Bedbugs
Itchy, scratchy BEDBUGS!
Bedbugs are small, wingless insects found all over the world. They are a nocturnal parasite, which means they rest during the day and are active at night. However, bedbugs are opportunistic and will bite in the day, especially if starved for some time. They feed on the blood of humans and prefer to hide in bedding and on mattresses where they have ready access to a source of food.
However, their presence can be distressing and their bites can be highly irritating! Please note their presence is not an indicator of poor hygiene!
Where do bed bugs like to hide?
- Mattresses, particularly along the seams
- Bedding such as sheets and blankets
- Beneath loosened edges of wallpaper
- Between the cracks of wooden floors
- Wall cracks or crevices
- Carpet
- Furniture, particularly in seams and cracks
- Luggage and clothing being transported from one location to another
What do they look like? Can you see them?
Bed bugs can be detected visually, especially in the later stages of their life cycle when they can be over 5mm long. Small blood stains on mattresses are also another clear visual indicator of infestation; you may sometimes even be able to observe their “exoskeletons” after moulting.
Life Cycle of Bed Bugs
The 6 stages of bed bugs are as follows:
The Egg: The bedbug egg is 1mm long and hatches after 7 – 12 days.
Stage 1: First Instar Nymph : The bedbug is about 1.5mm long. When hatched, it is a beige colour however after its first blood meal, it will turn red. It will then shed its outer shell.
Stage 2: Second Instar Nymph: Immature – At 2mm long, the bed bug will shed its shell.
Stage 3: Third Instar Nymph: Immature – At 2.5mm long, the bed bug will shed its shell.
Stage 4: Fourth Instar Nymph : Immature – At 3mm long, the bed bug will shed its shell. The bed bug continues to grow and becomes easier to see.
Stage 5: Fifth Instar Nymph: Immature – At 4.5mm long, the bed bug will shed its shell. The bed bug is getting bigger and almost at its adult stage.
Stage 6: Adult: At 5.5mm long, the bed bug will feed and reproduce constantly.
Important note: Unlike headlice, bed bugs can survive for months away from the human host!
How do I know if I have been bitten by bed bugs?
- Bed bugs will usually bite on the arms and shoulders (or any exposed area of the body) which may result in small areas of swelling and itching of the skin. When bed bugs bite, they inject an anaesthetic (so you do not wake up from your sleep) and an anticoagulant (to make the blood thinner and feeding easier). Most people will not even realise they have been bitten until marks appear from one to several days after the initial bite.
- It can be difficult to distinguish bedbug bites from other insect bites. In general, the sites of bedbug bites usually are:
- Red, sometimes with a darker red spot in the middle (but this spot is not always visible)
- Itchy (although this symptom does not help you to distinguish from other “allergic” skin conditions)
- Arranged in a rough line or in a cluster, rather than just “here and there” on the skin (note this lines are not always clearly seen, especially if the person has had a
- “restless” sleep and has been “rolling” and moving around in the bed)
- Located on the face, neck, arms, legs and hands (rather than the ankles where sand- flies more commonly will focus their attack). Mosquitoes can also often be “ruled out” as the patient will usually “hear them” unlike the silent bed bug.
It is important to note that some people have no reaction at all to bedbug bites, whilst others experience an allergic reaction that can include severe itching, blisters or hives. Therefore, you may have slept in the SAME bed as someone else and only ONE of you will be experiencing symptoms.
Treatment Options for Optimal Care of our patients
Bed bugs bites do not usually pose a serious medical threat. The best treatment for a bite is to AVOID SCRATCHING the area along with the use of these common over-the- counter products found in your pharmacy:
Antihistamine Tablets
Antihistamine tablets will help to relieve the allergic reaction that you are experiencing from the bites and will help to reduce the inflammation and “itching.” They will also help to clear up the bite marks faster, thus removing any unsightly “spots” on the skin. It is important to note that antihistamines should be used every day until the spots have cleared totally, as ceasing treatment too early may lead to the bites “flaring up” again and causing more unwanted symptoms. Non-drowsy antihistamines are usually preferred, as they are less likely to interact with your daily activities. E.g. Telfast, Fexorelief, Aerius. Drowsy antihistamines may be preferred in cases where the “itching” of the bites is disturbing your sleep at night. E.g. Phenergan, Polaramine – please note these “drowsy” antihistamines are Schedule 3 products and require consultation with the pharmacist.
Soothing creams with anaesthetic
These creams will help to “numb” the affected area, so that you are less likely to scratch while waiting for the antihistamines to “kick in.” They contain local anaesthetics (such as lignocaine and benzocaine) and antiseptic in a soothing cream base and are able to be used on open or closed lesions/wounds. E.g. SOOV Bite cream, Apothecary Itch-Eze Plus Cream (currently only available in QLD). Please note that non-sedating antihistamines are FIRST LINE treatment for beg bug bites and these creams are used IN ADDITION to these medicines and preferably not alone (as it will take much longer for the itching to stop and bites to clear).
Hydrocortisone Cream
If the bites are very red and inflamed or if there is blistering, your pharmacist may recommend some hydrocortisone cream alongside some antihistamine tablets to relieve the symptoms. These creams work by reducing the amount of “inflammatory mediators” in your body visiting the affected area and thus reduce inflammation and itching. E.g.
Dermaid, Cortic-DS, Amcal Skin Irritation Cream. Note: these creams cannot be applied to broken skin!!
Antiseptic cream
Sometimes a secondary bacterial infection may develop if you have been scratching the bed bug bites. If the skin has become broken, it is important to apply a good quality antiseptic cream to avoid any infection. E.g. Betadine, Savlon, Bepanthan Antiseptic cream.
Soap-free washes
Soaps can dry out the skin and cause further irritation to the already inflamed and “itchy” bites. Consider using a soap-free wash (especially those with pine tar or oatmeal) to avoid drying out the skin and soothe those irritating bed bug bites. E.g. Pinetarsol, Dermaveen.
Ice Packs
Ice packs provide symptomatic relief of itching from the bed bug bites. Consider using ice packs to soothe particularly “itchy” bed bug bites, along with the other products
recommended previously in order to maintain “optimal care.”
Repellants
Deet will work well to repel these insects at night; however, it is important to choose an appropriate strength that will last over 8 hours; otherwise, they will start to bite as soon as the repellent wears off. We recommend Bushman’s Gel with 80% DEET. Please ensure you apply to all exposed skin before sleep.
Lifestyle Advice for Management and Prevention of Bed Bugs
- Avoidance of infested areas is THE method for prevention of bed bug bites. Thus, recognition of bed bug infestation ( see page 1 of this information leaflet) and proper treatment of affected rooms is the best way to prevent bed bugs in the home.
- Reduce the number of hiding spots available to bed bugs by eliminating cracks and crevices.
- Tuck your sheets in around you at night or wear clothes to bed!
- Sleeping with the lights on has not been shown to be effective in preventing bed bug bites.
- If you suspect you have bed bugs, look thoroughly in the areas they like to hide (see page 1 of this information leaflet). Remove mattresses from bed frames to complete a thorough check of the bedroom. Infested areas including all possible hiding places should then be treated with an appropriate insecticide (by using a qualified pest control company!!)
- Vacuum the infested area thoroughly including the mattress and place the contents of the vacuum cleaner bag in a sealed plastic bag for disposal. Mattresses should be sealed in dark plastic and left outside in the hot sun for as long as possible.
- The application of steam to the infested areas may also help to treat the infestation.
- All clothes and bedding suspected of being infested should be washed in hot water (at least 60 degrees Celsius) and/or heated ironing or drying. Delicate materials can be placed into the freezer.
Items not able to be washed should be put in black plastic bags and hung in the sun for a few hours, as high temperatures will kill any infestation –please note this includes your toiletries, purse, notebooks etc
Get your carpets steam cleaned professionally on a regular basis.
Good hygiene practices in your home such as regular house cleaning should help to prevent further infestation
Note: The best way to prevent bed bugs is regular inspection for the signs of an infestation! Make sure YOU know what to look out for!
Cold and Flu
Sneeze, sneeze….sniffle, sniffle do I have a cold or the flu?!
Common colds and the ‘flu’ (influenza) are viral infections affecting the nose, sinuses, throat and airways. Antibiotics do not work against these viral infections, but colds and the flu usually get better on their own. Medicines may relieve some of the uncomfortable symptoms of colds and flu.
How are colds and flu spread?
When someone has a cold or flu, the fluid from their nose, mouth and airways contains the infecting virus. Colds and flu spread when this infected fluid passes to someone-else (e.g., by touch, coughing, sneezing). Colds spread easily, especially between children who spend a lot of time together (e.g., at childcare or school). A cold is most infectious in the first one or two days after symptoms develop.
Signs and symptoms
Cold Symptoms include:
- Runny Nose
- Blocked Nose (Congestion)
- Sore Throat
- Red, watery eyes
- Sneezing
- Coughing
- Mild Fever
- Headache
- Tiredness
Flu (influenza) symptoms are similar to cold symptoms, but are usually more severe and may also include:
- High fevers, sweating and shivering
- Aching muscles and joints
- Weakness and lethargy
- Loss of appetite, nausea and vomiting
Cold and flu symptoms usually go within 10 days, although a cough may last longer.
