Ever since she was a little girl, Patricia Huntley, 68, has been troubled by eczema. "I've had problem skin all my life," she says. "As a child, I used to get small round patches of dry, itchy, flaky skin on my wrists, hands and ears. These were early signs of atopic eczema - but in those days nobody talked about such things. So, I just learned to ignore my symptoms and hoped they would go away. It wasn't until I was much older that the eczema became really bad."
By the time she was in her mid-50s, her eczema had become chronic. "My symptoms got worse after I had a road accident when I was knocked down by a car. I didn't sustain any serious injuries but, I was very shaken and it took me a while to get over the shock." Stress was obviously a major trigger. To alleviate her symptoms, Huntley was prescribed with different topical emollients, steroid creams and two powerful immunosuppressants (cysclosporin and azathioprine) - but nothing really worked.
"At one point, the skin between my fingers was raw, cracked and oozing yellow pus, and my face and neck were permanently red and inflamed. This affected my confidence and made me feel depressed. On one occasion, my eczema flared up so badly, I was covered from head to foot and had to be hospitalised immediately."
That was six years ago. Today, Huntley's skin has dramatically improved. Her complexion is no longer red and angry-looking, and apart from the odd minor patch, the eczema is almost totally under control. Emotionally, too, her confidence has come back and she feels happier in herself than she has done for ages. She attributes her "cure" to a course of thermal water treatments at a spa in the south of France. What makes her experience particularly interesting is that her initial three-week treatment at the Avene Dermatological Spa (costing £400) was paid for by the NHS.
"I couldn't believe it when the consultant dermatologist at North Durham Hospital suggested I might be eligible for treatment at a spa abroad," says Huntley. "I had no idea that something like this was possible. I'd only recently started using emollient creams from the Avene skincare range and they really helped to soothe my eczema. My dermatologist agreed that these were more beneficial for my skin than the conventional emollients I was using on prescription. As a result, she recommended I apply for NHS funding to have a course of treatment at the Avene spa."
"Many people simply don't realise that it is possible to get NHS funding to have treatments abroad - including medical spa treatments," says Maggie Sixsmith, medical information manager at Pierre Fabre Dermo-Cosmetics (the French healthcare company that owns Avene Dermatological Spa). "This is probably one of the best-kept health secrets in the UK. Yet, there are three possible ways to go about this. You can apply for funding via one of the two international forms, E111 and E112 (where all the costs for treatments are covered by NHS). These are available from most post offices. Or, you can approach your local healthcare trust for funding. In each case, your starting point is your GP. After that you need to be referred to a consultant who will recommend you for treatment to the Department of Health. The whole process can be lengthy (around six months). Whether you are lucky or not, though, depends on whether there are sufficient funds available in your area."
Last year, 60 patients travelled from the UK for treatment at Avene - only two were funded by the NHS, but more NHS applications are in the pipeline. In 2002 Huntley took the E112 route, paying for her flights and accommodation herself, and was so delighted with the improvements to her skin that she went again the following year (paying all her own costs). "I was prescribed four treatments a day by the spa dermatologist, including a 20-minute thermal bath treatment, a multi-jet shower, a spray treatment for my face and special underwater massage. I saw improvements after only a week. Now, my skin is almost totally clear. "
"Avene Dermatological Spa has a well-established reputation for helping to treat problem skin conditions including eczema, psoriasis and other skin problems, such as dermatitis, allergies and burns," says Marie-Ange Martincic, spa director. "The natural thermal water is rich in minerals such as calcium, magnesium, managanese and silicon, which help to soothe the skin."
The therapeutic properties of Avene thermal spring water were officially validated by the French National Academy of Medicine back in 1874. More recently, its benefits have been acknowledged by a number of clinical trials (reported in clinical journals, including the Lancet, 1999). And the results of a recent trial - involving a group of children with chronic eczema from Great Ormond Street Children's Hospital, London, who were treated at Avene - are pending publication. The Avene Dermatological Spa also has the approval of the Sécurité Sociale, the French equivalent of the NHS, which funds French patients to have treatment at the spa.
"The thought of being sent for three weeks to a spa abroad is a wonderful idea," says Margaret Cox at the National Eczema Society. "But how many areas will have funding for this type of treatment? We know from experience that eczema and dermatology are not given high priority on the NHS. We already struggle to see people getting some of the newer treatments on prescription in the UK. Also, what works for one person doesn't always work for another. However, if you're really keen to try it, by all means talk to your GP - just don't be disappointed if it's difficult to get funding."
Meanwhile, Dr David Fenton, consultant dermatologist at St John's Institute of Dermatology, London, believes we should be concentrating on treatments closer to home. "Spa water may well have therapeutic effects," he says. "But that's a bit like saying psoriatics improve by going to the Dead Sea - it's not always possible for sufferers to get there. Also, we don't know whether it's the mineral content of the water alone that is making the difference, or whether it is a combination of factors? We know, for example, that eczema is exacerbated by hard water. So, for many people just changing from hard to soft water can bring about a huge improvement. Also, eczema is often triggered by stress. Being in a spa will automatically make you feel less stressed. So that's another area worth looking at. Ultimately, we need to work out what it is exactly that is having the therapeutic effect - and then try to incorporate it into treatments in the UK."
