SMC not accepted. SMC not recommended medicines must go through the non-formulary medicines process, this includes PACS Tier One & Two, as outlined in the NHS Tayside Policy on Prescribing of Non-Formulary Medicines (including Peer Approved Clinical System (PACS) Tier One & Two) Rowe, J., McCall, E. & Kent, B. (2008) “ Clinical effectiveness of barrier preparations in the prevention and treatment of nappy dermatitis in infants and preschool children of nappy age.” International Journal of Evidence Based Healthcare, vol. 6, pp. 3-23. Potent to very potent topical corticosteroids are not recommended for regular use over prolonged periods because of concern over long-term adverse effects. Blume-Peytavi, U., Cork, M., Faergermann, J., Szczapa, J., Vanaclocha, F. & Gelmetti, C. (2009) “ Bathing and cleansing in newborns from day 1 to first year of life: recommendations from a European round table meeting.” Journal of the European Academy of Dermatology and Venereology, vol. 23, pp. 751-759. However, if you are also using medicated creams, ointments or lotions, including topical corticosteroids, you shouldn't apply them immediately after using this moisturiser, as this could dilute them and make them less effective. You should ideally leave at least 30 minutes after using this moisturiser before applying different creams, ointments or lotions. Other medicines containing the same active ingredients

Epaderm cream and ointment can also be used in place of soap when washing to prevent drying of the skin, and as a moisturising bath additive. After washing, the skin should be patted rather than rubbed dry to avoid rubbing the oil off the skin. This medicine should not be used if you are allergic to any of its ingredients. Please inform your doctor or pharmacist if you have previously experienced such an allergy. Adam, R., Schnetz, B., Mathey, P., Pericoi, M. & de Prost, Y. (2009) “ Clinical demonstration of skin mildness and suitability for sensitive infant skin of a new baby wipe.” Pediatric Dermatology, vol. 26(5), pp. 506-513. Can be used for existing patients if switching toExocream/Zerocream is not acceptable to the patient.

Ichthammol in this medicine may stain fabric. A protective covering may be placed over the application area to avoid staining clothes and bed linen.

Other first line options are Epimax ®ointment and Liquid & white soft paraffin ointment (Fifty:50®). Barrier preparation: Orabase paste mixed with Yellow soft paraffin (half and half mixture) at each nappy changeCoughlin, C., Eichenfield, L. and Frieden, I. (2014) Diaper Dermatitis: Clinical Characteristics and Differential Diagnosis. Pediatric Dermatology. [Online] Vol.31, pp.19-24. Ichthammol ointment contains three main ingredients, ichthammol, yellow soft paraffin and wool fat. Zeroveen is a moisturising cream containing glycerol, liquid paraffin, isopropyl palmitate and Avena sativa kernel flour. Epaderm cream and ointment are moisturisers that contain a mixture of yellow soft paraffin, liquid paraffin and emulsifying wax. They work by providing a layer of oil on the surface of the skin to prevent water evaporating from the skin surface. No new patients to receive prescriptions in primary care. Patients already receiving Red Medicines in primary care should be handled on a case by case basis with the support of the Medicines Optimisation team.