How can I protect myself from colds and flu?
Protection against Influenza
A ‘flu injection’ will give protection against the ‘flu’. Vaccination, before the ‘flu’ season starts each year, is recommended for all adults over 65 years, and others at a higher risk of getting influenza. Please note that the flu vaccine CANNOT give you the flu—this is a common misconception in the community. Prescription medicines to treat influenza are also available. Ask a doctor or pharmacist for advice.
Please note: you can now have your annual flu vaccination given by your local LiveLife pharmacist. We have trained pharmacists available most days for this service.
Self care for colds and flu
- Get plenty of sleep and rest and stay comfortably A child with the flu should rest and keep warm until their temperature has been normal for 48 hours.
- Drink plenty of fluids to help thin mucus and prevent dehydration. Offer babies water between feeds. Adults and children should drink enough water every day to satisfy thirst and keep their urine light-coloured (unless a doctor advises not to).
- Breathe in steam (e.g., from inhalations, vaporizers, showers, baths) to loosen Avoid inhalations for young children, as steam can burn.
- Blow nose gently, with one or both nostrils Mucus can be removed from a baby’s nostrils with a bulb syringe – ask a pharmacist.
- Cover nose blowing with a tissue and dispose of used tissues Cover nose and mouth when coughing and sneezing, preferably with a tissue or the bend of your elbow, not your hand.
- Wash hands regularly with soap and water, especially before cooking or eating and after blowing nose, coughing or sneezing. If soap and water are not available, use an alcohol based hand sanitiser.
- Wash children’s dummies and toys
- Keep hands away from eyes, nose and
- Avoid sharing eating and drinking
- Eat regular, healthy meals, including plenty of fruit, vegetables and grain Limit foods high in fat, sugar or salt.
- Avoid cigarette smoke – it can make symptoms worse
- Limit alcohol
What medicines are available to help my symptoms?
A variety of non-prescription medicines can help relieve cold and flu symptoms. Some cold and flu medicines should not be used by young children, pregnant or breastfeeding women or people with certain medical conditions (e.g., diabetes, glaucoma, high blood pressure). Some can interfere with other medicines. Always ask a pharmacist for advice.
Medicines that can help relieve cold and flu symptoms include:
Decongestants
- May clear a blocked nose. They are available as syrups, tablets, nasal sprays and
- Nasal sprays and drops should not be used for more than five days in a
- Check with a doctor or pharmacist before giving to children. Antihistamines
- May help relieve a runny nose, sneezing and a dry
- Should not be used for a ‘chesty’ cough that brings up mucus (phlegm or sputum).
- Check with a doctor or pharmacist before giving to Cough suppressants
- May relieve a dry
- Should not be used for a ‘chesty’ cough that brings up
- Check with a doctor or pharmacist before giving to Expectorants and Mucolytics
- May loosen and thin mucus in the nose, sinuses and
- Check with a doctor or pharmacist before giving to children. Medicines that can help relieve pain and fever:
Simple pain relievers (e.g., paracetamol, ibuprofen) can relieve headache, sore throat, aches, fever and shivering.
Note: Aspirin should not be given to children under 16 years of age, unless advised by a doctor.
Other treatments:
- Saline (salt water) nose sprays and drops may help loosen and remove mucus in the nose and sinuses.
- Medicated inhalations (e.g., menthol, eucalyptus) may help clear a blocked nose. Check with a doctor or pharmacist before giving to
- Sucking on lozenges may relieve sore throats and coughing. Avoid in young
- Gargles (anti-inflammatory, anaesthetic or antiseptic) can relieve sore throats. Avoid in young children. Betadine anti-viral sore throat gargle is particularly effective, as it contains iodine which helps to reduce the spread of the virus in the upper respiratory
- Vitamins and herbal supplements such as Echinacea, vitamin C, Olive Leaf, probiotics and Garlic— please consult one of our pharmacists for further advice on which supplement would be suitable for you
When should I go back to my pharmacist/doctor?
A more serious viral or bacterial infection or other medical condition may develop from a cold or the flu (e.g., an ear infection, sinusitis, asthma, bronchitis, pneumonia). Bacterial infections usually need antibiotic treatment.
Consult a doctor if symptoms persist for more than 10 days or if any of the following symptoms develop:
- High temperature (over 38.50 C) or chills
- Severe headache
- Stiff neck
- Light hurts eyes
- Skin rash, pale or mottled skin
- Unusual drowsiness or confusion
- Ear ache
- Shortness of breath, noisy or fast breathing or difficulty breathing
- Cough lasting longer than 4 weeks
- Yellow, brown, green or blood stained mucus (phlegm)
- Chest pain
- Muscle aches
- Eyes sticky with pus
- A child refuses feeds or fluids, is excessively irritable, has a strange high pitched cry or has a bulging
Cold Sores
Help I think I have a cold sore!! Does that mean I have herpes??
Cold sores ARE caused by the herpes simplex virus. However, there are 2 (two) types of herpes virus; HSV-1, which typically causes infection in or around the mouth and nose, and HSV-2, which usually causes genital herpes. However, it is important to note that it is possible for both type 1 and type 2 to cause sores in the genital area.
Cold sores affect a large amount of the population, with over 75% of adults have been exposed to the virus at some time in their life.
However, only one-third of infected people experience cold sores!
Most people suffering with a cold sore will visit their local pharmacy for advice. This information leaflet will give you some understanding of this condition, how it occurs, what it looks like and most importantly, how to treat it effectively. One of the most important things to remember with cold sores is that “time is of the essence!” The faster you start treating a cold sore with an antiviral tablet/cream, the better it will respond. Please don’t leave your cold sores for several days before visiting the pharmacy; if in doubt, check it out!
How do I know if I have a Cold Sore? What do they feel and look like?
The cold sore infection has four main stages:
- Tingle (prodromal stage) – most people experience localised itching and tingling a day or two before the cold sore appears.
- Blister—a collection of small blisters form; these may be accompanied by pain, tenderness and a sensation of heat and burning.
- Weeping—these blisters burst after a few days.
- Scab—the crust of the burst blisters dries up and eventually falls off after about 10 days. This leaves pink skin behind and does not generally leave a scar.
Who is at risk and how do you catch them?
As previously discussed, the cold sore is caused by a virus; most commonly, the Herpes Simplex Virus or HSV-1. This virus is extremely contagious, with the primary/first infection commonly transmitted by contact such as kissing the infected person or sharing eating utensils (important to note a person may still be infective AFTER their cold sore has “cleared up” through transmission of saliva). This primary/first infection with the virus may cause symptoms such as fever, tiredness, swollen neck glands, swelling, blisters/ulcers in and around the mouth and a sore throat. Once a person is infected with the virus, it may then lie dormant in their body for years, sometimes WITHOUT causing any symptoms. It is only when a “trigger” event occurs that these common cold sore symptoms actually present.
Some of the most common cold sore triggers include:
- Emotional or physical stress
- Lowered immune status
- Exposure to cold or windy conditions
- Sunburn
- Hormonal changes, such as the menstrual period
- Feverish illnesses, like the flu or a chest infection
Dental Health
You know the old saying, “don’t judge a book by its cover;” well unfortunately we are all guilty of doing just that. Think of how you felt the last time you met someone that had poor dental hygiene and bad breath – was your first thought that they didn’t take good care of their health? If you don’t brush and floss teeth daily, food particles can remain in your mouth, which promotes bacterial growth between teeth, around the gums, and on the tongue.
Dentists recommend brushing the teeth twice daily!
• Floss teeth before brushing – allowing loosening of any particles
• Brushing Your Teeth concentrating on every section of your mouth; don’t forget your gums and tongue!
• After brushing, it is important to use a good quality mouthwash for extra fluoride protection
Keeping your toothbrush safe from germs and working to its full potential
• After brushing, rinse your toothbrush under running water
• Store your toothbrush in a clean dry place
• Do not share a toothbrush, as this can spread germs
• Replace your toothbrush often (usually every 3 months)
How do I safely whiten my teeth?
This is such a common request in the pharmacy and it is important that you consult our pharmacists if you are at all unsure, as not everyone’s teeth are suitable for whitening. If your teeth and gums are not in healthy condition before whitening, the procedure may even cause more damage. Even if there appears to be nothing wrong with your teeth there may be other reasons why whitening may not work or be suitable.
If we find there aren’t any appropriate whitening kits for you in the pharmacy, remember artificial whitening is not the only option for maintaining white teeth. For healthier and better looking teeth in general you should:
• Brush the teeth twice a day for 2 minutes using a fluoride toothpaste
• Floss your teeth daily
• Chew sugar free gum after meals
• Drink water throughout the day
• Consume a sensible diet
• Visit your dentist regularly
• Avoid foods and drinks which may stain the teeth; e.g. herbal/black tea, coffee, red wine, spicy foods like curries, and cigarettes.
