Page 96 - Community pharmcy practice E-book 2025

02/11/2025, 00:10 Otic & Ophthalmic Disorders | Dermatological Disorders

Some gels may contain alcohol or similar organic solvents that may cause irritation or burning when

applied to open lesions.

Sprays (pros & cons ???????)

Fragrances, found in some preparations, can be sensitizing.

Proper patient counseling for topical corticosteroids use:

✓ Apply in a thin layer on non-occluded skin.

✓ Don't use for more than 5-7 days in a row.

✓ If symptoms persist after 5-7 days, stop and refer physician.

✓ If emollients applied before topical corticosteroids, Wait at least 30 minutes before applying a topical
steroid to ensure the steroid is not diluted by the emollient.

✓ Educate patients with local adverse effects as Thinning of the skin (Skin atrophy) & Masking symptoms of
fungal or bacterial skin infections.

Precautions and warnings for topical corticosteroids use:

✓ No dressing or bandages should be applied when hydrocortisone is used in self-care treatment. (to prevent
excessive absorption)

✓ Don't apply in case of infection (risk of secondary infection).
✓ Do not apply hydrocortisone to infected, open, or cracked skin.

Don't dispense for lesions on:
✓ The groin, genitals (high risk of systemic absorption),
✓ Between the toes (potential fungal infection & systemic absorption).

✓ The face, Eye & eyelid (sensitization & systemic absorption).

Anti-pruritics; Antihistaminic (OTC)

Sedating (1st generation) For patients with nocturnal scratch
Examples: Chlorpheniramine, Diphenhydramine

Topical antihistamines As chlorphenoxamine HCL creams

Non sedating long acting (2nd generation) cetirizine (Zyrtec®), desloratadine, fexofenadine (Allegra®),
levocetirizine (Xyzal®), and loratadine (Claritin®)

Anti-histamines for Allergic CD???!!!!

Topical ointments and creams containing antihistamines (e.g., diphenhydramine) should not be used for

pruritus related to ACD, where evidence supporting their effectiveness is weak.

95