Chapter 13: Skin

13.1 Management of skin conditions

13.1.1 Vehicles

i. Aqueous Cream BP
ii. Cetomacrogol
iii. Emulsifying Ointment BP
iv. Paraffin, white soft

13.2 Emollient and barrier preparations

13.2.1 Emollients

i. Emulsifying Wax
ii. Liquid Paraffin BP
iii. Liquid Paraffin and White Soft Paraffin Ointment 50:50
iv. Light Liquid Parafin
v. Hydrous Ointment, BP
vi. Diprobase Cream
vii. Doublebase gel
viii. E45 Cream
ix. Epaderm Ointment
x. Arachis Oil
xi. Aveeno Cream
xii. Cetraben Cream
xiii. Balneum
xiv. Balneum Plus
xv. Dermol 500 Dispenser
xvi. Dermol Cream
xvii. Hydromol Intensive Cream
xviii. Paraffin Gauze dressing 10cm x 10cm
xix. Ultrabase Cream Emollient bath and shower preparations

i. Aqueous Cream BP
ii. Diprobath. Primary Care Only
iii. Doublebase Bath Additive, Shower Gel. Primary Care Only

13.2.2 Barrier preparations

i. Conotrane Cream
ii. Drapoline Cream
iii. Zinc & Castor Oil Cream 15%
iv. Siopel Cream
v. Metanium Ointment

13.3 Topical local anaesthetics and antipruritics

i. Calamine BP lotion 200ml
ii. Crotamiton 10% Cream
iii. Calamine Oily lotion 200ml
iv. Levomenthol Cream BP 0.5%, 1%, 2% (e.g. Dermacool)
v. Doxepin Cream 5% 30g
vi. Eurax HC Cream
vii. Menthol 0.5% in Calamine. Hospital Only

13.4 Topical corticosteroids – See NICE Steroid Guidance

i. Hydrocortisone Cream 1%
ii. Hydrocortisone Cream 0.5%
iii. Betamethasone Valerate Cream 0.1%
iv. Clobetasone Cream 0.05%
v. Clobetasone Ointment 0.05%
vi. Betamethasone Valerate Ointment 0.1%
vii. Betamethasone Valerate (Betnovate RD) Diluted cream 0.025%
viii. Betamethasone Valerate (Betnovate RD) Diluted ointment 0.025%
ix. Betamethasone Valerate Lotion 0.1%
x. Hydrocortisone Ointment 0.5%, 1%
xi. Hydrocortisone Butyrate (Locoid) Cream 0.1%, 30g, 100g
xii. Hydrocortisone Butyrate (Locoid) Lipocream 0.1%, 30g
xiii. Hydrocortisone Butyrate (Locoid) Ointment 0.1%, 30g, 100g
xiv. Clobetasol Cream 0.05%
xv. Clobetasol Ointment 0.05%
xvi. Betamethasone Dipropionate (Diprosone) Cream 0.05%
xvii. Betamethasone Dipropionate (Diprosone) Ointment 0.05%
xviii. Mometasone Cream
xix. Mometasone Lotion
xx. Daktacort Cream
xxi. Diprosalic Ointment
xxii. Fucibet Cream
xxiii. Trimovate Cream (Clobetasone butyrate 0.05%, oxytetracycline 3% & nystatin 100000iu/g)
xxiv. Lotriderm Cream
xxv. Cutivate Cream
xxvi. Cutivate Ointment

13.5 Preparations for eczema and psoriasis

13.5.1 Preparations for eczema

i. Ichthammol Ointment, BP 1980
ii. Alitretinoin Capsules 10mg, 30mg (See NICE guidelines – Severe chronic hand eczema)
iii. Ichthopaste Bandage, 75mm x 6mm

13.5.2 Preparations for psoriasis

i. Calcipotriol Cream 50 micrograms/g
ii. Calcipotriol Scalp Application 50 micrograms/ml
iii. Polytar Emollient
iv. Dovobet Gel
v. Capasal Shampoo
vi. Ichthammol in Oily Calamine Lotion 0.5%
vii. Sebco Scalp Ointment
viii. Coal tar solution 10% Cream (Carbo-Dome)
ix. Dovobet Ointment
x. Dithranol Cream 0.25%, 0.5%, 1%, 2%
xi. Dithranol Paste 0.05%, 0.1%, 0.25%, 0.5%, 1%, 2%
xii. Acitretin Capsules 10mg, 25mg. Hospital Consultant Only
xiii. Coltapaste Bandage Zinc Paste and Coal Tar, Bandage 75mm x 6m
xiv. Methoxypsoralen Tablets 10mg. Hospital Only, Named Patient
xv. Methoxypsoralen Gel 0.005%. Hospital Only, Named Patient
xvi. Methoxypsoralen Lotion 1.2%. Hospital Only, Named Patient
xvii. Tacalcitol Ointment 4 micrograms/g
xviii. Calcipotriol 50mcg/g with Betamethasone 0.05%  (Enstilar®)  , aerosol foam. Specialist initiated

