issue. While anyone can get it, as it is very contagious, being active makes it more likely. A person can catch it by walking barefoot in communal areas, such as in changing rooms and showers. Wet or sweaty feet, such as after exercising, can also encourage it.

Athlete’s foot is a very common complaint, with symptoms including scaly, peeling, or cracked skin between the toes, fluid-filled blisters, and itchiness. It should be treated as soon as possible with a specialised product like Scholl Athlete’s Foot Cream to help prevent the infection from spreading to the nails. The cream contains an anti-fungal ingredient that is clinically proven to treat athlete’s foot effectively. It also provides long-lasting treatment. It kills the fungal infection and soothes itching in a sevenday treatment time.

Scholl’s Antifungal Shoe Spray is also an effective disinfectant that kills 99.9% of the fungus which causes athlete’s foot and fungal nail. It also helps prevent recurrence of fungus in shoes.

Canesten Cream with 1 % Clotrimazole is also a trusted product. It is used to treat fungal skin infections including ringworm, athlete’s foot, fungal sweat, and nappy rash. It provides soothing relief from the irritation caused by fungal infections. ●

HELPING CUSTOMERS WITH IBS

IRRITABLE BOWEL SYNDROME (IBS) IS AN INCREASING PROBLEM IN THE COMMUNITY BUT THERE IS HELP IN THE PHARMACY TO IMPROVE QUALITY OF LIFE FOR SUFFERERS

It is estimated that anywhere between 10 and 20 per cent of the Irish population sufferers with IBS, making it a huge problem in community health. Overall, it is the most commonly-diagnosed gastrointestinal problem and places a huge burden on the healthcare system. There is no cure, and women are more likely to suffer with IBS than men, with symptoms sometimes becoming worse during a menstrual cycle. Studies have shown a link between IBS and mental health, and the symptoms are often exacerbated during times of high stress. There is also a stigma around IBS, with many people reluctant to discuss the problem in the pharmacy due to embarrassment.

SYMPTOMS

According to the HSE, the most common symptoms of IBS are stomach cramps, bloating, diarrhoea, and sometimes constipation. Other symptoms can include flatulence, tiredness/lack of energy, nausea, backache, bladder issues, incontinence, or passing mucus from the rear end. Triggers for an IBS flare-up include caffeine, alcohol, stress, and some foods, such as very fatty or spicy foods. Some more serious illnesses can have symptoms that mimic IBS, so it is important to be on the lookout for these. Customers should be advised to seek a medical opinion urgently if the have symptoms similar to IBS, but also have:

 Unexplained weight loss.

 Bleeding from the bottom, or blood in diarrhoea.

 A lump or swelling in stomach.

 Palpitations, pale skin, shortness of breath.

The exact cause is not known, but

having a family history increases the risk of being diagnosed with IBS.

TREATMENT

A medical professional may suggest a course of treatment that combines lifestyle and medications. For example, the low FODMAP diet is based on avoiding food that is difficult to break down in the gut. These can include certain types of wheat products, milk, or fruit and vegetables. As well as dietary adjustments, IBS sufferers should strive to incorporate regular exercise, hydration, good quality and quantity of sleep, and measures to manage life stressors. It is sometimes also useful for people with IBS to keep a ‘food diary’ to help them identify the foods that cause them to have a flare-up of symptoms.

Research has also shown the value of pharmacological products in helping to manage the symptoms of IBS. The HSE states that antispasmodic agents can help with the symptoms of IBS and these may contain hyoscine, which relaxes the muscles in the bowel and abdomen to help prevent them from cramping.

The GP may also recommend psychological supports, such as counselling, to help someone with IBS to manage their stress. If a combination of lifestyle, diet, pharmacological and psychological supports have no effect in the medium term, then the customer’s GP may refer them for more specialist tests.

ADVICE

However, most cases of IBS are managed in the community, and the pharmacy has a vital role to play as a link in the chain of care. Aside from over-the-counter therapies, customers with IBS can be advised to cook homemade meals with fresh ingredients if possible, and should be counselled not to skip meals or eat too quickly. As well as alcohol and caffeine, fizzy drinks may also provoke their IBS, so this is again where a food diary can be useful to identify triggers.

To help with flatulence, cramps and bloating, the HSE advises eating oats regularly, avoiding the sweetener sorbitol, and using an antispasmodic. To help reduce diarrhoea, the Executive recommends cutting down on high-fibre foods, nuts and seeds, and again, avoiding sorbitol can help. There are also overthe-counter medications that can help with diarrhoea. For constipation, it is recommended to increase soluble fibre intake, take plenty of hydration, and perhaps take a laxative.

There is an important role to be played at the pharmacy counter to help provide the best advice and therapies to improve quality of life for IBS sufferers. At the counter, you also have an opportunity to discuss with empathy the symptoms a customer may be living with, to help open the conversation and dispel stigma around the condition. ●

Image: iStock.com/ Pikovit44

“ Cow’s milk allergy is associated with dysbiosis and increased susceptibility for infections, and it has been suggested that it can be managed

(in

part)

pro-, pre-, and synbiotics ””

Only Nutricia’s SYNEO range contains prebiotics and probiotics (synbiotics):

GOS/FOS

SYN EOTM OURPATENTED COMBINATION

FOS/FOS

Clinically proven to restore the gut microbiome in infants with cow’s milk allergy,2-6 supporting immune development and long-term health7-10

