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Cutaneous Membrane = Skin
Figure 6.2
Demulcents
Are inert substances which sooth inflamed/denuded mucosa or skin by preventing contact with air/ irritants in the surroundings.
Liquorice Methylcellulose Propylene glycol Glycerine
Emollients
Indication: To soften and soothe rough, dry skin and increase absorbability of topical medications
Directions: Apply as necessary or as prescribed; generally after showering/bathing and pat drying; apply liberally to affected areas
Olive oil, sesame oil, cocoa butter, liquid paraffin
Adsorbants and protectives They are finely powdered, inert and
insoluble solids capable of binding to their surface
Magnesiu/zinc stearate Talc-hydrous megnesium silicate Calamine Starch Boric acid Aloe vera gel Polyvinyl polymer
Astringents
Astringents reduce secretions (by causing contraction of tissues) and are antibacterial
Best used in eczema where vesicular or draining lesions are present
Acetic Acid 5% (white vinegar) – especially useful in Pseudomonas infections
Burow’s Solution (Domeboro and others) Potassium Permanganate Tannic acid Zinc
Topical Vehicles
Creams: Less greasy and most acceptable to patient Applies more easily Penetrates skin well Works well in intertriginous and hairy areas Can be drying Have a cooling effect Easy to wash off
Lotions: more water content and less viscous than creams
Ointments: Petrolatum based Alleviates dryness by prevention of evaporation Removes scales Enables medication to penetrates skin well Water repellant Remains on the skin Occlusive and protective Soothing and lubricating
Irritants and counter irritants
They stimulate the sensory nerve endings and induce inflammation at the dite of application
Rubificiants –irritation+hyperemia+sensory stimulation
Vesicants –strong irritation+hyperemia
+sensory stimulation+ capillary
permeability
Irritants and counter irritants
Volatile oils- turpentine oil, Clove oil, eucalyptus oil, camphor,
menthol Mustard seeds, capsicum, canthridin Methyl salicylate alcolhol
Caustics and escharotics
Corrosive Podophyllium resin Silver nitrate Phenol Trichloro acetic acid
Keratolytics
Salicylic acid Resorcinol –antiseptic, antifungal,
local irritant Urea –hygroscopic, with steroid
Anti -seborrheics
Selenium sulfide Zinc pyrithione Corticosteroids Immidazole antifungals Sulfur, coaltar
Melanizing agents
Increase sensitivity to solar radiation Psoralen Methoxsalen Trioxsalen
Psoriasis
Calcipotriol- supresses epidermal proliferation
Tazarotene –synthetic retinoid Coaltar –exerts phototoxic action Photochemotherapy-PUVA Acitretin-synthetic retinoid Etanercept Methotrexate
Coal Tar Preparations
Tegrin cream and lotion Medotar ointment PsoriGel gel Polytar and Tegrin soaps Tegrin, T/Gel, and other shampoosIndication: to relieve and control itching,
and flaking skin associated with psoriasis and seborrhea as well as eczema
Directions: Depending on product 1-4 times daily
Demelanising agents
Hydroquinone Monobenzene Azelaic acid
Sun screens
Chemical –PABA, benzophenones Cinnamates Physical – petroleum jelly, zinc oxide,
calamine
Drugs for acne vulgaris
Topical therapy-benzoyl peroxide Retinoic acid Adapalene – synthetic tretinoin Tazarotene Topical antibiotics Azelaic acid
Systemic therapy Antibiotics , Isotretinoin
Steroid Classifications
Other Medicines
Antiinflammatory topicals Hydrocortisone creams, 0.5% to 1%
Antipruritics and others1. Benadryl (diphenhydramine 25-50mg q6h
prn)2. Calamine Lotion (zinc oxide and ferric oxide
used as a mild astringent)3. Caladryl Lotion (both of above)4. Burow/s solution
Coal Tar Preparations(cont’d)
Contraindications: HypersensitivityPrecautions: Do not use on broken skin, genital or
rectal area except on the advise of your health care provider.
Photosensitivity x 24hr after application May stain light colored hairWarning: High concentrations of some chemicals in
coal tar may cause cancer. Concentrations of 0.5% to 5% appear to be safe.
Recommended