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 Formulary Chapter 13: Skin - Full Chapter
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13.02.01  Expand sub section  Emollients
 note 

Link NHS Grampian emollient choices

Prescribe an emollient according to the dryness of the skin, and individual preference/tolerance. The key to successful management is finding the correct balance between these factors, some patients may require more than one product at a time, e.g. a cream to apply during the day and an ointment for night time. The effectiveness and acceptability of a particular emollient may vary with time. If the person feels that a particular product is no longer suitable for them (or if they have developed a sensitivity to it), prescribe an alternative emollient. It may be necessary to try a range of emollients before a person settles on a product/combination.

Note - some products are considered less suitable for prescribing due to their excipients being common allergens:

  • sodium lauryl sulphate (SLS), e.g. Aqueous cream, Emulsifying ointment
  • lanolin (wool fat), e.g. E45 range, Zerocream
  • acrylates, e.g. AproDerm gel, Zerodouble gel
13.02.01  Expand sub section  Ointments
 note 

Ointments are preferable for dry skin because they are more effective than creams. However, compared with creams, they are more stiff and greasy products which may affect their acceptability (and compliance) for some people.
For ointments that come in pots, using a clean spoon or spatula (rather than fingers) to remove the ointment helps to minimise contamination.

Epimax Ointment
First Choice
Green

Active ingredients:

  • Liquid paraffin 40% w/w
  • Yellow soft paraffin 30% w/w
 
AproDerm Ointment
Formulary
Green

Active ingredients:

  • Liquid Paraffin 5% w/w
  • White Soft Paraffin 95% w/w
 
   
Zeroderm Ointment
Formulary
Green

Active ingredients:

  • Liquid Paraffin 40% w/w
  • White Soft Paraffin 30% w/w
 
   
Hydromol Ointment
Formulary
Green

Active ingredients:

  • Liquid Paraffin 42.5% w/w
  • Yellow Soft Paraffin 32% w/w
 
   
Epimax Paraffin free Ointment
Formulary
Green

Active ingredients:

  • Polyoxyethylene (40) Hydrogenated Castor Oil 38% w/w.
 
   
Cetraben Ointment
Formulary
Green

Active ingredients:

  • Liquid Paraffin 45% w/w
  • White Soft Paraffin 35% w/w
 
   
13.02.01  Expand sub section  Creams
 note 

Creams are less effective emollients compared to ointments, but are more practicable. Since creams contain more ingredients than ointments, stinging is more common, especially if applied to inflamed skin.

Epimax Original Cream
First Choice
Green

Active ingredients:

  • Liquid Paraffin 6% w/w
  • White Soft Paraffin 15% w/w
 
AproDerm Emollient Cream
Formulary
Green

Active ingredients:

  • Liquid Paraffin 6% w/w
  • White Soft Paraffin 15% w/w
 
   
Zerobase
Formulary
Green

Active ingredients:

  • Liquid Paraffin 11% w/w
  • White Soft Paraffin 10% w/w
 
   
QV Cream
Formulary
Green

Active ingredients:

  • Liquid Paraffin (light) 10% w/w
  • White Soft Paraffin 5% w/w
 
   
Cetraben Cream
Formulary
Green

Active ingredients:

  • Liquid Paraffin (light) 10.5% w/w
  • White Soft Paraffin 13.2% w/w
 
   
13.02.01  Expand sub section  Colloidal Oatmeal Creams
Epimax Oatmeal Cream
First Choice
Green

Active ingredients:

  • Avena Sativa (Oat) Kernel Flour
 
AproDerm Colloidal Oatmeal Cream
Formulary
Green

Active ingredients:

  • Avena Sativa Kernel Flour 1%
 
   
Zeroveen Cream
Formulary
Green

Active ingredients:

  • Avena Sativa (Oat) Kernel Flour
 
   
13.02.01  Expand sub section  Urea 5% Creams to top
imuDerm emollient
(urea 5%)
First Choice
Green

Active ingredients:

  • Urea 5%
  • Glycerine BP 5%
 
13.02.01  Expand sub section  Gels
 note 

Gels are less effective emollients compared to ointments, but are more practicable. Since creams contain more ingredients than ointments, stinging is more common, especially if applied to inflamed skin.