DRACMA: Diagnosis and Rationale for Action against Cow’s Milk Allergy; GOS: Galacto-Oligosaccharides; FOS: Fructo-Oligosaccharides

1. Jensen SA et al. World Allergy Organization Journal. Diagnosis and Rationale for Action against Cow’s Milk Allergy. 2022;15:100668. 2. Burks AW et al. Pediatr Allergy Immunol. 2015;26(4):316–22. 3. Candy DCA et al. Pediatric Res. 2018;83(3):677–86. 4. Fox AT et al. Clin Transl Allergy. 2019;9(1):5. 5. Chatchatee P et al. JACI. 2021;0091-6749(21)01053-8 6. Van der Aa LB et al. Clin Exp Allergy. 2010;(40):795–804. 7. Martin R et al. Benef Microbes. 2010;1(4):367–82. 8 . Wopereis H et al. Pediatr Allergy Immunol. 2014;25:428–38. 9. West CE et al. J Allergy Clin Immunol. 135(1):3–13.10Walker WA et al. Pediatr Res. 2015;77(1):220-8. IMPORTANT NOTICE: Breastfeeding is best. Foods for special medical purposes should only be used under medical supervision. May be suitable for use as the sole source of nutrition for infants from different ages, and/or as part of a balanced diet from 6 months onwards. Refer to label for details.

Nutricia Ireland, Deansgrange Business Park, Deansgrange Co. Dublin. Date of publication: April 2024

CARING FOR AN INFANT CAN BE A MAZE OF CONSIDERATIONS BUT YOU CAN HELP WITH ADVICE AND RECOMMENDATIONS

ew parents, especially those welcoming their first child, might seem to go through a lot that is overwhelming, especially if they are alone and do not have the support of friends or family. Many simple issues can be stressful not just for the infant, but can be extremely troubling for the mother and father as well.

Numerous challenges encountered by a baby’s parents can be straightforward to address, yet they may appear daunting to a parent lacking proper guidance or who has been misled by contradictory information found on websites or social media. This creates a chance at the pharmacy counter to ease some of these concerns, give guidance, and make suggestions.

Several frequent challenges

encountered while looking after infants involve feeding difficulties, diaper rash, fever, teething discomfort, and coughs and colds. There are several other difficulties that may emerge during early life, but for the scope of this article, we will concentrate on these prevalent concerns.

NUTRITION

The majority of infants typically obtain the necessary nutrition naturally via breastfeeding. Nevertheless, for certain mothers, breastfeeding may not be feasible or preferred for various reasons. As stated by the HSE, these reasons might encompass:

 Cluster feeding — this occurs when a baby desires to feed frequently during specific periods, followed by extended breaks without feeding. This might

indicate that the baby prefers to feed more in the evening and less during the day, which is a typical situation, particularly during growth spurts.

 Oversupply — leading to leaking breasts — occurs when the breasts generate more milk than the baby requires. Generally, the more frequently your baby nurses, the greater amount of milk you will produce. In cases of oversupply, excessive milk is produced, irrespective of the baby’s requirements. The milk supply typically adjusts to satisfy the baby’s requirements by the time they are four-to-six weeks old, although for some mothers, it may take as long as 12 weeks for various reasons.

 Breast engorgement occurs when the breasts are overly filled with milk,

resulting in hardness and discomfort, and this may cause breastfeeding issues if not addressed. Engorgement typically happens in the initial days of feeding since it may take several days for breast milk production to align with the baby’s requirements. Nonetheless, it can also occur when a baby starts solid food (termed ‘weaning’).

 Sore nipples are a frequent issue during the initial days of breastfeeding since the nipples are unaccustomed to the activity. The discomfort typically persists for a brief period, usually about one week. However, soreness that continues during breastfeeding or lasts beyond a week is not typical and consulting a GP is recommended, since this length of nipple pain can arise from various factors. Often, nipple pain may arise from inadequate positioning while breastfeeding or difficulties with attachment. Visit the HSE website for comprehensive guidance on positioning and attachment.

 Mastitis is an inflammatory condition of the breast that leads to pain, heat, and swelling, which can be severe. Mastitis can be classified into two categories — infective and non-infective — with various potential causes. Certain types of mastitis might require medication, while others can be managed at home through breast massage, heat application, rest, proper nutrition, and hydration. Other problems that may be encountered during breastfeeding include concerns around breast milk supply, breastfeeding after a Caesarian section, restarting breastfeeding after a break, or if a baby insists on breastfeeding from one side. These issues are covered in more detail at www.hse.ie.

CAUSES OF NAPPY RASH

Diaper rash is very frequent, and the majority of infants experience it at some point. It features red, irritated, or damp skin in the nappy region, and certain babies are more susceptible to it than others. There are several factors to consider, including:

 If the infant is experiencing teething.

 If the infant has recently taken antibiotics.

 The skin of a baby might react sensitively to soap, bath products, or laundry detergent.

 If the infant has remained too long in a soiled or damp diaper.

 A coarse diaper might be chafing against the baby’s diaper area.

 If alcohol-containing baby wipes are utilised.

 If the baby has a thrush infection.

The HSE advises that baby wipes should not be utilised until the baby is at least two-to-four weeks old. A light coating of protective barrier cream is advisable, while bubble baths, talcum powder, and any fragrant products are

TEETHING FREQUENTLY OCCURS ALONGSIDE A NAPPY

RASH

not recommended. Leaving the nappy off for a brief period during a change can often benefit the baby by soothing and cooling their skin.

