Skin clinics exploit desperate patients

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The Independent Online
A patient with a disfiguring skin condition was charged almost pounds 1,000 by a private clinic for a small pot of cream which on analysis was found to have little or no therapeutic value.

Two leading skin-care charities say that desperate patients are being increasingly exploited by clinics, which may offer patients free consultations but charge large sums for any drugs that are prescribed subsequently.

Chris Barrett, chief pharmacist at the Royal Hospitals NHS Trust in London, and who has analysed skin creams on behalf of the Vitiligo Society and the National Eczema Society, said that charging large sums for creams which will have little impact on a patient's condition was "inhuman".

Mr Barrett said: "As a pharmacist I am horrified by what some of these clinics are doing. Despicable is not a strong enough word for it. They put the whole of the medical profession in disrepute."

Michael Wadsworth, chief executive of the Vitiligo Society, said: "We are aware of four or five cases but we know there must be many more. People are too embarrassed to come forward and admit that they have been taken in. But they are desperate people in a vulnerable position.

"Many of the clinics offer free consultations but charge exorbitant prices for the drugs."

There is no cure for vitiligo - a pigmentation disorder in which patches of skin lose their colour, and which affects up to 2 million people in Britain. Spontaneous repigmentation occurs in about 30 per cent of cases, but available NHS treatments using steroid creams and light therapy have mixed success, which prompts some patients to seek help wherever they can.

The depigmented patches are particularly obvious in dark-skinned people, occurring most commonly on the face, hands, armpits and groin.

One 20-year-old man with the disease spent his savings on a 50gram pot of cream from the West One Clinic in Harley Street. "He was unemployed and he came in here in tears when he realised what he had done. It was a small pot, with a hand-written label and there was no indication of the ingredients. He showed us the receipt for pounds 950," Mr Wadsworth said.

Analysis of the cream revealed that it contained tiny amounts of the steroid drug, Synalar (fluocinolone acetamide) heavily diluted in white soft paraffin, a non- therapeutic carrier for the drug. A 225gram pot of white soft paraffin costs around pounds 1 from the chemist. A tube of Synalar, a prescription-only medicine, costs the NHS less than pounds 1.50.

"It was difficult to do a quantitative analysis because there wasn't enough active [therapeutic] ingredient in it," Mr Barrett said.

A pharmaceutical analysis of a similar cream from another clinic suggested there was no active ingredient present at all.

The National Eczema Society cites another case in which a teenage girl with acne paid a clinic pounds 900 for "two tiny pots" labelled Acne Cream 1 and Acne Cream 2.

"After three months she went back for more cream but didn't have the pounds 900 for another course. She asked her father for the money and he contacted us because he thought it was such a rip off," a spokesman said.

No medically qualified member of staff at the West One Clinic in Harley Street was available to comment on the case reported by the Vitiligo Society. The medical director did not return The Independent's call, made earlier this week. A spokesman said that the vitiligo patient had paid for three months' treatment and the cream he had been given was a "preparatory" cream.

"I have his file here in front of me. He did not return for further treatment over the three months," he said earlier this week. However, Mr Wadsworth said the patient had been told by the clinic that the small pot of cream was intended for use over three months, and that if he wanted further supplies after that he would have to pay for them.