By British Association of Dermatologists (BAD)
The British Association of Dermatologists (BAD) makes statements on best practice, teaching, training and research in dermatology which is often followed by dermatology departments and consultants in the Republic of Ireland. This statement was last updated by the BAD on 18th March.
If you become unwell or develop a fever, follow the advice given by the HSE and consult your prescribing doctor to consider whether you should discontinue your biologic or immunosuppressant treatment.
COVID-19 is an illness that can affect your lungs and airways. It is caused by a type of new coronavirus. There are several other sorts of coronaviruses which are well known, and which usually only cause mild infections.
The BAD is aware of the concerns about COVID-19 amongst people who are taking medicines that affect the immune system. The BAD is not aware of any good evidence that these people are at a greater risk of getting COVID-19 or having a more severe form of the illness. This advice may change as we find out more about this new condition, in Ireland check the HSE website regularly for updates).
The current advice is for us all to limit contact with other people to slow the rate of spread of the virus. This is called “social distancing” and is explained further in the advice here.
They also recommend that certain individuals are especially stringent about observing social distancing. This applies to you if you are aged over 70, or if you have been advised to get a flu jab as an adult each year, or if you are pregnant.
The BAD advises that creams used for skin conditions, in the correct quantities recommended by dermatologists or GPs, are not likely to increase the risks of getting COVID-19 or having a more severe form of the illness.
You can find out more about your medicine by looking at the patient information leaflets on the BAD website here. Not all dermatology medicines affect the immune system, for example hydroxychloroquine, chloroquine, acitretin.
To date, there is no public health guidance specifically for people taking drugs that affect the immune system although this situation may change.
At present, most people are choosing to continue treatment until there is evidence on which to base advice.
If you are considering stopping your treatment, please discuss this with your dermatology team first. Any decision made about stopping treatment should include the consideration that your skin condition may deteriorate. It may also be more difficult to access healthcare services over the upcoming months. This will need to be a joint decision made between you and your doctor.
Treatments should not be stopped unless this has been discussed and agreed with a doctor as this can sometimes be dangerous.
It is particularly dangerous to stop long-term steroid tablets suddenly – steroid tablets must not be stopped without advice.
If you are taking medicines that affect the immune system and become unwell or develop a fever, follow the advice given by the HSE and consult a healthcare professional such as your dermatologist. This will be a joint decision made by you and your doctors, depending on your circumstances, but some treatments may be stopped for a while until you are better.
It is particularly dangerous to stop long term steroid tablets suddenly – steroid tablets must not be stopped without advice.
If you are diagnosed with COVID-19 by your doctor, and you are taking medicines that target the immune system, then it is likely that your dermatologist or the doctors treating you will discuss with you about stopping or postponing your skin treatment until after you recover. As explained above, it is dangerous to stop long-term steroid tablets suddenly, so steroid tablets should not be stopped unless advised and supervised by a doctor.
Each person is different so advice will vary depending on your skin condition and whether you have any other health problems. This means that decisions are usually best made by shared discussions between the patient and their dermatologists, and other doctors involved in their care.
As there is limited knowledge at present, some people may decide with their dermatologists to hold off treatment and use other options such as creams, until more is known about COVID-19.
If you need guidance or support about managing a skin disorder, contact the ISF Helpline for free assistance and information.