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.