MTW NHS Trust West Kent CCG

Drug Status Key

  • Preferred
  • Second Line
  • Third Line
  • Specialist Initiation
  • Hospital Only
  • Not Approved for Formulary

Management of Skin conditions

The vehicle used in skin preparations will affect the hydration of the skin, has a mild anti-inflammatory effect and aids the penetration of the active drug.

Ointments (greasy preparations) are often preferable to creams in most circumstances as they contain fewer skin sensitisers, are more hydrating and there is better penetration of the active ingredients. However, they are often less cosmetically acceptable. Patient preference may necessitate a combination of products, e.g. cream during the day, ointment at night.

Creams are emulsions of oil and water and are generally well absorbed into the skin. Creams are suitable for normal or moist skin; they are cosmetically acceptable but may contain potentially sensitising preservatives. Creams need to be applied more frequently and generously to have the same effect as ointment.

Gels consist of active ingredients in suitable hydrophilic and hydrophobic bases. They generally have a high water content.

Lotions are liquid and have a cooling effect. They are preferred to ointments or creams for application over a hairy area or on wet rashes.

Pastes are stiff preparations containing a high proportion of finely powdered solids such as zinc oxide and starch suspended in an ointment.

Possible contact sensitivity to preservatives or antiseptics is the reason for the range of topical agents.

Bath additives: there is inconclusive evidence for efficacy.

Suitable quantities of preparations to be prescribed for specific areas of the body

These amounts are usually suitable for an adult for twice a day application for one week.

Creams & ointments Lotions
Face 15g - 30g 100mL
Both hands 25g - 50g 200mL
Scalp 50g - 100g 200mL
Both arms 100g - 200g 200mL
Both legs 100g - 200g 200mL
Trunk 400g 500mL
Groin & genitalia 15g - 25g 100mL