Diarrhoea
Diarrhoea is when bowel movements become watery, foul-smelling and the need to go to the toilet becomes frequent and urgent. It is important to note that diarrhoea has many different causes and can sometimes be a sign of a more serious condition, such as inflammatory bowel disorders. There are 3 different types of diarrhoea. Osmotic diarrhoea occurs when too much water is drawn into the bowels.
Common Symptoms accompanying diarrhoea
- Watery, foul smelling bowel movements
- Stomach cramps
- Nausea and vomiting
When do I need to see the pharmacist?
Please always check with the pharmacist if the person suffering with diarrhoea:
- Is a baby less than 6 months old or is elderly
- Is pregnant
- Has signs of dehydration (e.g. Sunken eyes, loss of skin elasticity)
- Is vomiting up all drinks for longer than 12 hours if an adult, or 6 hours if a child
- Has been vomiting for more than 24 hours
- Has had diarrhoea for more than a few days
- Vomits blood, or brown/green bile
- Has bloody or black faeces (bowel motions)
- Has severe pain in the abdomen or rectum
- Has a high fever (over 38°C)
- Is losing weight
- Has a weakened immune system
- Has an underlying medical condition (e.g., diabetes, epilepsy).
Common risk factors and causes for diarrhoea
Sometimes, as in the case of food poisoning, the cause of diarrhoea may be quite obvious, but it can be worrying when you don’t understand why you are experiencing these symptoms.
Some of the most common causes of acute diarrhoea include:
- Viral or bacterial infection
- Travellers’ diarrhoea (discussed further on page 2)
- Allergy or intolerance to certain foods
- Eating too much spicy or oily food or drinking too much alcohol!
- Menstruation (many women suffer from diarrhoea just before or after their periods)
- Stress
- Irritable bowel syndrome or Inflammatory Bowel Disease
Ear Conditions
Our ears are one of the most important parts of our body, not only allowing us to hear, but they also play a role in maintaining our balance, which is vital in our ability to function in daily life. Ear problems may be in the ear canal (external), such as infections, blockages, or perforations of the eardrum ; or internal, such as inner ear infections of the middle or inner ear areas. Sometimes the symptoms are similar, so it is sensible to seek medical care or advice if there is pain or a loss of hearing.
Basic Ear Anatomy
The ear has two important roles. It is our organ of hearing and our organ of balance. The lining of the ear canal is coated with wax, a type of lubrication that stops the tissues from drying out. The ear is made up of three different parts:
- The outer ear—this is the part you can see and its shape helps to collect sound waves
- The middle ear—separated from the outer ear by the eardrum, the middle ear contains tiny bones that amplify the sound waves.
- The inner ear—sound waves are changed into electrical impulses and sent to the brain. The sense organ of balance is located here too.
Why do I have trouble with my ears when I fly or scuba dive?!
You may have a blocked eustachian tube!
A rapid change in altitude and thus air pressure is equalised across the eardrum by a normally functioning Eustachian tube which opens frequently and widely enough to equalise these changes in air pressure. With altitude changes during the descent of an airplane, air pressure increases as the plane lowers. The air pressure change pushes the eardrum inward (retraction). This is when patients with Eustachian tube blockage can develop symptoms such as pain and fullness in the ear. These patients may also experience similar symptoms when riding elevators, driving through the mountains, or scuba diving.
Otitis Externa
Also known as “Swimmer’s Ear” or “Tropical Ear”
An inflammation or infection of the outer ear canal. This commonly occurs in climates that experience higher levels of humidity, as humid conditions cause excessive perspiration, and prolong the amount of time it takes for moisture to dry from the ear canal after swimming or bathing, hence making it more susceptible to infections. People who spend a lot of time in the water are also at an increased risk of getting this condition. The condition may also be caused by irritation from chemicals in hairsprays, shampoos, hair dyes etc, or cleaning
the ear canal with cotton buds/fingertips (don’t do this!). Symptoms include:
- Irritated, itchy ear
- Ear pain, often made worse by movements such as chewing
- Discharge from ear (may be smelly)
- Feeling of fullness in ear
- Reduced hearing
What is the treatment? Treatment is aimed at clearing any infection and keeping the ear canal dry. Ear drops containing a combination of antibiotics, antifungals and steroids are often prescribed by the doctor, and are the best treatment if there is a lot of pain or hearing loss.
For mild or early signs of discomfort there are effective treatments available over the counter that “dry” up the moisture in the ear and limit the infection progressing, and some of these drops are also effective to prevent infection if used each time water enters the ear.
Otitis Media
Also known as a “Middle Ear Infection”
An inflammation or infection of the middle ear. This condition is particularly prevalent in childhood and research shows 83% of children will have at least one episode of acute otitis media by the age of three years! This is because the tubes (called the Eustachian tubes) that connect the middle ear to the throat are smaller in this younger age group. The infection is usually caused by a viral or bacterial infection and often happens dur- ing or after a child has a cold.
Symptoms include:
- Ear pain and possible discharge
- Reduced hearing
- Fever
- Vomiting
- Irritability (infants may be unsettled, wake at night, rub their ears, have diarrhoea, lose their appetite)
What is the treatment? Paracetamol or ibuprofen may be used for the pain associated with the ear infection. Ear drops are not recommended and you should consult a doctor if symptoms do not improve in a few days (when they may decide to prescribe antibiotics).
Inner Ear Problems
These problems can affect both hearing and balance and are often caused by a virus.
Symptoms may include:
- Hearing loss, dizziness and nausea, vertigo (feeling light- headed and “giddy”).
What should you do? Patients experiencing any of these symptoms should see their pharmacist or doctor.
Foreign Body
A foreign body in the outer ear canal can cause inflammation, damage and infection. Seek medical attention as soon as pos- sible, especially with children.
Symptoms include:
- Ear pain
- Discharge from ear
- Reduced hearing
- Noise (if the object is a live insect)
Ear Wax
Wax build up is one of the most common causes of temporary hearing loss. But why does it happen? A waxy oil called cerumen is produced by the hair follicles and glands that line our ear canal. This ear wax actually protects the ear by trapping dust, microorganisms, and other foreign particles and thus preventing them from entering and damaging the ear. It also functions as protection of the delicate skin of the ear canal, preventing irritation when water is in the canal. The body’s normal function has a natural clearing mechanism of this wax, causing it to make its way to the opening of the ear, where it falls out or is removed by washing. However, in some people, the glands produce more wax than can be easily removed from the ear. This extra wax may harden in the ear canal and block the ear. Another common reason for wax blocking the ear ca- nal is if you try to clean the ear with a cotton tip and accidentally push wax deeper into the ear canal!
Symptoms include:
- Ear discomfort
- A feeling that the ear is blocked or full
- Noise in ears (tinnitus)
- Reduced hearing
What is the best treatment? Most cases of ear wax may be treated at home. There are many ear drops on the market containing ingredients that “soften” the wax and allow it to naturally clear from the ear. There are also ear syringing kits, which involve irrigating the ear in order to “flush” out the wax plug.
Eye Conditions
There are many different types of eye conditions that can affect people. Some can be easily fixed with over-the-counter medicines and do not cause any permanent damage; however others are more serious and may require urgent medical attention. This information leaflet will discuss the most common types of eye conditions that present in our LiveLife pharmacies and what treatments we have available for you.
Anatomy of the Eye
The front part of the eye (the part you see in the mirror) includes the:
- Iris (the pigmented part – the amount of pigment is determined by genes inherited from both parents)
- Cornea (a clear dome over the iris)
- Pupil (the black circular opening in the iris that lets light in)
- Sclera (the white part)
- Conjunctiva (an invisible, clear layer of tissue covering the front of the eye)
- Lens (helps to focus light on the back of the eye)
- Retina (special light-sensing cells that cover the inside lining of the eye – the retina converts light into electrical impulses which are then carried to the brain)
- Optic nerve (carries these electrical impulses)
- Macula (a small sensitive area within the retina that gives central vision)
Eye drop/ointment Administration
Here are some basic steps to remember when administering products into the eye:
- Shake the bottle if required and wash the
- Sit in front of a mirror if needed so you may see what you are doing
- Wipe the eyes to clear any discharge (with a clean tissue/pre-moistened eye wipe)
- Tilt the head back and gently pull down the lower eyelid and look up
- Hold the dropper or bottle above the eye and gently squeeze into the inside of the lower eyelid – please note: it is important to take care not to touch the eye or eyelashes with the dropper/bottle so as to avoid cross-contamination
- Press the tip of the index finger gently against the inside corner of the closed eye (over the tear duct) for 2 minutes to reduce drainage and increase the effectiveness of the
- Repeat the procedure with the other eye if needed and replace the
- If you have more than one type of eye drop to instil, wait 5 minutes before putting the next one in. This ensures the second drop won’t wash away the first
- If using eye ointment, usually a 5cm line of ointment inside the lower lid is a sufficient amount, then blink the eyes to distribute evenly
Are there certain storage conditions I should know about?