Epimax Isomol Gel
First Choice
Green

Active ingredients:

  • Isopropyl myristate 15%
  • Liquid Paraffin 15%
 
13.02.01  Expand sub section  Lotions
 note 

Lotions are more suitable for hairy skin, skin which is not very inflamed or for hotter days, when creams and ointments are perceived occlusive.

QV Lotion
First Choice
Green

Active ingredient:

  • White Soft Paraffin
 
Cetraben Lotion
Formulary
Green

Active ingredients:

  • Liquid Paraffin 4% w/w
  • White Soft Paraffin 5% w/w
 
   
13.02.01  Expand sub section  Spray emollients
 note 

Spray emollients can be applied without touching the affected area, they are useful for treating hard to reach places, sore or infected skin e.g. severe nappy rash, severe cradle cap, elderly patients with fragile skin, patients with sensory issues.

13.02.01.01  Expand sub section  Soap substitutes
 note 
  • Soap substitutes should be used as a wash in place of other proprietary soaps and shower gels.
  • It is not recommended to use ointments as a soap substitute or bath additives as a soak.
Emulsifying Wax
Unlicensed Drug Unlicensed
Red

Restricted Item Restricted to use in hospital only for the removal of tar based products

 
   
 ....
 Non Formulary Items
Aqueous Cream

Non Formulary
Black

Aqueous cream contains sodium lauryl sulphate (SLS) and is not recommended as a leave-on emollient or soap substitute.

Link  Drug Safety Update: Aqueous cream: may cause skin irritation (Dec 2014)
 
  
Key
note Notes
Section Title Section Title (top level)
Section Title Section Title (sub level)
First Choice Item First Choice item
Non Formulary Item Non Formulary section
Restricted Drug
Restricted Drug
Unlicensed Drug
Unlicensed
Track Changes
Display tracking information
click to search medicines.org.uk
Link to adult BNF
click to search medicines.org.uk
Link to children's BNF
click to search medicines.org.uk
Link to SPCs
SMC
Scottish Medicines Consortium
Cytotoxic Drug
Cytotoxic Drug
CD
Controlled Drug
High Cost Medicine
High Cost Medicine
Homecare
Homecare

Traffic Light Status Information

Status Description

Green

General use.
Treatment may be initiated in either Primary or Secondary Care.  

Amber 1

Available for restricted use under specialist supervision.
Treatment may be initiated in Primary Care on the recommendation of a consultant/specialist.  

Amber 2

Available for restricted use under specialist supervision.
Treatment to be initiated in hospital prior to handover.  

Red

Hospital use only.
Treatment should be supplied by the hospital for the duration of the treatment course.  

Blue

Products shown as blue have multiple indications with varying formulary classifications. For further information see text next to the product.  

Grey

Work is ongoing and will be reviewed at a future meeting  

Non Formulary

Not routinely available in NHS Grampian however if local need is identified:
  • Contact the Pharmacist Team Leader/Principal Pharmacist Supply (ARI)
  • Treatment is available:
    • From a Specialist Centre in another health board
    • From the National Specialist Service for pulmonary arterial hypertension (Scottish Pulmonary Vascular Unit or similar specialists)
    • Through the National Services Scotland:
      • Ultra-Orphan Medicines Risk Share Scheme
      • Inherited Metabolic Disorders Risk Share Scheme
    • For SMC recommended medicines/indications where local clinical experts do not wish to add to the formulary at this time
  

Black

Not routinely available in NHS Grampian.
Includes medicines/indications that:
  • Are not recommended for use within NHS Grampian
  • Are not recommended for use within NHS Scotland
  • Have not been considered by SMC or NHSG Formulary Group
  • Are not recommended for use at present due to limited clinical and/or cost effective data
  • There is a local preference for alternative medicines
  

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