If a customer is concerned about symptoms like blood in the stool, pain and discomfort during bowel movements, vomiting or fever, a bloated abdomen, or lack of growth, they should be urged to see their GP right away.

TEETHING PROBLEMS

Teeth typically begin to emerge after about six months, and this can cause the baby to become upset. They will also dribble, and this should be cleared away to avoid soreness and irritation. Their cheeks will look red and rosy, and they will bite on their toys or hands more often than normal. Teething frequently occurs alongside a nappy rash.

A visit to the GP should be scheduled if the baby has a high fever, diarrhoea, and appears to be unwell, as these symptoms typically aren’t caused by teething.

VIRAL INFECTIONS

Since children have not fully developed immunity to the numerous cold viruses available, it’s typical for a child to experience around eight colds within a year while they gradually strengthen their immune system.

The symptoms resemble those in adults — a sore throat typically appears first, accompanied by a blocked or runny nose, and sneezing. Though older children may recover from a cold in roughly the same time as adults, in young children, complete recovery can take as long as three weeks. In most instances of a cold in infants or young children, the issue can be managed at the pharmacy counter.

A typical temperature range for a child is from 36 to 36.8 degrees Celsius, and although it could just be a response to cold, a fever may occasionally indicate another issue. Medical help must be pursued if the child cannot be awakened or remains drowsy; if an infant breathes rapidly or makes grunting sounds; if they are frequently vomiting; if the child exhibits blotchy or pale skin; or if they emit a persistent, high-pitched cry.

THERAPIES AND PRODUCTS

If you are unsure that any therapy is suitable for an infant, consult with the pharmacist on duty to discuss treatment options.

For mothers unable to breastfeed whose child has a cow’s milk allergy, Aptamil Pepti 1 800g offers a nutritionally complete solution for managing dietary needs related to cow’s milk allergy. It serves as an adequate exclusive nutrition source from birth and can substitute cow’s milk in beverages and cooked meals when weaning begins. Aptamil Pepti 1 is a highly hydrolysed formula, where the milk proteins have been broken down (hydrolysed) to minimise the chances of triggering an allergic reaction.

SMA LF Lactose Free Infant Milk 400g is a lactose-free milk

Colief ® Infant Drops

Colief Infant Drops

Gentle Colic Relief Backed

Decades of Experience

The original lactase enzyme trusted by families and professionals alike.

Infant colic is a common yet distressing condition with multiple causes. In around 40% of cases, temporary lactose intolerance—an inability to fully digest lactose—contributes to excessive crying, wind, and discomfort.

Colief® Infant Drops contain lactase enzyme, which breaks down lactose into simpler sugars, aiding digestion and reducing discomfort. This can be particularly beneﬁcial in the ﬁrst few months while lactase production is still developing.

Suitable from birth, Colief® Infant Drops integrate easily into feeding routines by adding them to expressed breast milk or formula without disrupting normal feeding. By improving lactose digestion, they can provide a practical, e ective solution for infants struggling with colic-related discomfort.

orders@oceanhealthcare.ie www.oceanhealthcare.ie Tel: 01

orders@oceanhealthcare.ie www.oceanhealthcare.ie

designed for lactose-intolerant infants or those suffering from symptoms like diarrhoea, tummy pain, or wind due to temporary lactose intolerance, and is appropriate for babies from birth to 18 months. For older infants, it can additionally serve as an element of a varied diet.

Aptamil 1 First Infant Milk

From Birth 800g is appropriate f rom birth for babies who do not have intolerance issues. It is a uniquely formulated product that is appropriate for babies not receiving breast milk or for those being fed a combination of both.

Also within the SMA range is SMA Pro First Infant Milk 800g , a nutritionally complete substitute for breast milk that is fortified with Omega 3. Breastfeeding is consistently recommended for babies; however, if that’s not feasible, a nutritionallycomplete formula provides the necessary nutrition until they’re ready to transition to solid foods.

Certain infants are delivered with a low birth weight. During their hospital stay, these infants will obtain the necessary nutrition; however, upon returning home, special formulas might be needed. C ow & Gate Nutriprem 2 Baby Formula 800g is specifically designed to cater to the nutritional requirements of premature and low birth-weight infants, aiding in their catch-up growth after leaving the hospital.

For babies who are teething, Nelsons Teetha Teething Granules come in 24 sachets and are a homeopathic remedy. It is utilised for alleviating the symptoms of teething pain and related signs, such as tender gums, flushed cheeks, and excessive drooling. It is appropriate for use on infants older than three months.

CaldeBaby Teething Gel 10ml assists in caring for your baby’s delicate gums by providing cooling relief and comfort during teething. Parents should rub the baby’s delicate gums with

CaldeBaby Teething Gel to alleviate the pain of emerging first teeth. It contains chamomile and has no sugar.

Bonjela Teething Gel For 4 Months 15g is designed to provide immediate relief for babies experiencing pain and discomfort from teething. This teething gel is an efficient, calming gel that alleviates pain sensations while also combating infections.

The Bepanthen collection features Bepanthen Nappy Care Ointment , a breathable barrier cream that is simple to apply. It effectively aids in safeguarding babies’ bottoms from

CERTAIN INFANTS ARE DELIVERED WITH A LOW BIRTH WEIGHT

the triggers of nappy rash. It is gentle enough to be used with every nappy change to soothe the most sensitive skin, as it does not contain any fragrance, preservatives, colourants, or antiseptics.

