Lotions are more occlusive than oils and are best applied immediately after bathing, to retain the water in the skin, and at other times as necessary. A policy detailing clinician responsibilities in Shared Care Agreements must be referred to in all cases of Shared Care. If you’ve tried cetomacrogol cream or another therapeutic skin lotion, we encourage you to share your experiences to help other patients. PatientsLikeMe’s unique data-sharing platform allows you to share detailed data about all types of treatments, interventions and lifestyle modifications that have helped you or simply had no effect. Non-formulary drugs - any drug or formulation not listed in the formulary is deemed to be non-formulary. Varothai S, Nitayavardhana S, Kulthanan K. Review article: Moisturizers for patients with atopic dermatitis. Asian Pac J Allergy Immunol 2013; 31: 91-8. Journal

NHSE commissioned drug for Paediatric indications (in line with NICE TA734) - see Specialised Commissioning: Key documents MHRA (2018). Mycophenolate mofetil, mycophenolic acid: updated contraception advice for male patients. Leave-on moisturising ointments, creams, and lotions are most effective when applied immediately after bathing, as water that has entered the epidermis remains there, but they can also be applied at other times. Systemic antimuscarinic medicines can be effective for generalised hyperhidrosis and propantheline is licensed for hyperhidrosis. These medicines should be avoided in patients with closed angle glaucoma. There are several side effects including dry mouth which can lead to dental caries. Small doses should be used.

Rozex®) Cream; Gel; 30 g, 40 g (Only licensed for rosacea) 0.75% (Anabact®) Gel;15 g, 30 g(Only licensed formalodorous fungating tumours A trial of a selective serotonin re-uptake inhibitor can be considered for patients with hyperhidrosis which is associated with or is likely to be exacerbated by anxiety or social phobia e.g. It should be continued for 2 months before assessing response. When bathing, try to use warm, not hot, water and avoid staying in the bath for long periods. This could make dry skin conditions worse. NHSE commissioned drug for Paediatric indications (in line with NICE TA 455) - see Specialised Commissioning: Key documents Medicines recommended or initiated by specialists in primary or secondary care. Non-specialist prescribing in primary care may follow according the RAG criteria. In process of being superceded by Amber Recommended, Amber Initiated and Amber Patient Retained.

In the community, acute impetigo on small areas of the skin may be treated by short-term topical application of fusidic acid or mupirocin. They should not be used for longer than 10 days and local microbiology advice should be sought before using it in hospital to avoid the development of resistance. soften, moisturise and protect your skin by trapping moisture in the skin and restoring the normal protective function of the skin For further information on the Atopic eczema in children: Management of atopic eczema in children from birth up to the age of 12years consult NICE CG 57 Requires short to medium term specialist prescribing and monitoring of efficacy or toxicity until the patient’s dose and condition is stable Where prescribing and monitoring are required under shared care, it is implicit that the responsibility for both of these tasks rests with the prescriber.Bath emollients are oils or emulsifiers designed to disperse in the bath, and are best used in conjunction with other moisturisers including leave-on products. Until such time as a single suite of commissioning policies can be developed and adopted, NHS Cheshire and Merseyside will continue to adopt and operate the CCG policies it has inherited at Place/borough level, which means that there will be no immediate change in commissioning policy for local people resident in those Places/boroughs from what was in place prior to 1st July 2022. Danby SG, Chalmers J, Brown K, Williams HC, Cork MJ. A functional mechanistic study of the effect of emollients on the structure and function of the skin barrier. Br J Dermatol 2016; 175: 1011–9. DOI: 10.1111/bjd.14684. Journal NHS England commissioned for paediatrics (aged 12-17); must be treated within a specialised treatment centre and meet the criteria within NICE TA534 for adults. Only where inflammatory skin conditions are associated with bacterial or fungal infection, such as infected eczema. The antimicrobial drug should be chosen according to the sensitivity of the infecting organism and used regularly for a short period (typically twice daily for 1 week). Longer use increases the likelihood of resistance and of sensitisation.

NICE TA701 (2021): Crisaborole for treating mild to moderate atopic dermatitis in people 2 years and older (terminated appraisal) SC3 Requires specific long-term monitoring (blood test or other measurement) for adverse effects and / or efficacy of the drug to be completed in Primary Care, and requires on-going specialist support for the dose changes or management of adverse effects. Monitoring is required on a regular basis (typically four times a year). Amber Patient Retained. Requires specialist initiation of prescribing. Prescribing to be continued by specialist until stabilisation of the dose is achieved and the patient had been reviewed. Patient remains under the care of specialist (ie not discharged) as occasional specialist input may be required. Amber Patient Retained medicines must meet criteria: Urea and other acidic preparations often sting if applied to scratched or fissured skin. They are also keratolytic, ie, they have a descaling or peeling effect, which is important in the management of ichthyosis. Preservatives The amount of moisturiser applied per week in patients with eczema averages from 150–200 g in young children to 500 g in adults.Urea is a keratin softener and hydrating agent used in the treatment of dry, scaling conditions (including ichthyosis) and may be useful in elderly patients. It is occasionally used with other topical agents such as corticosteroids to enhance penetration of the skin.

MHRA (2020). Ingenol mebutate gel (Picato▼): suspension of the licence due to risk of skin malignancy AproDerm Colloidal Oat Cream, a light, paraffin-free emollient which has all the benefits of colloidal oat including protecting and restoring the skin barrier, soothing the itch, irritation and redness associated with dry skin conditions like eczema and psoriasis, as well as having humectant properties and maintaining the skin’s normal pH. As well as being a moisturiser it can also be used as an effective soap substitute, to prevent the skin from drying out further. MHRA (2013). Cyproterone acetate with ethinylestradiol (co-cyprindiol): balance of benefits and risks remains positiveNHSE commissioned drug for Paediatric indications (where Adult TA available) - see Specialised Commissioning: Key documents Thermal burns from paraffin-containing ointments on clothing or bedding can be dangerous and can occur if ignited by cigarettes or naked flames. Slips and falls mg/ml solution for injection. For treatment of submental fat (use restricted to private clinics only) Creams are more occlusive again. They include sorbolene cream, cetomacrogol cream, fatty cream, oily cream. Preparations containing an antibacterial (section 13.10) should be avoided unless infection is present or is a frequent complication.