Skin Flashcards
What are ointments
- greasy
- forms occlusive barrier over skin
- most hydrating
What are creams
- less greasy
- cosmetically accepted
- drys quicker
- applied more frequently
What are gels
- high water content
- scalp and face suited
What are lotions
- cooling effect
- preferred for large/ hairy area
- alcoholic base which can sting broken skin
What is the caution with salicylate containing preparations
can cause toxicity
- in neonates
- when applied over large areas
When should you avoid benzyl alcohol and why
avoid in neonates as can cause fatal toxicity
When to apply Emollients for eczema
- as often as required
- maintain moisture
How to apply emollients
- apply in direction of hair growth
- to avoid folliculitis (inflamed hair follicles)
How long should you soak with bath additives for improved hydration
at least 10 to 20 mins
What is the MHRA caution with paraffin based skin emollients
- fire risk
- clothes, dressings are easily ignited
- do not smoke
Topical corticosteroids mode of action
reduces inflammation in inflammatory skin conditions
e.g eczema, dermatitis
When are Topical corticosteroids contra-indicated
- acne
- rosacea
- skin infections
What is the most potent Topical corticosteroids
Clobetasol
(Dermovate)
What are the second most potent Topical corticosteroids
- betamthasone 0.1 (betnovate)
- hydrocortisone butyrate
- mometasone
What are moderate poteny Topical corticsteroids
- clobetasone (Eumovate)
- Betamethasone 0.025 (Betnovate RD)
What are mild potency Topical corticosteroids
Hydrocortisone <2.5%
How to apply Topical corticosteroids
- apply thinly to affected area, no more than twice daily
- apply emollient first and wait 30 mins before applying steroid for maximum absorption
- Keep away from eyes
Why should you avoid prolonged use of Topical corticosteroids (especially on face)
as they can cause
- skin thinning
- hypo / hyper pigmentation
How long is the treatment course for rosacea
6 to 12 weeks
Treatment for Rosacea (facial erythema) (face redness)
Brimonidine gel
What are the brimonidine
- risk of cv effects
(bradycardia, hypotension, dizziness) - risk of rosacea exacerbation
How to avoid CV effects of brimonidine
avoid application to irritated or damaged skin
How to avoid exacerbation of rosacea when using brimonidine
- do not exceed maximum daily dose
- stop and report if symptoms worsen
What is Oral Isotretinoin
acne treatment only prescribed under supervision
Tretinoids (Isotretinoin) and vitamin A and pregnancy
they are teratogenic (deformities in babies)
Tretinoids and contraception
effective contraception 1 month before and after treatment
Tretinoids and contraception part 2
- needs 2 types of contraception
- pregnancy test needs to be negative (every months)
At which day of the menstrual cycle should you start teratogenic drug treatment
2nd or 3rd day
Side effects of Isotretinoin
- hypoglycaemia
- high cholesterol
- pancreatitis
- hepatotoxicity
- visual disturbances
- redness
- severe dryness
- erectile dysfunction
- decreased libido
At which level of triglycerides is there a higher risk of pancreatitis when taking Isotretinoin for acne
9mmol/litre
When should you discontinue Isotretinoin
- if >9mmol/litre triglycerides
- pancreatitis
- severe skin peeling
- hemorrhagic diarrhoea
- visual disturbances
- psychiatric reactions
Patient counselling for Isotretinoin
Photosensitivity
- avoid UV light
- use high SPF sunscreen