The AVEENO line-up features

AVEENO Baby Daily Care Barrier

Nappy Cream . This product alleviates sensitive and delicate skin in babies, shielding it from the triggers of nappy rash. The formula forms a breathable shield over the nappy area, safeguarding it from external irritants. It provides swift and enduring comfort along with noticeable enhancement in skin look.

Caldesene Powder 55g is a therapeutic powder that prevents and alleviates nappy rash; due to its medicinal properties, it combats harmful bacteria. It calms skin irritation, thereby aiding in the prevention of rashes. Its unique formulation ensures that it creates a barrier against moisture on the baby’s skin.

For coughs and colds, Colief Breathe Easy Vapour Rub 30g is a stick that can be delicately and gently applied to baby’s chest and back to aid in soothing and comforting. It can likewise be applied to a tissue or handkerchief. To prevent very young children from moving the product to their eyes or other areas of their body, the cloth must be kept entirely out of reach. It is appropriate for children aged three months and up.

The Colief range features Colief Breathe Easy Patches 3+ Years 6 Pack , which includes eucalyptus, peppermint, and lemon, designed for kids over three years old. It is a mild decongestant patch that can be placed on clothing or bedding to provide a cozy way to enhance breathing.

The Nurofen line-up features Nurofen For Children - 10 Suppositories, designed specifically for infants aged three months to two years. They are intended to facilitate the rapid absorption of ibuprofen from the suppository to swiftly alleviate and reduce pain. In addition to treating coughs and colds, they are appropriate for alleviating pain associated with teething, earaches, sore throats, toothaches, and headaches.

Bronchostop Junior Cough Syrup-200ml is suitable as a cough remedy for kids aged one and older who experience dry or chesty coughs. Bronchostop Junior contains no artificial colors, is free from lactose, gluten, alcohol, and genetically modified organisms.

Panadol Baby 120mg/5ml Oral Suspension – 100ml includes paracetamol for efficient short-term relief of fever and discomfort. It is appropriate for children with asthma who are allergic to aspirin and NSAIDs. It is appropriate for infants and kids ranging from two months to 12 years old. Panadol Baby alleviates teething discomfort, tooth pain, sore throat, as well as colds and fevers. ●

MELANOMA SKIN CANCER: PREVENTION AND EARLY DIAGNOSIS

THE WARMER WEATHER IS WELCOME, BUT GETTING THE WRONG TYPE OF SUN EXPOSURE CAN HAVE SERIOUS CONSEQUENCES

Malignant melanoma, the most serious type of skin cancer, is the fifth-most commonly diagnosed cancer in Ireland (excluding non-melanoma skin cancer), accounting for one-in-20 new cancer cases. Every year, over one thousand people in Ireland will be diagnosed with this disease, with males and females affected equally. The incidence of melanoma

almost trebled between 1994 and 2017 in Ireland, and is expected to increase by 172 per cent between 2015 and 2045, potentially giving rise to 3,078 new cases of melanoma annually. Melanoma disproportionately affects younger age groups, with one-in-three cases (33 per cent) occurring in people under 50 years of age.

Survival rates for melanoma skin cancer are high and it accounts for just

1.8 per cent of cancer deaths in Ireland, equating to approximately 170 deaths per year. Overall, 88 per cent of people diagnosed with melanoma are still alive 10 years after diagnosis. However, early diagnosis is strongly associated with improved survival; 97 per cent of people diagnosed with stage I melanoma are alive 10 years after diagnosis, compared to just one-in-two (48 per cent) people with stage IV disease.

RISK FACTORS FOR MELANOMA ULTRAVIOLET (UV ) LIGHT

The single biggest risk factor for melanoma is exposure to ultraviolet (UV) light, such as sunlight or sunbed use. It is estimated that up to 90 per cent of cases of melanoma are caused by exposure to UV light. Sunlight comprises a number of wavelengths, from infra-red to UV light. UV rays, specifically UVA and UVB, are damaging to skin, causing DNA damage that can result in cancer.

Sunburn, especially during childhood, is particularly harmful as it increases risk of melanoma later in life, but even non-burning, intermittent exposure to UV light can increase risk. Exposure to UV light through use of sunbeds also increases risk. A recent study of 31 European Union (EU) and European Free Trade Association (EFTA) countries found that sunbed use accounted for approximately 5.1 per cent (n=4,450) of all newly diagnosed cases of melanoma across these countries combined in 2012, with

A PERSON’S NATURAL SKIN COLOUR INFLUENCES THEIR RISK OF UV DAMAGE AND SKIN CANCER

an associated economic cost of between €32.5-33 million.

SKIN TYPE

The effects of UV exposure on skin are not the same for everyone. A person’s natural skin colour influences their risk of UV damage and skin cancer. Most people living in Ireland have fair skin (Fitzpatrick type I and II), which burns easily and tans poorly, placing them at increased risk of UV damage and skin cancer.

FAMILY HISTORY

About 10 per cent of patients with melanoma skin cancer have a family history of melanoma. Risk is increased in people who have a first-degree relative (parent, sibling, child) who had melanoma at a young age (younger than 30). Carriers of BRCA 2 gene mutations have an increased risk of melanoma.