13.5.3 Drugs affecting the immune response

i. Tacrolimus Ointment 0.03%, 0.1%
ii. Pimecrolimus 1% Cream
iii. Ciclosporin Capsules (Neoral) Capsules 25mg, 50mg, 100mg
iv. Secukinumab. As Per NICE TA350 Only and NICE TA445
v. Etanercept. Hospital Only. Including NICE TA373 NICE TA455
vi. Infliximab. Hospital Only
vii. Adalimumab. Hospital Only NICE TA455
viii. Ustekinumab Injection. As Per NICE TA180 , NICE TA340 and NICE TA455 Only – Hospital Only
ix. Apremilast Tablets. Hospital Only.  As Per NICE TA419
x. Ixekizumab (Taltz) injection for specialist initiation only in accordance with NICE TA442
xi  Dimethyl Fumarate. Hospital Only. as per NICE TA475.  
xii Brodalumab Hospital only. as per NICE TA511
xiii Dupilumab. Hospital only, as per NICE TA534
xiv Guselkumab (Tremfya). NICE TA521
xv Tildrakizumab. NICE TA575
xvi Risankizumab NICE TA596

13.6 Acne and rosacea

13.6.1 Topical preparations for acne – See Northern Lincolnshire APC Acne Pathway

i. Erythromycin 40 mg and Zinc Acetate 12 mg/mL Topical Solution
ii. Benzoyl Peroxide Gel 5%, 10%
iii. Benzoyl Peroxide 5% and Clindamycin 1% Gel
iv. Adapalene 0.1% Cream, Gel
v. Adapalene 0.1% and Benzoyl Peroxide 2.5% Gel
vi. Metronidazole Gel 0.75%
vii. Tretinoin Cream 0.025%
viii. Tretinoin Gel 0.01%, 0.025%
ix. Azelaic Acid 20% Cream
x. Tretinoin 0.025% and Clindamycin 1% Gel

13.6.2 Oral preparations for acne

i. Lymecycline Capsules 408 mg
ii. Co-Cyprindiol Tablets
iii. Isotretinoin Capsules 5mg, 20mg (hospital/specialist only)

13.7 Preparations for warts and calluses

i. Salicylic Acid Preparations, e.g. Salactol, Salatac, Occlusal, Verrugon
ii. Imiquimod Cream 5%
iii. Podophyllin in Acetone / Spirit 15%, 20%
iv. Podophyllotoxin Solution 0.5%
v. Podophyllotoxin Cream 0.15%
vi. Salicylic Acid and Trichloroacetic Acid (Wart Paste)

13.8 Sunscreens and camouflagers

13.8.1 Sunscreen preparations

i. Sunsense Ultra
ii. Uvistat Ultrablock Cream Factor ’30’
iII. Fluorouracil 5% Cream (Efudix)
Iv. Ingenol Mebutate Gel (Picato)
v. Fluorouracil 0.5%, salicylic acid 10% Solution (Actikerall). Hospital Initiated Only
vi. Zyclara® Cream (Imiquimod 3.75%)  Zyclara AK Pathway
vii Metvix. Hospital only

13.8.2 Camouflagers

i. Keromask. Primary Care Only, ACBS
ii. Dermacolor. Primary Care Only, ACBS
iii. Dermablend. Primary Care Only, ACBS

13.9 Shampoos and other preparations for scalp and hair conditions

i. Polytar Liquid Tar
ii. Capasal Shampoo
iii. Betadine Shampoo
iv. Betamethasone Valerate 0.1% Scalp Application
v. Betamethasone Dipropionate 0.05% Alcoholic Solution
vi. Ceanel Concentrate
vii. Cade Oil Scalp cream 6%, 12%
viii. Hydrocortisone Butyrate Alcoholic solution 0.1%
ix. Dermol 200 Shower Emollient
x. Eflornithine 11.5% Cream. Consultant Paediatrician Initiated Only (U)

13.10 Anti-infective skin preparations

13.10.1 Antibacterial preparations Antibacterial preparations only used topically

i. Mupirocin 2% Cream, Ointment
ii. Mupirocin 2% Nasal Ointment
iii. Silver Sulphadiazine 1% Cream Antibacterial preparations also used systemically

i. Fusidic acid 2% Cream
ii. Fusidic acid 2% Ointment
iii. Metronidazole 0.75% Gel (Rozex, Metrogel)

13.10.2 Antifungal preparations

i. Clotrimazole Cream 1%
ii. Miconazole Cream 2%
iii. Ketoconazole Shampoo
iv. Nystatin Cream
v. Terbinafine Cream 1%
vi. Terbinafine Tablets 250mg
vii. Itraconazole Capsules 100mg
viii. Nystaform Cream

13.10.3 Antiviral preparations

i. Aciclovir Cream 5%

13.10.4 Parasiticidal preparations

i. Permethrin Cream Rinse 1%
ii. Phenothrin Aqueous Based Lotion 0.2%
iii. Malathion Aqueous Solution 0.5%
iv. Dimeticone 4% Lotion
v. Benzyl Benzoate Application 25%
vi. Carbaryl Aqueous Liquid 1%

13.10.5 Preparations for minor cuts and abrasions

i. Magnesium Sulphate Paste 50mg
ii. Proflavine Cream – hospital only

13.11 Skin cleansers, antiseptics, and desloughing agents

13.11.6 Oxidisers and dyes

i. Potassium Permanganate Solution 0.1%
ii. Hydrogen Peroxide Solution 3%, 6%
iii. Hydrogen Peroxide Cream 1%

13.11.7 Preparations for promotion of wound healing

See wound care formulary or BNF guidance

13.12 Antiperspirants

i. Aluminium Chloride 20% in Spirit Roll-on

13.13 Topical circulatory preparations

i. Heparinoid 0.3% Cream, Gel

13.14 Miscellaneous Inflammatory/vasulitic dermatosis

i. Mycophenolate Mofetil. Hospital Dermatology Consultant Only, See Chapter 8.2.1

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