Some eye drops require refrigeration (e.g. some prescription products from the pharmacist); this is done in order to maintain integrity of the product and avoid premature degradation. However, most drops given over-the-counter may be kept below 25degrees Celsius.
You may prefer to still keep the drops in the fridge; this is fine and may even be a good
idea, as they will feel “cold” when put into the eye, thus making it easy to know whether the drop has made it inside the eye or not. Instilling “cold” eye drops will not do any damage to the person’s eyes.
If the eye drops are to be used at bedtime, it might be a good idea to keep them on your bedside table, hopefully aiding in compliance.
Always have a look at the expiry instructions for the eye drops/ointment you are buying; most eye drops used to have an expiry of 1 month after opening; however, there are some new preservatives on the market now that allow you to keep your bottles/tubes for up to 6 months. It is important to be aware of this, as keeping your eye drops for too long may lead to bacterial contamination.
Preservatives in eye drops – are they are problem?
It is important for anything that is put into the eye to be sterile. Thus, preservatives are often put into eye drops in order to make them last longer as a sterile product for your use. Of course these preservatives are safe; however, some people don’t tolerate them or may have some type of allergy when they use them.
There are a couple of options when this happens:
- The person can try and pinpoint if there is a particular preservative that irritates their eye (e.g. benzalkonium chloride) and try other drops that use a DIFFERENT preservative; OR
- They can try using “preservative free” drops in the single use minims (ask your pharmacist for further information).
Why are there moisturising drops, gels and ointments for dry eyes? What is the difference and why are all of these different formulas needed?
- Drops are quite thin in consistency; they are easy to apply into the eye, cause negligible blurring of the eyes and spread easily over the
- Gels are generally a bit thicker in consistency than drops but are still water based. They are still quite easy to apply and spread easily over the eye. Because they are thicker, they will generally last longer than the drops before draining out through the tear ducts.
- Ointments are thick and greasy; this makes them more difficult to apply and they can cause blurring of the vision before they melt into the eye. However, they provide intense moisture for the eyeball and do last considerably longer in the eyes, so are perfect for bedtime use. Often your pharmacist may suggest use of a similar product in “drop form” for during the day, then reserve the use of the ointment for
Why does the pharmacist ask about contact lenses? Why would that make any difference to what drops go into my eyes?
Some eye drops can damage the contact lenses if put in at the same time as a person is wearing the lenses. It is important that you let your pharmacist know if you are planning on wearing contact lenses whilse using other eye preparations.
Conjunctivitis
Most people think that conjunctivitis is when you get a sticky eye with yellow discharge. Although this may be correct in some cases, you may not be aware that there are actually many different varieties of conjunctivitis all with very different symptoms. The information below should help you to distinguish between these different conditions, but please remember you should speak with the pharmacist with any symptom based requests. To explain what conjunctivitis is, this condition is an inflammation or infection of the transparent surface layer that covers the white of the eyes (i.e. the conjunctiva).
Infective: Both viruses and bacteria can infect the eye and cause conjunctivitis. However it is important to be able to distinguish between these, as they require very different treatment regimens. You can catch infective conjunctivitis from being in close contact
with another person who has it, so it’s important to wash the hands after coming into contact with another infected person.
- Viral – often caused by a virus called adenovirus, this condition is accompanied by redness, irritation and clear, tear-like discharge from the eye. Usually starts in one eye, then moves to the other. This condition is usually treated with a combination of lubricant eye drops and decongestant if needed for redness/irritation; e.g. Visine advanced
- Bacterial – commonly caused by bacteria found in the skin/respiratory system (i.e. Staphylococcus aureus or Streptococcus pneumonia). This condition is accompanied by redness, irritation and a moderate-large amount of thick pus-like discharge (usually yellow) from the eye. Usually starts in one eye then moves to the other. It is important if you have this conditions, that you speak with the pharmacist, as the drops generally used are a S3 (pharmacist only) product; e.g. Chlorsig. The pharmacist may also need to refer onto the GP/optometrist.
Allergic – usually accompanied by intense itching, tearing, and swelling of the eye membrane. Pain is usually minimal or absent. This condition may also be accompanied by other “allergic” symptoms such as sneezing, itchy nose, scratchy throat and some swelling of the eyelid(s). Usually affects both eyes. Treated with a variety of different drops depending on the symptoms; e.g. antihistamine drop like Livostin or Zaditen, combination antihistamine/decongestant if there is associated redness e.g. Naphcon-A, a combination of oral antihistamine tablets plus eye drops, or even prescription products if not properly controlled with over-the-counter products.
Chemical – Conjunctivitis due to chemicals is treated via irrigation with saline solution. This type of eye injury is a medical emergency, as it can lead to severe scarring and intraocular damage. People with chemically induced conjunctivitis should not touch their eyes, regardless of whether or not their hands are clean, as they run the risk of spreading the chemical to another eye. A cleansing solution/rinse is usually used to try and remove the chemical; e.g. Optrex wash. However, it is important that all people with a possible chemical injury speak directly to the pharmacist.
Dry Eyes
A thin film of tears is swept over the eye surface every time you blink. However, sometimes you are unable to produce enough tears (lubrication) for your eyes, thus causing the surface of the eye to dry out. This condition can occur at any time in our lives; however it is most common as we get older because we produce a smaller volume of tears. Some medicines can also predispose a person to dry eye, as can some health conditions. Laser eye surgery may also cause a decreased tear production and dry eyes. If a person is suffering with dry eyes, they may find it difficult to wear contacts and spend time in air-conditioned environments. There are many different brands/varieties are dry-eye products; these will be discussed later in the leaflet.
So what type of symptoms does a person with dry eye experience? They may feel stinging or burning, itchiness in the corners of the eyes, redness, excessive tearing (to try and compensate for the dryness), stringy mucous in/around the eyes and increased sensitivity to smoke/wind, difficulty wearing contact lenses and blurred vision.
Welding flash/flash burn
This occurs when you are exposed to bright UV light and results in painful inflammation of the cornea, which is the clear tissue covering the front of the eye. It is quite common among welders (thus the name) as they are often exposed to a welding torch. Other causes may be from direct sunlight, a sunlamp in a tanning salon or reflection of the sun off the water or snow. This is generally a self-limiting condition that may be controlled with over-the-counter decongestant eye drops (which we will discuss later), but if the person does see any flashes of light, have changes in vision or worsening pain, it is important for them to be referred to an optometrist/GP.
**Prevention is always better than treatment—Protective eyewear should always be worn when in contact with bright UV light!
Blepharitis
This is an inflammatory condition that affects the eyelids and usually involves the part of the lid where the eyelashes grow. People suffering from blepharitis may experience itchy eyelids that can appear greasy, red and swollen eyes/eyelids, flaking of skin around the eyes, crusted eyelashes and even loss of eyelashes. The cause of this condition isn’t clear, but it is often associated with a type of dermatitis (seborrheic), bacterial infections, certain medications and allergies to eye medications/makeup. People with this condition need to clean the eyelids regularly and manage with over-the-counter products to minimise outbreaks; e.g. LidCare (we will discuss further later)
Blocked tear duct in an infant
Many infants are born with tear ducts that are not fully developed, or are narrower than usual. This means that the tears produced to keep the eye lubricated and moist are not able to drain through the tear ducts, into the nose. As a result of this, the infant’s eye is kept too moist and develops a sticky discharge (often referred to as “sticky eye”), with tears running down onto the cheek.
This condition is usually managed by regularly rinsing the eyes with sterile saline and wiping away the tears/sticky discharge with a clean cotton wipe. Sometimes gently massaging the tear duct will also help to drain away the tears. We have sterile saline wipes (Fess Little Eyes) available in the pharmacy which are perfect for use in this condition also. Please remember if the condition does not clear itself and/or if the discharge starts to look yellow/green, it is important to speak with your pharmacist.
Styes
A stye is a sore, red lump near the edge of eyelid, commonly caused by an infection at the base of an eyelash (in the hair follicle). The bacteria that can cause this infection commonly live on our skin, but if our skin is damaged, they can cause infection. As you have probably already guessed, this condition can sometimes occur as a complication of blepharitis if not well managed. Usually styes will clear up within a few days by using a hot/cold compress on the eye. However, if the condition does not clear spontaneously, the person may require assistance with an over-the-counter product – please consult the pharmacist with this symptom based request. See optimal care section for treatment options. NB. It is important NOT to squeeze the stye – it contains bacteria, which if released, may make the condition spread and worsen.
Foreign objects in the eye
A foreign body simply means when there is an object in the eye that shouldn’t be there; this may refer to things such as a speck of dust, wood chip, metal shaving, insect or piece of glass. Obviously this is something we need to clear from the eye as quickly as possible. Usually we would recommend a cleaning solution such as Optrex to try and clear the object from the eye asap; however, it is also important the person is referred to an optometrist/GP for further observation, as the objects can sometimes cause a scratch on the eye’s surface and/or infection.