OTHER RISK FACTORS

Other risk factors for melanoma include:

 A=A new or changing mole (this is the most important sign of a possible melanoma)

 Atypical moles

 A large number of moles (>50)

 A previous history of melanoma or other non-melanoma skin cancer

 Immunosuppression

MELANOMA PREVENTION

AVOID EXPOSURE TO UV LIGHT

Up to 85 per cent of melanoma skin cancers are due to exposure to UV radiation. UV rays are invisible and unlike infra-red rays that cause heat, they cannot be seen or felt on our skin. The UV Index tells us how much UV radiation our skin is exposed to at any time. When the UV Index is 3 or above, skin needs to be protected. Typically in Ireland, the UV index is 3 or above from April to September, even when it is cloudy. Limit time in the sun when UV rays are strongest, typically between the hours of 11:00am-3:00pm.

WEAR PROTECTIVE CLOTHING

Use of appropriate sun-protective clothing is one of the most important tools for sun protection. Cover skin as much as possible, wear long sleeves and collared t-shirts. To protect skin and eyes from UV radiation damage, wear a hat that protects the face, back of the neck, eyes and ears. Wide-brim, bucket or ‘legionnaire’ hats offer the best protection from UV radiation. Baseball caps are not recommended, as these styles do not protect the ears, cheeks or neck.

The European standard for sun protective clothing (EN 13758-2) stipulates a UPF (ultraviolet protection factor) greater than 40. For those garments that do not have a UPF label, some items will provide better sun protection than others:

 Fabric that is tightly-woven and not transparent.

 Clothing that gets wet or stretched may lose some of its protective qualities.

 Dark clothes block more UV rays than light-coloured clothes.

USE SUNSCREEN

The ideal sunscreen would prevent 100 per cent of UV radiation from penetrating the skin and would provide long-term protection without the need for re-application. Unfortunately, such a sunscreen does not exist! Therefore, sunscreen alone is not sufficient to protect the skin, but should be used alongside other protective measures such as clothing and shade.

Sunscreen should be applied thickly and re-applied regularly (every two hours). Remember that water-resistant sunscreen can be rubbed off by clothing or towelling.

protection factor (SPF) of at least 30+ for adults and 50+ for children.

By adopting appropriate skinprotective behaviours, the majority of skin cancers caused by harmful UV radiation could be prevented.

DIAGNOSING MELANOMA EARLY

Early diagnosis of melanoma is a critical first step in achieving higher survival rates and reducing treatment severity.

 Loose-fitting clothing is better because it is less likely to become stretched and allow UV light to penetrate.

 Remember to wear sunglasses with appropriate UV protection.

Sunscreens should provide protection against both UVB rays (indicated by the SPF rating) and also UVA rays (indicated by a star rating). Use a broad-spectrum sunscreen with a sun

It is crucial that healthcare professionals and patients can recognise the early signs of melanoma. If a GP suspects that a patient has melanoma skin cancer, they can refer that patient to a pigmented lesion clinic (PLC) or to a dermatology or plastic surgery service. The National Melanoma Referral Guidelines, available here

FIGURE 1: ABCDE lesion system for melanoma

www.hse.ie/eng/services/list/5/cancer/ profinfo/resources/gpreferrals/nationalmelanoma-gp-referral-guidelines.pdf, aim to guide decision-making around which patients require referral.

Suspicious lesions which may require urgent referral include:

 Any new or changing pigmented lesion.

 A long-standing pigmented lesion which is changing progressively in shape, size or colour regardless of age.

 A new pigmented line in a nail, especially where there is associated damage to the nail, or a lesion growing under a nail.

 A pigmented lesion which has changed in appearance or which is persistently itching or bleeding.

 An ‘ugly duckling’ pigmented lesion is one that looks different to all the other pigmented lesions that person has.

The ABCDE lesion system (Figure 1) can help to determine whether a mole or skin lesion is suspicious for melanoma. Shave excisions and punch biopsies should not be carried out on naevi. If a patient presents with a suspicious pigmented lesion, the patient should be referred with the lesion intact to a consultant dermatologist or consultant plastic surgeon. If a melanoma has been inadvertently excised, the patient should be referred urgently to a consultant dermatologist or consultant

REFERENCES

1. National Cancer Registry Ireland (NCRI). Cancer incidence statistics. (Accessed April 2022). www.ncri.ie/data/incidence-statistics

2. NCRI. Cancer incidence projections for Ireland 2020-2045. 2019. https://www. ncri.ie/publications/cancer-trends-andprojections/cancer-incidence-projectionsireland-2020-2045

3. NCRI. Melanoma factsheet. https:// www.ncri.ie/sites/ncri/files/factsheets/ Factsheet%20melanoma.pdf

4. NCRI. Survival statistics: Melanoma.

A SIGNIFICANT PROPORTION OF MELANOMA CASES ARE PREVENTABLE BY ADOPTING SKIN PROTECTIVE BEHAVIOURS

plastic surgeon for multidisciplinary follow-up and care.

RESOURCES FOR HEALTHCARE PROFESSIONALS

Currently, GPs in most regions in Ireland have access to PLCs. Patients are referred to the PLCs using the electronic National Pigmented Lesion GP Referral Form. This form can be accessed via all of the four accredited GP computer software systems or by contacting Healthlink (www.healthlink.ie). If the region is not covered by a PLC, doctors can refer a patient with suspected melanoma to the local dermatology or plastic surgery service for urgent review. The National Cancer Control Programme (NCCP) has developed two early detection of cancer modules which are available free of charge to all healthcare professionals via HSeLanD, the HSE’s national online learning and development portal. These offer

www.ncri.ie/data/survival-statistics

5. Maslin DL. Do sunscreens protect us? Int J Dermatol. 2014 Nov;53(11):1319-23. doi: 10.1111/ijd.12606. Epub 2014 Sep 10.

