Skin Flashcards
What are ointments good for?
Greasy, more occlusive barrier and most hydrating
What are creams useful for?
Less greasy, cosmetically acceptable, dries out quicker than ointments
What are gels useful for?
High water content suitable for scalp and face
Why are lotions useful?
Cooling effect
Large or hairy area
Can sting broken skin
What needs to be known about excipients and sensitisation in skin formulations?
Patch test
Preparations containing salicylate can cause toxicity in neonates
Avoid benzyl alcohol in neonates as causes fatal toxicity syndrome
What are emollients used for?
Mainstay treatment in eczema
Apply as often as required
Apply emollient in direction of hair growth
Apply after washing to maximise hydration
What is the MHRA warning for emollients?
Clothes/dressings easily ignited by naked flame
Do not smoke
What is the mechanism of action of topical corticosteroids?
Reduces inflammation in inflammatory skin conditions
Contraindicated in acne, rosacea, skin infections
Which steroid creams are very potent?
Clobetasol - dermovate
Which steroid creams are potent?
Betamethasone (0.1%) - betnovate
Hydrocortisone butyrate
Mometasone
What are the moderate topical steroids?
Clobetasone (eumovate)
Betamethasone 0.025% (betnovate RD)
What are the mild topical corticosteroids?
Hydrocortisone < 2.5%
How do you apply topical steroids?
Apply thinly to affected areas no more than twice daily
Avoid prolonged use due to thinning and pigmentation
Emollient first the steroid 30 mins later
How long is the treatment for rosacea?
6-12 week course. Repeat intermittently
What is the MHRA warning for brimonidine?
Risk of systemic CV effects
Risk of exacerbation of rosacea
What is used for rosacea treatment?
Topical - metronidazole, azelaic acid, ivermectin
Oral - oxytetracycline, tetracycline, erythromycin
How long does effective contraception need to be used for while taking isotretinoin?
During, 1 month before and after treatment
POP is not effective contraception
Pregnancy test must be negative
Start treatment on 2nd or 3rd day of menstrual cycle
Seek urgent medical advice if you fall pregnant during treatment or up to 1 month after
What are the other side effects of isotretinoin?
Teratogenic Hyperglycaemia, hypertriglyceridaemia, high cholesterol, pancreatitis, hepatotoxicity Visual disturbances Skin peeling Severe dryness of skin
What is the MHRA advice for isotretinoin?
Erectile dysfunction
Decreased libido
How do you manage isotretinoin side effects?
Risk of pancreatitis if triglycerides > 9mmol/L
- discontinue
Discontinue if severe skin peeling or haemorrhagic diarrhoea
Visual disturbances require expert referral
What are the counselling points for isotretinoin?
Avoid during treatment and 6 months after - wax epilating, dermabrasion
Photosensitivity
Stop if psychiatric reactions