Scratches to the eye—usually occur after a foreign object has been in the eye. It is important that the eye is rinsed out thoroughly as described above and the person should be referred straight away to their optometrist/GP.
Floaters
Floaters are tiny dark specks that may be seen in your field of vision, especially when looking at something light-coloured such as a blue sky or white wall. They are created when little clumps form in the clear, jelly-like substance inside the eyeball. The floaters are suspended in this jelly, so they move when the eyeball moves. Usually floaters are normal and harmless; however, a sudden increase in their number may indicate damage to particular internal structures of the eye (e.g. retina) and thus requires urgent medical attention, especially if there are any other associated symptoms such as flashing lights or auras. Please speak to your pharmacist if you experience this.
Optimal Care Products
- Lubricating eye drops/gels/ointments—e.g. Refresh Tears Plus, Genteal Drops/Gel, Optive, Lacrilube
- These preparations moisturise and lubricate the eyes by replacing an artificial tear film.
- Useful for dry eyes, irritated eyes (e.g. after laser surgery)
- Available over-the-counter
- Antihistamines—e.g. Zaditen, Livostin, eyezep
- Eye drops useful for treating allergic conjunctivitis
- Available over-the-counter (schedule 2)
- Anti-redness—e.g. Clear Eyes, Albalon
- Contain “decongestants” such as naphazoline, phenylephrine, tetrahydrozoline—these work by constricting the blood vessels in the eyes and thus reducing redness
- Useful for welding flash, viral conjunctivitis, sore red eyes from swimming
- These products should not be use regularly for more than 5 days, as they can lead to REBOUND CONGESTION (i.e. the condition worsening)
- Combination products—Visine Advanced, Albalon-A, Naphcon-A
- Contain a combination of lubricant/antihistamine/decongestants so they may control several symptoms; e.g. Visine advanced is decongestant plus lubricant, Naphcon-A and Albalon-A are decongestant plus antihistamine
- Useful when the person is suffering from several symptoms (e.g. redness and dryness, or itching, swelling and redness)
- Antibiotic Drops/Ointment—e.g. Chlorsig. These are a S3 item that will need pharmacist involvement. Useful in bacterial conjunctivitis and sometimes in
- Wash solutions—e.g. Optrex
- These solutions are made to soothe tired, dry or irritated eyes and are also really useful for rinsing out the eyes if there has been any “contamination” of the area (e.g. sunscreen, moisturisers etc that can sting they eyes).
- Optrex has an eye bath inside the packaging—how do I use that? Rinse eye bath before and after use. Fill eye bath one third full. Bend head slightly forward, holding eye bath by its base. Placed over eye. Slowly raise head with eye open so that the wash flows freely over it. Gently rock head from side to
side for at least 30 seconds. Discard any wash left in eye bath. Repeat for other eye with fresh wash solution.
- Eye-lid cleaners—for blepharitis; e.g. Lid-Care. These solutions help to cleanse the lid and lashes of any crusting, oils etc in order to control
- Eye baths sold separately—these are useful to have at home even with some sterile saline ampoules just in case of any accidents requiring a quick eye wash—great for first aid kits too!
- Contact multipurpose solutions—these come in a variety of sizes—people going on holidays sometimes like to purchase “travel size” as well as their usual “bulk size” so they have something practical to pack
- Storage containers for contacts—essential for storing/disinfecting those contact lenses.
- Fess Little eyes—these are the sterile pre-moistened saline wipes mentioned earlier in the conjunctivitis and blocked tear duct section. They are especially useful for parents to keep with them during the day (as open saline ampoules can be quite impractical for cleaning the eyes when out-and-about). These are very safe and may be used at any age. Also great for first aid kits!
- Saline ampoules—may be purchased separately—yet again another essential for the first aid kit, not only for the eyes, but also for washing down any wounds. May be used to rinse the eye if irritated and also to cleanse in between using eye drops for conditions that cause any exudate from the eye (e.g. Conjuntivitiis)
- Make-up wipes (preferably without the messy fibres so they don’t get stuck in the eyes)—useful for wiping the eyes out after rinsing with
Fat and Cholesterol
Our bodies need cholesterol and fats (triglycerides), but having too much cholesterol or fat in our blood can increase our chances of developing high blood pressure, heart disease and stroke. High cholesterol and triglyceride levels can be lowered with healthy eating, lifestyle changes and medicines.
Fats occur in our food as:
Polyunsaturated fats
They include:
• Omega-3 fats – mainly in oily fish and fish oils (e.g. salmon, sardines, some tuna), some plant and seed oils (e.g. canola, soyabean), walnuts and linseeds (flaxseeds)
• Omega-6 fats – mainly in fish, plant and seed oils (e.g., canola, sunflower, soybean, sesame), some nuts (e.g., walnuts, peanuts, pecans, brazil nuts, pine nuts) and linseeds
Monounsaturated fats
These fats are found mainly in fish, plant and seed oils (e.g., olive, canola, sesame), some nuts (e.g., hazelnuts, peanuts, cashews, almonds, macadamias, pecans, pistachios) and avocados
Saturated fats
These fats are mainly in animal products (e.g., milk, cream, cheese, butter, yoghurt, meats), coconut and palm oils, commercially baked products (e.g. pastries, cakes, biscuits, pies, buns) and deep-fried fast foods (e.g. chips, crisps)
Trans fats
Occur mainly in commercially baked products (e.g., pastries, cakes, biscuits, pies, buns) made with hydrogenated or partially hydrogenated Vegetable fats or oils
Our bodies convert fats from our food into triglycerides and cholesterol. Saturated and trans fats are especially readily converted into cholesterol.
Cholesterol (which is similar to fat) also occurs naturally in animal products (e.g. dairy products, meats, egg yolks, shellfish, liver, kidney, brains). Saturated and trans fats in food increase ‘bad’ cholesterol blood levels more than cholesterol in food does.
Cholesterol and Triglycerides
Our bodies need a certain amount of cholesterol to make cell membranes, bile salts, hormones and vitamin D. Our bodies need a certain amount of triglycerides as a source of energy. Some of this cholesterol and triglycerides comes from food and some is produced by the liver. Cholesterol and triglycerides travel in the blood in lipoproteins.
LDL cholesterol
Low-density lipoproteins (LDL) carry cholesterol from the liver to body tissues that need it. Excess LDL cholesterol can build up in blood vessel walls and block blood flow. LDL cholesterol is called ‘bad’ cholesterol.
HDL cholesterol
High-density lipoproteins (HDL) carry cholesterol away from body tissues back to the liver, for removal from the blood. HDL cholesterol is called ‘good’ cholesterol.
Triglycerides
Very low-density lipoproteins (VLDL) carry triglycerides from the liver to body tissues where they are stored or used for energy. Excess triglycerides build up in body tissues as ‘body fat’.
Problems caused by excess LDL cholesterol and triglycerides include:
• Blocked blood vessels – leading to heart attack, stroke, angina, high blood pressure, kidney failure
• Cancer of the colon and rectum
• Constipation and bowel problems
• Diabetes
• Weight gain.
Healthy cholesterol and triglyceride levels
To reduce the risk of heart attack, stroke and other cardiovascular conditions, the Heart Foundation currently recommends a:
• LDL cholesterol blood level less than 2.5 mmol/L (or less than 2.00 mmol/L for people with heart disease)
• HDL cholesterol blood level more than 1 mmol/L
• Triglycerides blood level less than 1.5 mmol/L.
High LDL cholesterol and triglyceride levels are usually the result of eating too much food containing saturated and trans fats. Some people have a high LDL cholesterol or triglyceride level despite a healthy diet, as they metabolise fat in a different way. This can be inherited.
Tests
A blood test can measure blood cholesterol and triglyceride levels. Ask your doctor for this blood test if you:
• Are over 45 years old
• Have a family history of heart disease, diabetes or high cholesterol
• Have had a heart attack or stroke or have heart disease
• Have high blood pressure, diabetes or kidney disease
• Are an Aboriginal or Torres Strait Islander
• Smoke
• Are overweight
• Regularly eat high fat foods
Hay Fever
Hay fever is the common name for allergic rhinitis; rhino meaning ‘of the nose’ and its meaning ‘inflammatory.’ Thus, allergic rhinitis is defined as an inflammation of the nose caused by allergies. Hay fever may be perennial, which means symptoms are present throughout the year, or seasonal, with symptoms present during the months of spring and summer only.
The incidence of allergies in Australia has approximately doubled over the past few decades and statistics now predict 1 in 3 Australians will develop allergies at some time during their life! This shows you how important it is to understand allergies and what effect they have on your body.
Why do some people get allergies?
An allergic reaction occurs when the body’s immune system treats a harmless substance as if it is dangerous. This means that the body will launch an attack, causing the nasal passages to become inflamed and produce excess amounts of mucus. These substances that the body reacts to are called “allergens” and it is important to note that only susceptible people will react to them.
So what are these allergens?