6. Krensel M, Schäfer I, Augustin M. Modelling first-year cost-of-illness of melanoma attributable to sunbed use in Europe. J Eur Acad Dermatol Venereol. 2019 Mar;33 Suppl 2:46-56. doi: 10.1111/jdv.15313.

7. Goldman L, Schafer A (eds). Melanoma and non-melanoma skin cancers. Goldman-Cecil Medicine. 26th ed. Elsevier; 2029: 1344-50.e2

a valuable learning opportunity for melanoma and other skin cancers and are available at www.hseland.ie.

Resources on skin cancer prevention are also available at www.hse.ie/sunsmart/.

A significant proportion of melanoma cases are preventable by adopting skin protective behaviours. GPs and general practice nurses (GPNs) should take every opportunity to counsel patients about sun avoidance, sun protection and early diagnosis of melanoma. GPs and GPNs are also encouraged to opportunistically assess patients attending their practice for signs of skin malignancy. ●

AUTHORS: Dr Una Kennedy, GP Advisor to National Cancer Control Programme (NCCP), Dr Heather Byrne, Public Health Consultant NCCP, Ms Aine Lyng, Cancer Prevention Officer NCCP, and Ms Maria Greene, Cancer Prevention Officer NCCP.

8. Cancer Research UK. Risks and causes of melanoma. www.cancerresearchuk.org/ about-cancer/melanoma/risks-causes

9. Gambichler T, Laperre J, Hoffmann K. The European standard for sun-protective clothing: EN 13758. J Eur Acad Dermatol Venereol. 2006 Feb;20(2):125-30. doi: 10.1111/j.1468-3083.2006.01401.x.

10. Department of Health. National Cancer Strategy 2017 – 2026. 2017. https://www.gov.ie/en/ publication/a89819-national-cancerstrategy-2017-2026/

CANCER TRIALS IRELAND URGES PATIENTS ‘DON’T BE SHY – JUST ASK!’ AS NEW CAMPAIGN ENCOURAGES CLINICAL TRIAL

Ahead of International Clinical Trials Day on May 20, Cancer Trials Ireland is mounting a ‘Just Ask’ campaign, urging people with cancer undergoing treatment to ‘just ask’ their doctors of the clinical trial options open to them.

With over 24,000 people newly diagnosed with cancer each year in Ireland, Cancer Trials Ireland is dedicated to finding new ways to prevent, find and treat cancer. It currently has over 110 trials open and recruiting new patients.

The charity hosted an information webinar on Tuesday May 20 from 2.30-3.30pm offering an overview of trials here, how they work and how to access them. The session featured the perspectives of both cancer researchers and patients, with contributions from Prof Gerry Hanna, Vice Clinical Lead, Cancer Trials Ireland, Dr Claire Kilty, Head of Research at the Irish Cancer Society, and patient advocate Jed van de Poll. Broadcaster and former GP, Ciara Kelly, hosted the webinar which was free of charge to members of the public.

For Prof Hanna, Vice Clinical Lead at Cancer Trials Ireland, the ambition is to achieve an up to 75 per cent five-year survival rate for people diagnosed with cancer within the next decade: “We’re seeking to constantly improve outcomes for people with cancer and we’ve gone from 25 per cent of people being alive five years after a cancer diagnosis 30 years ago, to now over 50 per cent. “We

DISCUSSION WITH MEDICAL TEAMS

want to get that figure up to 75 per cent in the next 10 years and one of the ways that we can do this is through clinical trials in finding the next generation of treatments that will improve outcomes for people with cancer. The intention with a prospective trial treatment received by patients is that it should be at least as good as the standard of care and hopefully better.

“We also know that in hospitals that run clinical trials, the outcomes are generally better, even for those patients who are not taking part in the trial, as the quality of clinical care improves for everyone. With this campaign, I would encourage any person going through cancer treatment to ‘just ask’ their doctor if there is a cancer trial currently available that would be suitable for them.”

When it comes to the latest

attitudes of members of the public to clinical trials, a survey conducted by Cancer Trials Ireland in July last year yielded some very interesting findings:

 Approximately one-in-five (18 per cent) either know of someone who has taken part in a clinical trial, or have taken part themselves, while three-in-five (62 per cent) would be willing to take part in one.

 Seven-in-10 (70 per cent) would take part in a trial to potentially help others get better treatment for their health issues in the future, while almost four-in-10 (38 per cent) would do it to have a longer life, and approximately one-third would sign up to access a new treatment before it’s widely available (32 per cent), or to cure their disease (30 per cent).

 Over half (53 per cent) would get involved in a trial to improve their health and wellbeing, while two-infive would like to have a more active role in their healthcare if ill (44 per cent), or to access medical care and more frequent health checks as part of treatment (40 per cent).

Interestingly, three-in-four of those surveyed (77 per cent) know someone who has had cancer, or have had cancer themselves.

For more information on the work of Cancer Trials Ireland, visit www. cancertrials.ie, or call the Irish Cancer Society’s Cancer Nurseline on Freephone 1800 200 700. Cancer Trials Ireland is partly funded by the Health Research Board and the Irish Cancer Society.

