Expert Q&A: Help patients kick severe dry skin

Podiatrist and Medline consultant Debra Manheim, DPM, ACPM, FAPWCA, reveals how one powerful product wins over patients who have dry skin

Dry skin can be irritating. When not managed properly, extreme dry skin can cause fissures and cracking. This can be particularly true for patients with venous insufficiency, especially when using compression wraps, says Debra Manheim, DPM, FACFAOM, FAPWCA. To help her podiatric patients, Dr. Manheim put her best foot forward with a treatment that has led to significant improvement.

Q. What are the challenges in treating this disease state of severe dry skin?
A. The challenge is getting patients to like and want to use a product and getting them to see a benefit with the product they’re using.
Q. You tried the urea-based Remedy Enlivaderm Hydrating Serum skin care product. What drew you to the product?
A. Because it’s a urea product, it doesn’t leave a white powdery film. Also, the vehicle is not a thick, heavy cream, but rather it goes on smoothly, absorbs readily and doesn’t leave a greasy feeling. It’s not occlusive like a petroleum. It checks all the boxes of what I’m looking for and what patients are looking for.
Q. What were you using on your patients prior to trying Enlivaderm?
A. I’ve tried a whole host of different products for specifically dry skin, and it’s very hard to get compliance and results.
Q. How often would a patient need to use Enlivaderm?
A. I think there’s always a need for use of moisturizer daily. Does it have to be Enlivaderm every day, twice a day, long term? Maybe. People in the category who have just neglected their skin for a long time may be able to switch back to a less concentrated product. But patients with venous inefficiencies and diabetic polyneuropathies are prone to severely dry skin and they’re going to want to use it long term.
Q. What has been patient feedback on the product?
A. The feedback has been fantastic. The patients love it. They’re ready to buy it. I’ve used it with diabetics with polyneuropathy, and I’ve used it in patients who do not moisturize. Those who have severely dry skin from not moisturizing regularly love it because it works better than anything else they’ve tried. I’ve never before had a patient call and say, ‘Do you have the cream? Can I buy it?’ The hard part is getting patients to use a product. They’re willing to use Enlivaderm and buy it because they like it. There hasn’t even been a discussion on cost. It’s been, ‘I like this cream; when can I get more?’ They love it—and I love the results I’ve been getting.
Q. Do you have any educational tips for wound care nurses to help their patients care for severe dry skin?
A. One of the things I like to do is, with one foot, I apply the Enlivaderm, and on the other foot another product, and I let the patient feel the difference. Then I take photos side by side of the different creams and how they look on the skin. That speaks wonders. I don’t even have to say anything. When the patient feels the Enlivaderm and starts moving their foot around and their skin around, they say, ‘Wait a minute, my foot feels different; it’s softer.’ It just speaks volumes. And something for me that hasn’t worked in the past is that my assistant took a sample, and she talks about how wonderful it is. Having her talk it up also works fantastically. She can say, ‘I like this; I use it on myself.’
Q. Any other suggestions?
A. I would encourage people to take pictures along the way. The pictures show the progression. To have patients who have had chronically dry skin say it feels better because of that cream and then, when they see the difference in the photos from what their foot looked like in the beginning, it’s worth everything. They can’t believe what their feet looked like before and what they look like now.
Watch this video to see Remedy Intensive Skin Therapy Enlivaderm in action.
Learn more about the Remedy system of advanced skin care.
Dr. Debra D. Manheim, DPM, FACFAOM, FAPWCA is a Medline consultant and the founder and owner of Step by Step Family Foot Care in Parsippany, New Jersey. Dr. Manheim is also a Diplomate (board certified) of the American Board of Podiatric Medicine and fellow of both the American College of Podatric Medicine and the American Professional Wound Care Association.