There are many different types of allergens. Some of the most common allergens include:
• Food (e.g. shellfish, peanuts, eggs, milk)
• Plants
• Insects (e.g. dust mites, venom from wasps, ticks and bees)
• Moulds
• Animal dander
• Medicines and chemicals (e.g. antibiotics, latex rubber)
Since allergic rhinitis mainly affects the nose, it is important to understand how the nose works and what it does for the body…..
The nose is a very important part of our body and provides 5 essential functions:
• Provides an airway to assist us in breathing
• Warms and moistens the air entering our body
• Filters inspired air in order to cleanse it of foreign matter
• Serves as a resonating chamber for speech
• Houses our smell (olfactory) receptors
How do you treat allergic rhinitis?
Your pharmacy stocks a wide range of treatments that may help to relieve the symptoms of allergic rhinitis (hay fever). It is important to remember all patients with a symptom-based request should speak to your LiveLife pharmacist to ensure the most effective treatment strategy is used.
Head Injuries and Concussion
Chances are you have bumped your head before. Usually the injury is only minor because our skull is so hard and protects our brain. But some head injuries can be more severe, such as skull fracture, concussion or traumatic brain injury. Some of the most common causes of head injury include accidents at home, work, outdoors or while playing sports, falls, physical assault and traffic accidents. This information leaflet will discuss head injuries to give you a better understanding of how they happen, what they look like and how they should be managed.
So what do you mean by head injury? Do you mean when someone splits their head open?
Head injuries can present in many different ways, but are categorised broadly into 2 categories:
• Open/penetrating head injury – when a high velocity object breaks through the skull and enters the brain. This usually happens when you move at high speed such as going through the windshield during a car accident.
• Closed – when the head sustains a blunt force by striking against an object that does not break the skull ***Important to note that closed injuries are not always less severe than open injuries – you should treat them all with extreme caution***
Some examples of common head injuries:
• Concussion – occurs when there is no structural damage that can be seen on standard imaging tests like CT scan, but there ARE functional changes that occur in how the brain works. The brain floats in cerebrospinal fluid and is encased in the skull. These protections allow it to withstand many of the minor injuries that occur in day-to-day life. However, if there is sufficient force to cause the brain to bounce against the rigid bones of the skull then there is potential for injury.
• Brain contusion – this is when the brain becomes bruised; thus leading to some bleeding in the brain, resulting in swelling.
• Skull fracture – this is when the actual skull cracks. Another complication can occur from this, with the edges of the broken skull bones sometimes cutting into the brain and causing injury.
• Haematoma – this is bleeding in the brain that collects and clots to form a bump. Note that a haematoma may not be apparent for a day or even as long as several weeks!
Signs and symptoms
Symptoms vary according to the type and severity of the injury. Some of the more common ones are:
• Headaches
• Dizziness
• Fatigue
• Being a little slower than usual to think
• Difficulty performing complex tasks
• Mood changes
• Difficulties with concentration
• Difficulties with memory, especially with the events surrounding the head injury
Note that these symptoms generally only last a few days and then improve. Refer below for when to speak to your health professional for more critical medical assistance.
When to seek urgent medical care
• If there is severe head or face bleeding
• If the person is confused, drowsy, or unconscious
• If the person stops breathing
• If you suspect a serious head or neck injury
• If the person behaves abnormally
• If they develop a severe headache or stiff neck
• If they vomit more than once
• If there is any bleeding or watery discharge from the ears or nose
• If the person suffers from any fits
What not to do in a head injury
• Do not wash a head wound that looks deep or is bleeding profusely—this may disturb the natural clotting around the wound and cause it to bleed more
• Do not remove any objects stuck in the wound
• Do not move the person unless absolutely necessary
• Do not shake the person, even if they seem dazed
• Do not remove a helmet from a person who may have serious head injury
• Do not pick up a fallen child with any sign of head injury
• Do not stay in bed until you are better. You do need sleep for recovery; however, your brain also needs enough to do to help it recover.
• Do not use drugs or alcohol, as your brain may not deal with these things in the normal way.
• Do not drive your car/motorbike until you are sure your concentration and reaction times are back to normal
• Do not play sport or put yourself in a position where you are likely to get another bang on the head, as your body is still trying to heal.
Head Lice
Head Lice
A comprehensive tool for you to learn all about those dreaded head lice. If you require any further information, please don’t hesitate to call on your local LiveLife pharmacy for fantastic advice on controlling and preventing this condition.
Let’s learn something about head lice…
• Head Lice are small wingless insects that are found on the human head, living on the hair and feeding by sucking blood from the scalp.
• They cannot fly or jump but have strong claws and will swing from head to head through close contact such as cuddling, playing or working closely together. They can only survive up to 48 hours away from a human host; this is because they need to regularly feed on human blood or they will die from dehydration.
• It is important to be aware they cannot live or breed on animals, clothes, toys, furniture, carpet, or bedding; they can only survive on the human head. There is a lot of misguided information about the nature of head lice and the types of treatments available for managing the problem. Head lice can be extremely frustrating for parents/carers as they are a very common occurrence amongst school aged children and they often have reoccurring problems. It is important to be aware that head lice are not related to poor hygiene and there is no preference for clean or dirty hair. They do not carry or transmit disease and have been around for thousands of years.
How do I know if someone has head lice?
When most people think of head lice, they immediately think of someone scratching their head as this is the obvious symptom. However, less than half of patients suffering with head lice will have an itch.
Other signs and symptoms to look out for include:
• Rash (which is caused by scratching),
• Presence of eggs (these look like white specks which are stuck to the hair near the scalp and do not fall out when shaken),
• Presence of lice on the scalp/hair,
• In some cases, patients may have an allergic reaction to the bites which can cause severe itching and become infected.
• Please refer below on how to use the “Conditioner & Comb Method” so you are easily able to detect head lice – please see below:
Conditioner & Comb Method
The most effective method of detecting head lice is to use the conditioner & comb method. To do this you will need white conditioner, a normal comb, a fine tooth comb and white tissues.
1. Apply enough conditioner to dry hair to cover the scalp & hair from roots to tips.
2. Using the normal comb, detangle hair to distribute the conditioner evenly & divide into four sections.
3. Using the fine tooth comb, comb hair from roots to tips and wipe the comb on the tissue after each stroke to check for lice & eggs.
4. Continue process until the whole head had been checked and the majority of the conditioner is off the hair.
5. Ensure that all the tissues are placed in a plastic bag, tied up and put in the rubbish bin.
6. This process should be repeated weekly on all members of the family/household if infestation remains.
Treatment Options
What methods are available to treat head lice?
Regardless of the treatment used, the only way to eradicate head lice is by removing the lice and eggs (dead or alive). There are two methods of treatment that can be used, and it is important to note that there is no need to treat if lice or eggs are not present.
Conditioner & Comb Technique:
• As explained, this is the best way of detecting head lice but can also be used as a treatment. This is the safest option as it contains no chemicals and should be used especially if the patient has sensitive skin, is under 2 years of age, pregnant, breastfeeding, or has sores on the scalp. Note this method will not kill/remove eggs.
• This method is a cheaper alternative but should be repeated daily for 10 consecutive days until no live lice are found.
Insecticide products:
• These can be either synthetic or natural and are listed in the table below.
• Should not be used in children under 2 years of age or in pregnancy or breastfeeding. Care should also be taken for use in people who suffer from asthma, allergies or eczema (always check with your pharmacist).
• Where a parent/carer is pregnant or breastfeeding and they are treating their child, they must ensure that gloves are worn as the chemicals can still be absorbed through the skin.
• By examining the life cycle on the previous page, you can see that eggs hatch in around 7-10 days; therefore a second treatment should be applied 7-10 days after the initial treatment. You may ask why all of the eggs won’t be dead already after the first treatment. It is important to inform them that even the most effective chemical treatments will not kill 100% of the eggs present!
• Please note that these products should not be repeated twice in a week even if the treatment does not work. Using a product too frequently can cause head lice to build up a resistance to the agent used and can also lead to toxicity (due to excess absorption of the product through the skin).
Please note:
Just because the product says it is natural, doesn’t mean the person is not going to have an adverse reaction. Always test for irritation/allergy on the skin (perhaps using the back of your hand) before using any new product. This is especially important for those who have sensitive skin.
Heartburn & Indigestion
Ever had that rising pain and burning sensation in your chest? Feel like you’re having a heart attack? It’s more likely that you are suffering from heartburn or indigestion.
Heartburn affects more than your physical health; it can affect your quality of life. Up to 1 in 5 Australians experience heartburn at least once a week—a staggering statistic and certainly good reason for you to understand the condition and be able to manage it should you or a close family member/friend experience it.
Heartburn is a common feature of indigestion and happens when the acid contents from your stomach escape back up into your oesophagus (gullet). This causes a burning sensation in your chest which often rises up towards your throat.
Common Signs and Symptoms
• Abdominal pain
• Acid indigestion (acid reflux) with an acidic taste in the mouth
• Bloating
• Nausea with/without vomiting
• Excessive gas (burping or flatulence)
• Constipation/diarrhoea
• Decreased appetite
• Gurgling, rumbling or growling stomach discomfort
Risk Factors
A person may suffer from heartburn/indigestion for a number of reasons.