Prof Gerry Hanna

CIALIS FOR MEN ® NOW AVAILABLE OVER -THE - COUNTER IN IRISH

PHARMACIES FROM OCTOBER 2024

October 2024: Clonmel Healthcare, in conjunction with Opella, Sanofi’s consumer healthcare business unit, are pleased to announce that Cialis for men® 10mg film-coated tablets tadalafil is now available without prescription in Irish pharmacies for the treatment of erectile dysfunction (ED). This marks a significant development in the management of ED, providing an accessible, pharmacist-supervised alternative to previous OTC treatments.

Cialis for men offers a new OTC approach to managing ED with its active ingredient, tadalafil, which increases blood flow to the penis, helping men achieve and maintain an erection when sexually aroused. Its effect, lasting up to 36 hours, allows for greater flexibility and reduces the pressure on timing, thereby improving patient experience and satisfaction. Available exclusively in pharmacies throughout Ireland, Cialis for men requires pharmacist oversight to ensure patient safety and suitability, providing guidance on the proper use of the medication.

Recent research highlights the

prevalence of ED in Ireland, with nearly three-in-10 Irish men reporting experiences with the condition. Despite the availability of treatments, awareness of over-the-counter options remains low, with 50 per cent of men unaware of such solutions. The launch of Cialis for men directly addresses this gap, offering a longer-lasting, accessible treatment that does not require a prescription, thereby removing barriers that may prevent men from seeking help.

The availability of Cialis for men in pharmacies positions pharmacists at the forefront of men’s health, enabling them to play a critical role in supporting patients experiencing ED. As trusted healthcare professionals, pharmacists can provide discreet advice and support, ensuring that men receive accurate information and appropriate treatment.

Longford-based Pharmacist Paula

BUSCOPAN NOW AVAILABLE IN 60 -TABLET PACK

Buscopan 10mg Coated Tablets is now available in a 60 tablet pack. Contains Hyoscine butylbromide and is indicated for the relief of spasm of the gastrointestinal tract and for the symptomatic relief of Irritable Bowel Syndrome. Always read the label. Distributed in Ireland by Clonmel Healthcare Ltd.

Reilly comments: “With medications like Cialis for men now available directly through pharmacies, men no longer need to visit their GP for treatment, which has removed a significant barrier to seeking help. This ease of access is paving the way to make a real difference in promoting better health outcomes for men and their partners.”

The research also revealed critical insights into the state of men’s sexual health in Ireland. More than seven-in-10 men believe there is still a significant stigma surrounding the discussion of men’s sexual health, however, making treatment options more accessible and raising awareness about the commonality of these conditions can help reduce that stigma. The study also highlights the impact of social media and online content, including pornography, on men’s perceptions of sexual performance. It found that 31 per cent of men feel that social media has influenced their expectations, with nearly half (47 per cent) of men aged 18-to-34 admitting to regularly comparing their sexual experiences to these often-unrealistic portrayals.

CROHN’S & COLITIS IRELAND PUBLISHES NEW GUIDE ON TALKING TO PEOPLE WITH IBD

A new conversation guide on talking to people with inflammatory bowel disease (IBD) about their condition aims to banish thoughtless remarks and illinformed commentary to the past.

Published by Crohn’s and Colitis Ireland to mark World IBD Day on Monday May 19, Gut to Know aims to help people be understanding, better informed, and ultimately more empathetic when speaking to someone who has IBD.

Among those who contributed to the discussion were psychologist Dr Jennifer Wilson O’Raghallaigh, and two people living with IBD, Armagh GAA star Niall Grimley, and Gogglebox Ireland TV critic Sarah Reilly. Niall and Sarah shared their lived experiences and personal anecdotes of chats with family and friends about IBD, while Jennifer had lots of useful tips and advice on striking up conversations on the subject.

The webinar also featured a keynote contribution from consultant gastroenterologist, Prof Anthony O’Connor, based at Tallaght University Hospital, who provided an introduction to IBD, including symptoms, diagnosis, treatment, coping strategies, and supports available.

The free webinar was supported by Pharmacosmos, and can be viewed at www.crohnscolitis.ie.

For Dr O’Raghallaigh, like the person diagnosed with IBD, family members and friends are also embarking on a journey of health discovery of their own, with learnings for all involved.

“I often talk about the myth that some of us have that we can control our bodies. Not only does the myth shatter for people when pure bad luck leads to a diagnosis of a chronic disease, but they also need to find a

way to communicate about their health with their loved ones, who may still want to believe that control is possible. That’s a hard line to walk. The person diagnosed has to change the way that they are living which, by extension, means that the lives of those around them also change.

“Unless they’ve had a similar experience with IBD, and even sometimes if they have, our loved ones are learning alongside us on how to talk about health, symptoms, treatments and fears. Most of the time, they feel compassion but don’t know exactly how to express it. They worry that they are interfering, or being nosey, or that they might say the wrong thing. When we have a chronic condition like IBD, we don’t want to burden our loved ones or lose our autonomy. At the same time, we might need help sometimes. Using good communication strategies such as those outlined in the Gut to Know

conversation guide can help smooth over some of the rough patches in negotiating tricky conversations. Ultimately, it will enable family and friends to better offer support in managing the symptoms experienced.”

For Armagh senior footballer and All-Ireland champion, Niall Grimley (31), being diagnosed with colitis in May 2021 was hard to accept, but he is now much more positive about the future: “Back in 2020, I was in a lot of pain and discomfort before being diagnosed the following year. While I have since been hospitalised twice, thankfully, now, my symptoms are under control. I take fortnightly injections of a biologic medicine which allows me to live.”

