Tutorial 8 - Dermatology (B) - Emollients and steroids

Question 1

What is an emollient?

Answer 1

• Moisturiser which helps rehydrate the skin. It does this by forming a layer on the top of the skin which stops water loss.
• Used to treat dry, scaly , irritated skin.

Question 2

What formulations are emollients available In?

Answer 2

• Ointment (most oil content - hydrates most - usually used in night)
• Creams(less oily - often used in day)

Question 3

Where is the use of emollients useful?

Answer 3

• Eczema (atopic dermatitis)
• Psoriasis
• These conditions cause dry, irritated, blistered, scaly (psoriasis) skin.

Question 4

Name some common emollients.

Answer 4

• Petrolatum
• Shea butter
• Mineral oil

Question 5

How should you advise patients to use emollients?

Answer 5

• Wash and dry hands first.
• Take emollients using spatula (not hands - bacteria).
• Use liberally.
• Apply in stroking direction along direction of hairs.
• Apply as often as needed (3-4 times a day)
• If using steroidal cream too, wait 30 minutes after application of emollient.

Question 6

What potential adverse effects of emollients should you let the patient know?

Answer 6

• Stinging/burning sensation due to sensitivity to ingredient in emollient.
• Folliculitis/boils - if follicles become blocked by emollient.

Question 7

What are steroids.

Answer 7

• Topical preparation to treat inflammatory skin conditions - reduce redness/irritation.

Question 8

What formulations are steroids available in?

Answer 8

• Ointments/creams/nasal sprays/inhalers/injections/oral preparation.
• Generally stronger steroids used on body, weaker steroids used for face.

Question 9

Where is the use of steroids useful?

Answer 9

• COPD/asthma
• Inflammatory arthiritis
• IBD
• Eczema
• Psoriasis

Question 9

Name some common steroids?

Answer 9

• Hydrocortisone, betnovate, dermovate - topical preparation
• Prednisolone oral

Question 10

How should you advise the use of topical steroids?

Answer 10

• Wash and dry hands before.
• Apply finger tip amount - this is enough to coat palmar surface of both hands.
• Use thinly
• Wash hands thoroughly afterwards too.

Question 11

What adverse effects of topical steroids should you let the patient know?

Answer 11

• Burning/stinging
• Skin atrophy/thinning (thinning of epidermis/dermis)