Below is a list of risk factors that may increase the chances of developing heartburn symptoms:
• Eating a large meal too quickly
• Engaging in physical activity such as lifting or bending after eating a large meal
• Consuming coffee, alcohol or chocolate
• Eating spicy foods
• Eating fatty/greasy foods
• Smoking cigarettes
• Anxiety and/or stress
• Advanced pregnancy, when the baby starts to push up against the stomach contents
• Being overweight/obese—this is because the extra fat inside the abdominal wall reduces the amount of room for the stomach and small intestines. Thus any extra pressure on the stomach will force the stomach contents up into the oesophagus.
• Taking medicines that decrease the protective layer in our stomach, thus increasing
the effects of acid (e.g. Ibuprofen, aspirin, diclofenac)
• Wearing tight clothes that may put extra pressure on the stomach
I’ve heard people talk about GORD—is it the same as heartburn?
GORD stands for Gastroesophageal reflux disease and is a “disease” with heartburn being its most common “symptom.” GORD may be classified under 2 different entities:
Erosive GORD occurs when stomach acid moves in the wrong direction, flowing back up (reflux) into your oesophagus, causing discomfort. Over time, reflux of acid may erode the lining of the oesophagus, leading to inflammation and ulcers. The heartburn symptoms caused by this condition are generally controlled by very safe effective prescription medications from your GP.
Symptomatic GORD refers to a presence of typical symptoms of gastro-oesophageal reflux, but the wearing away process cannot be seen during an endoscopy. Although this condition may not lead to as many complications, symptoms can be as severe as those experienced with erosive oesophagitis.
When should you speak with your pharmacist?
• If you feel as though the pain may be from the heart (i.e. it radiates through the jaw or into the arm and/or it gets worse when you exert yourself)
• If you have severe abdominal pain and/or vomiting symptoms (especially if it is blood-stained)
• If you have experienced unexplained weight loss
• If the bowel motions are tarry and black
• If antacids are needed more then 3-4 times a week or for more than 2 weeks in a row
• If there is any difficultly/pain when swallowing
• If you are on other medicines, especially an anti-inflammatory
What is an endoscopy?
An endoscopy involves examining the inside of a person’s body using an endoscope (a small medical device consisting of a long, thin tube which has a light and a video camera). Images of the inside of the patient’s body can be seen on a screen. Endoscopy is a minimally invasive diagnostic medical procedure and is helpful in examining interior surfaces of organs/tissue and also enabling biopsies/retrieving foreign objects.
Lifestyle Advice
• Chew your food completely and eat slowly
• Eat smaller meals more frequently, rather than 3 large meals daily
• Avoid late-night eating (i.e. try timing your meal so that you finish at least 2 hours before lying down/going to bed)
• Keep a food diary to work out which foods are your heartburn triggers
• Recognise and avoid foods that cause symptoms. Common triggers include spicy or fatty foods, tomatoes, orange juice, coffee and chocolate.
• Avoid caffeine
• Quit smoking
• Avoid over-indulging in alcohol
• Wait at least 30 minutes after eating for exercise
• If you take NSAIDS (e.g. nurofen, aspirin, voltaren), make sure they are always taken with food in the stomach
• Elevate your bed-head
• If you are overweight, losing some weight will help
Sometimes you may not wish to use “pharmacological” means to relieve your heartburn. If this is the case, there are some other options available in the pharmacy which may provide some mild symptom relief. Please read on……
Antacids
If heartburn occurs infrequently and is mild, you may need to take medicine only “as needed” to soothe the symptoms when they arise. Antacid medicines are available over- the-counter at our pharmacies and are unscheduled items (i.e. kept in the front of shop).
Antacids act by neutralising the acid found in stomach juices and thus relieve heartburn symptoms quickly. However, it must be noted that their effect is temporary and short- lived, as they will only work on the acid present in the stomach at the time of taking them.
They may be taken as a liquid or as a chewable tablet and most commonly contain aluminium, magnesium and/or calcium salts.
Please note:
• Antacids can interfere with the absorption of some other medications, so it is important to check your other medicines with the pharmacist before taking these products.
• It is also important to note that some antacids are high in salt and this must be considered if you are on a salt-restricted diet or in pregnancy, heart disease and high blood pressure. If you suffer from kidney disease, the pharmacist may also need to check some further points with you.
Heat rash
Heat rash is the “generic” name for a number of skin problems that arise or worsen because of heat exposure. Common names for heat rash include prickly heat, miliaria rubra, sweat retention syndrome, and “sun” allergy.
This disorder occurs all year round in the tropics, and elsewhere in the summer months when the weather is hot and humid.
But why does it happen?
Heat rash is caused by a blockage of the sweat glands, especially after repeated episodes of sweating, leading to inflammation when sweat escapes into adjacent tissue. This causes the itching and prickling sensations that most people seek treatment for, as well as the red rash, which may be extensive.
Most heat rash resolves without treatment, often within a day of changing to a cooler environment. Even though the sweat glands may take a week or two to be repaired, if there is not an excessive demand placed on the body for cooling, then the rash will clear quickly.
The challenge is to manage heat rash if you need to remain in a hot and humid environment. Treatment will involve helping you with relief of symptoms, and giving advice as to how you can avoid it getting worse, or recurring.
Who is at risk?
· Infants, and overweight children/adults are at particular risk of getting heat rash, as is anybody doing more physical activity than normal in a hot and humid environment.
· Heat rash is also easily caused, or aggravated, by any skin lotion that has the ability to enter sweat glands (i.e. almost all skin lotions) and block them.
· It is common to find sufferers of heat rash who have recently arrived in a hot area from a cooler climate, put on a good quality water resistant thick 50+ sunscreen, spent a lot of time outdoors in the sunshine enjoying themselves, and moisturised diligently after noticing some redness appearing on the skin. The increased and unusual demands on their sweat glands for cooling the body, the sunscreen, and the moisturiser have all contributed to the heat rash.
How can you avoid it?
Keep cool!!
· Remain in a cool environment e.g. air conditioning, in the water, or close to a fan, and allow for adequate ventilation of the skin.
· Take cool showers or baths, several times a day, and always after exercise or heat exposure. Always pat dry the skin with a towel, do not rub vigorously.
· Use cool packs on affected areas (but not for longer than 20 minutes per hour).
· Wear loose fitting, light, soft clothes. Avoid clothing that traps heat or moisture. Cotton underwear is better than no underwear if the groin or buttocks are affected.
· Avoid skin to skin contact elsewhere by placing a soft, clean washcloth or other material between skin folds e.g. under breasts.
· If the skin is irritated, avoid soaps, but use a non-soap alternative like Pinetarsol if necessary for cleanliness, or itch relief.
· Always avoid hot spas and saunas.
· Always wear a sunscreen, as sunburn will aggravate heat rash, but use an alcohol based or evaporative based sunscreen.
· Do not apply after-sun moisturisers to the affected area as they will block the already aggravated sweat ducts.
Come in and visit your local LiveLife pharmacist for more advice!
Life – Let us help you Live it!!!!
Insomnia
Why is sleep important?
Sleep plays a vital role in good health and well-being throughout your life. Getting enough quality sleep at the right times can help protect your mental health, physical health, quality of life, and safety.
Sleep helps your brain work properly. While you’re sleeping your brain is preparing for the next day. It’s forming new pathways to help you learn and remember information. Sleep also plays an important role in your physical health. For example, sleep is involved in healing and repair of your heart and blood vessels.
What happens if you don’t get enough sleep?
The damage from sleep deficiency can occur in an instant or it can harm you over time. For example, ongoing sleep deficiency can raise your risk for some chronic health problems. It also can affect how well you think, react, work, learn, and get along with others.
• Ongoing sleep deficiency is linked to an increased risk of heart disease, kidney disease, high blood pressure, diabetes, and stroke.
• Sleep deficiency also increases the risk of obesity.
• Sleep deficiency results in a higher than normal blood sugar level, which may increase your risk for diabetes.
• Ongoing sleep deficiency can change the way in which your immune system responds. For example, if you’re sleep deficient you may have trouble fighting common infections.
How can I improve my sleep?
Medications and herbs from the pharmacy are useful in aiding sleep, but it is important to also ensure you are practising good sleep principles DAILY to make certain you are giving yourself the best quality sleep possible.
Here are some tips for those of you who might be having difficulty in the sleep department.
• Reduce your caffeine intake – do not have any food, medicines, or drinks that contain caffeine or other stimulants after midday or for six hours before bedtime.
• Reduce or quit smoking; nicotine is a stimulant.
• Reduce your alcohol intake or at least avoid alcohol within six hours of bedtime.
• Do not have a heavy meal just before bedtime
• Do not do any strenuous exercise within four hours of bedtime (but exercising earlier in the day is helpful). Exercise that involves relaxation or meditation (eg., yoga) may be useful close to bedtime.