It is estimated that there are approximately 50,000 people in Ireland living with IBD. Most common symptoms are urgent and frequent bowel motions, sometimes with blood, diarrhoea, nausea, vomiting, reduced

Niall Grimley, who was diagnosed with colitis, with daughter Olivia, following Armagh’s victory over Galway in All Ireland GAA Senior Football Final in 2024. Credit: Inpho Photography

appetite, weight loss, stomach cramps, and painful joints and skin rashes.

Anyone concerned about IBD can call the Crohn’s and Colitis Ireland Support Line on 01 531 2983 (Mon/ Wed/Fri, 9.30am to 12.30pm) or visit www.crohnscolitis.ie.

To access a copy of the Gut to Know conversation guide on supporting a loved one or patient with IBD, visit: https://bit.ly/444c3nt.

SIX TIPS FOR TALKING TO PEOPLE WITH IBD ABOUT IBD

1. Privacy please. Ask the person with IBD if it’s okay to ask questions about their condition. Some may be happy to talk. Others may not. Listening and offering your undivided attention helps the person to feel supported. Ask openended questions, such as “how are you feeling today?”

2. Offer empathy not pity. Acknowledge the person’s feelings and circumstances but avoid expressing

pity. “I’m here for you” or “is there anything I can do?” are so much more helpful than “I feel so sorry for you”. Acknowledging unseen symptoms such as fatigue, joint pain and mental stress with the words “I believe you” can provide great comfort and relief.

3. Think before you speak. Avoid blaming the person or trivialising what they are going through. Saying “you’re stressing too much” or “everyone gets stomach aches” or “I heard about a miracle cure” do nothing to improve their situation.

4. Getting down to business. If you’re an employer, are there ways in which you can adjust workloads, or provide for flexible hours, breaks or remote working, that would help your colleague? Think about the work environment and how accessible the toilet facilities are. Let your colleague know that it’s safe to discuss their needs without fear of judgement — “I want to sit down with you to find solutions that work for everyone”.

5. School of life. If you’re a teacher, allow the student to leave the class without having to ask for permission. For example, you could say “If you need to leave class, just go, we’ll catch you up later”. Think about how school deadlines can be adapted in the event of absence due to a flare-up. If going on a school trip, consider how the student can travel in comfort and enjoy the activity. Collaborate with the school counsellor to ensure emotional support is available as required.

6. A shoulder to lean on. If you’re a family member or friend, do include the person with IBD on invites to nights out and outings, but if the person is unwell and the answer is “no”, respect that. For example, you could ask “Would you like to stay in or do something low-key if you’re not up to going out?” Offer practical help with chores, errands and travel to medical appointments. On more manageable days, celebrate “small wins” and enjoy the moment.

FISH OIL SUPPLEMENTS ‘BEAT OILY FISH AT REDUCING HARMFUL BLOOD VESICLES’

A new study has shown that fish oil supplements can be more beneficial at reducing harmful blood vesicles than eating oily fish. Dr Anna Sanniti, a registered nutritional therapist and nutritional advisor to Wiley’s Finest, provides insights into the study and its findings.

She says: “This randomised, doubleblind, placebo-controlled trial looked at the change in numbers of extracellular vesicles if consuming omega-3 fatty acids EPA and DHA from the diet (oily fish) compared with supplementation. “Extracellular vesicles contribute to many processes in the body, such

as blood clotting and tissue repair, and may be linked to diseases such as cardiovascular disease or diabetes.

“This study has shown that fish oil supplements can have added benefits compared with just eating oily fish. The group consuming fish oil supplements had increased concentrations and ratio of EPA to DHA, as well as reduced extracellular vesicles and reduced thrombin, which can contribute to cardiovascular disease events, such as damage to the blood vessel walls.

“Scientists still do not have all the answers as to why this is, but it seems that these effects are due partly to an increase in EPA levels. Other studies have also

demonstrated that EPA can reduce the risk of cardiovascular disease and is anti-inflammatory.

“Good-quality fish oil supplements have an important place in helping to reduce the risk of cardiovascular disease, protect brain health, and reduce inflammation. I recommend Wiley’s Finest Peak EPA to my clients as it is a high-quality, wild-caught fish oil that is four times more potent than regular fish oils. Speaking to a nutritional therapist about the concentration, ratio of EPA to DHA, and type of supplement is important to help achieve these effects depending on the individual.”

TEST YOUR KNOWLEDGE AND WIN €50

TEST YOUR KNOWLEDGE OF CARE AT THE COUNTER WITH OUR QUIZ, WHICH IS BASED ON THE CONTENT IN THIS ISSUE

1. True or false: The HSE advises that baby wipes should not be used until the baby is at least sixto-eight weeks old.

2. Multiple choice: How many deaths per year on average are caused by melanoma skin cancer? a) 500. b) 350. c) 170.

3. True or false: Oral diseases also share common risk factors with chronic diseases such as heart disease.

4. Multiple choice: To help with cramps, flatulence and bloating in IBS, the HSE recommends that people regularly eat: a) Fruit. b) Oats, such as porridge. c) Garlic.

Please send your completed quiz entries to: Greencross Publishing, Top Floor, Ebony House, Main Street, Wicklow Town, Wicklow. The winner will receive a cheque for €50.

5. True or false: Regular exercise reduces a person’s risk of developing up to 10 different chronic diseases. The winner from the Spring edition is Ms

Aine McPolin, Co Down

SCAN HERE TO ENTER ONLINE

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