Page 95 - Community pharmcy practice E-book 2025

02/11/2025, 00:10 Fill spaces between skin Otic & Ophthalmic Disorders | Dermatological Disorders
cells. Occlusives when
Emollients applied heavily Ceramides, Vaseline, mineral oils
(OTC) and lanolin based products

Topical corticosteroids

OTC topical steroids for AD & CD:
1. Hydrocortisone 0.5%, 1% (Hydrocortisone® ointment) (In USA) &
2. Clobetasone butyrate 0.05% (Eumovate® cream): (in UK) are the only topical corticosteroid approved for
OTC sale.

Topical corticosteroids are recommended for first-line therapy for AD during acute disease flares.
Topical corticosteroids should be applied sparingly twice daily to affected lesions before application of any
moisturizers.

Dosage form selection:

The type of lesions:
Cream: for moist, weeping areas of skin
Ointment: for dry, scaly areas of skin.

The site of lesions:
Gels and lotions: Applied for hairy areas, the least greasy and occlusive, leave little residue and
penetrate easily. Long term use can cause dryness.

Creams: for intertriginous application and skin folds, while ointments may cause maceration & further
inflammation.

Irritant type:

Water-soluble irritants: If the irritant is an acid, alkaline, detergent, or water-soluble irritant, a water
repellent barrier should be selected (e.g. Ointments which are Water-in-oil emulsions).
Water-insoluble irritants: Use of Oil-repellant type barriers (gel, lotion, or cream) are protective against
such irritants as oil, varnishes, and organic solvents.
Symptoms Acuity:
Acute dermatitis: use hydrophilic preparations (gel, lotion, or cream).

Chronic ICD: water-in-oil–based preparations (i.e., ointments) are more likely to be effective.

Irritation or sensitization potential:
Ointments less irritating than O/W creams (preservatives or emulsifiers if allergy to these agents is a
concern).

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