• The bedroom should be a quiet, relaxing place to sleep
• Earplugs and eye shades may be useful if you are sleeping with a snoring or wakeful partner.
• Make sure the bedroom is dark with good curtains to stop early morning sunlight.
• Mood and atmosphere – try to relax and wind down with a routine before going to bed
• Do not do anything that is mentally demanding within 90 minutes of going to bed, such as studying.
• Go to bed when sleepy/tired.
• If you cannot get off to sleep after 20-30 minutes then get up. If you can, go into another room and do something else such as reading or watching TV rather than brooding in bed. Go back to bed when sleepy. You can repeat this as often as necessary until you are asleep.
Psoriasis
Psoriasis is a skin disease causing red, scaly patches of skin but can also affect the nails and joints. This condition is not infectious but can be severe. Its exact cause is yet to be determined but we do know that the immune system and genetics play major roles in its development. A common belief is that the immune system is somehow mistakenly triggered which, among other immune reactions, speeds up the growth cycle of skin cells.
Lifestyle advice
• It is essential to keep the skin moisturised as dry skin can lead to scratching. Therefore, it is important to use a soap substitute, and protective gloves when washing up, using cleaning products and so on.
• Keep fingernails and toenails short to prevent damage to the skin from scratching.
• Relaxation techniques, meditation and yoga may help to manage stress levels and prevent flare-ups.
• Cold, dry weather may worsen symptoms—try to ensure the skin is kept well moisturised in these climates. Consider using a humidifier at particularly bad times of the year to keep some moisture available for the skin.
• Get some sun, but not too much. We do not want to cause sunburn, but short 20-minute blocks 2–3 times a week may help to manage symptoms.
• Manage your diet if you find that certain foods exacerbate symptoms. For example, some sufferers find that gluten and dairy cause flare-ups.
We understand that this condition can be quite embarrassing and distressing for people, sometimes leading to low self-esteem and even depression; so it is important for you to know we offer empathy and patience to each and every one of our customers in the pharmacy.
Quit Smoking
It’s time to quit and we are here to help you..
People smoke because the nicotine in tobacco is very addictive. However as we all know, continual exposure to all of the other chemicals in the tobacco smoke can cause other health conditions such as heart disease, lung cancer, emphysema and bronchitis. If you’re a heavy smoker or been smoking for a long time, Nicotine Replacement Therapy (NRT) is a good option to consider.
So why should I use NRT? What makes it any better than smoking a cigarette?!! And isn’t it better to just quit ‘cold turkey?’
The main benefit of NRT is that it prevents cravings in a smoker whilst allowing them to abstain from tobacco; therefore…..
• You will not be inhaling all of the poisonous gases and chemicals that are usually found in nasty cigarette smoke.
• You will be using a product far less addictive than cigarettes, as less nicotine is absorbed into your body at a slower rate than with smoking.
• You will be able to reduce your body’s daily intake of nicotine gradually, by reducing the NRT dose over several months.
• Your withdrawal from nicotine will be reduced, making it much easier to quit than just simply going ‘cold turkey’.
If you have made the decision to try NRT it is really important to find ways to keep yourself ‘busy’ and embrace your life changing decision.
• Try to fit in a moderate amount of exercise into your week (30 minutes on all/most days of the week)
• Eat regular healthy meals, making sure you include plenty of fruit, vegetables and grains. Try to limit foods high in fat, sugar or salt
• Limit your alcohol intake—it is important not to replace your smoking with drinking.
• Join a support group to help enable you to overcome the emotional and psychological dependence on smoking.
• Quitline is a telephone service available to smokers who want to quit. You can call Quitline on 13 78 48 from anywhere in Australia for the cost of a local call (except for mobile phones—normal charges apply).
• Try to stay positive and motivated about quitting. A person may quit a number of times before they stop for good, and that is ok. Try to think of previous attempts to quit as past attempts—think about what worked for you and put that into practice during THIS next attempt.
Speak to your LiveLife pharmacist about a plan to help you finally ‘kick the habit’.
Snoring
Snoring……so many of us do it…..whether we like to admit it or not. But why does it happen? And is there anything you can do about it?
Snoring happens when the muscles of your airway relax too much during sleep and vibrate (creating noise) when air you breathe passes in and out. Occasional snoring is experienced by most people at some point in their life, but loud or chronic snoring can disrupt sleep quality, disturb others and may be the tell-tale sign of something more serious requiring treatment…..
• Male
• Aged between 30-65 years
• Overweight
• May have high blood pressure
• May be worse with alcohol consumption and with a cold
Some other common causes may be:
• Allergies
• Eating too much before bed
• Nasal congestion
• Consumption of alcohol and/or sleeping pills
• Pregnancy
• Sleep position (more likely on your back)
• Swollen adenoids/tonsils, especially in kids
• Deformity within the nose
Are there any simple remedies to try and avoid snoring?
• Avoid sleeping tablets and alcohol
• Sleep on your side rather than your back
• Treat nasal congestion (see your pharmacist for advice on nasal sprays and other anti-allergy treatments)
• Make sure the air in your bedroom in neither too dry nor too humid
• External nasal strips (useful in the 5-10% of individuals whose nostrils collapse during inspiration)
• Weight loss
• Quit smoking
• A properly fitted mouthguard
• Continuous Positive Airway Pressure (CPAP) – available in many of our LiveLife pharmacies – this involves treatment of “sleep apnoea” with the use of a compact air pump to deliver a continuous flow of pressurised air via a mask to the patient’s airway.
• Specialist intervention and surgery (in severe cases)
But regardless of what you think may be causing your snoring, if you snore – or if you suspect you snore – consider it a sign that something may not be right. Talk to you pharmacist or your doctor, and get some advice on how to keep you sleeping well, and leading a refreshed, energetic life!
Wound Care
Healing and dealing with wounds in the pharmacy…
Providing advice on wound care is a day-to-day occurrence in our LiveLife pharmacies….here are some helpful wound care hints that we would love to share with you this month!
Wounds are generally classified as either an “Abrasion” or an “incised wound.” But what does this mean?……..
• An abrasion means that the surface layer of the skin has been broken. Thin-skinned bony areas – knees, ankles and elbows – are more prone to abrasions than thicker, more padded areas.
• Incised wounds are caused by sharp objects, such as knives or shards of glass, slicing into the skin. Depending on the injury, underlying blood vessels can be punctured, leading to significant blood loss.
So what are the main first aid points for managing cuts and scrapes?
• Stop the bleeding – minor cuts/scrapes will usually stop bleeding on their own. However, if they don’t, you can apply gentle pressure with a clean cloth/bandage for 20-30 minutes and even elevate the wound to help this process along.
• Clean the wound – it is a very good idea to rinse out the wound with clean water. Soap will only irritate the wound, so try to avoid this. If you need to remove dirt/debris, then use some tweezers cleaned with alcohol to gently remove these particles. Why do we clean the wound? To reduce the risk of infection!
• Apply an antiseptic/antibiotic – applying a thin layer of antiseptic/antibiotic cream/ointment will keep the surface moist and will discourage infection and help the body’s natural healing process.
• Cover the wound – keep the wound clean and keep the bacteria out!
• Change the dressing – this needs to be done daily or whenever the dressing becomes wet or dirty.
• Get stitches for deep wounds if required – usually reserved for wounds more than 6mm deep or gaping or with a jagged edge and has fat/muscle protruding. Adhesive strips or butterfly tape may hold minor cuts together, at least short term until medical advice is sought.
• Look for signs of infection – if there are areas of redness, increasing pain, warmth or swelling, consult the pharmacist/doctor.
So here’s another common conundrum in the pharmacy…..”moist” wound healing vs. “dry” – which one is better and why?
For the past 100 years, wounds have been allowed to dry out. They have been left open and allowed to heal with the aid of dry dressings. Modern studies have now suggested that drying out the live cells which are trying to seal the wound actually SLOWS healing. I suppose this is understandable when we think about the fact that live cells only live in water. The other complication of dry wound healing is that when a dry dressing is changed, new cells may scab and stick to the old dry gauze. This is certainly not ideal.
So follow your LiveLife pharmacist’s advice and keep your wound clean and moist:
• Because it will speed up the healing of the skin
• Because it will prevent scabs
• Because it will prevent scarring and ensure beautiful healing
• Because moist wound healing is skin-friendly (i.e. the dressings are comfortable and often hypoallergenic)
And remember to report anything concerns about your wound to your doctor/pharmacist, especially if you notice any of the following:
• Pain from your wound
• Increase in drainage from your wound
• High blood sugar if you are a diabetic
• Redness in the skin around your wound (may be a sign of infection)
• Bleeding from your wound
• Changes in your body temperature, blood pressure or mental orientation
• Need for dressing supplies
• Any new wounds you find on your body
• Any changes in your medications
• Difficulty in completing the prescribed dressing changes
• Any questions or concerns you have about your wound care!
Remember we are always here to help!
LiveLife – let us help you LIVE it!