Dermatology Handbook 2021–2022

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topical treatments adjuvant treatments 001 Derma Handbook Cover 2021.indd 1 emollients 16/03/2021Efudix 15:26 (adult small); £70.99 (adult medium); £72.99 (adult Meda Pharmaceuticals lesions. Treatment of squamous cell carcinoma in Skinnies Silk large). Mittens: £13.49 (0–24 months); £13.49 (2–8 Description situ (Bowen’s disease), when surgical excision is Skinnies years); £13.49 (8–14 years). Gloves: £13.22 (child Efudix is a topical cytostatic preparation that exerts considered less appropriate. Price Price Description small); £13.49 (child medium); £13.99 (child large); a beneficial therapeutic effect on neoplastic and pre- Sizes A clinically proven range of seamless and coloured £17.98 (adult small); £18.19 (adult medium); £18.96 £2.48, £5.38, £10.39 £5.45 oral treatments neoplastic skin lesions without damaging normal 2g Price medical garments designed to be worn continuously (adult large). Tubular sleeves: £24.90 (33cm long); Cetraben Bath Additive E45 Bath Oil skin. The pattern of response follows this sequence: for the management of irritated skin caused by mild £29.90 (50cm long). Socks: £16.75 (6 months–8 erythema, vesiculation, erosion, ulceration, necrosis Contact supplier diagnostics Thornton & Ross Reckitt Benckiser Healthcare UK to moderate atopic eczema, epidermolysis bullosa, years); £16.75 (8–14 years). Knee-length sock: Sporanox and epithelialisation. palliative care, radiotherapy and as a non-irritant Description Description Indications Picato £22.39 (child small); £22.39 (child medium); £22.39 Janssen-Cilag Ltd believed to depend wholly or partly upon the dressing retention. The itch is controlled by using Cetraben Bath Additive is an emollient, moisturising An effective yet gentle bath oil that is clinically For the topical treatment of superficial pre- LEO Pharma (child large); £22.39 (adult small); £22.39 (adult Description triggered release of histamine. It is a potent the properties of stretch and seamlessness enabling medium); £22.39 (adult large); £22.39 (adult XL) and protective oil. Its ingredients have emollient, proven to soothe and moisturise dry skin. It creates malignant and malignant skin lesions, keratoses Description Sporanox is a triazole derivative with a broad competitive histamine H1 antagonist which lacks body temperature regulation and can reduceDiagnostics the moisturising and protective properties. a lasting barrier that protects against moisture loss. including senile, actinic and arsenical forms, The active ingredient in Picato gel is ingenol spectrum of antifungal activity that inhibits the significant anti-cholinergic effects, and has a low frequency and severity of eczema flare-ups. Skinnies Viscose Garments25 mm four-element lens, 28 high-powered LEDs Indications Indications keratoacanthoma, Bowen’s disease, superficial basal mebutate. growth of a broad range of fungi that are pathogenic potential to penetrate the central nervous system. It Indications DermoscopySkinnies and PigmentBoost illumination. For optimum Red, inflamed, dry, damaged or chapped skin For moisturising dry and itchy skin conditions. cell carcinoma. Deep, penetrating or nodular basal Indications in humans. is a non-sedating antihistamine. Dressing retention, wet and dry wrapping for the Description ease of use, a quick tap on its power button associated with eczema. Sizes cell and squamous cell carcinomas do not usually Picato is indicated for the cutaneous treatment DermLite Basic Sizes Indications Indications treatment of atopic eczema. A range of easy-to-apply, washable garments instantlyused toggles between polarization modes, 250ml, 500ml respond to Efudix therapy. It should be used only as of non-hyperkeratotic, non-hypertrophic actinic Price For the treatment of pityriasis versicolor and For the symptomatic relief of allergic rhinitis, Sizes Schuco Internationalin wet and dry (London) wrapping for the treatment of whileatopic the optional PigmentBoost mode produces a 500ml a palliative therapy in cases where no other form of keratosis in adults. Description Price dermatophytoses caused by organisms susceptible to including hay fever and also indicated for chronic Clavas: 6 months –14 years. Leggings: 6 months –14 eczema. warmer illumination reminiscent of conventional Contact supplier treatment is possible. Sizes itraconazole (Trichophytonspp., Microsporumspp., idiopathic urticaria. years; adult S–L. Vest long-sleeved: 6 monthsThe –14 DermLiteIndications Basic is the original choice for oil-free dermatoscopes. £5.75 Sizes 150 microgramme/g 3 x 0.47 single-use tubes; 500 dermoscopy. By incorporating 8 bright-white LEDs, Indications Hydromol Bath & Shower Epidermophyton floccosum), e.g. tinea pedis, Sizes years; adult S–L. Baby grow: premature–12 months. Wet and dry wrapping for the treatment of atopic 40g micrograms/g, 2 × 0.47-g single-use tubes; 47-g 10x magnification and advanced cross-polarisation, Dermalo Bath Emollient tinea cruris, tinea corporis, tinea manuum, and 8mg (x12) Shorts: 6 months–14 years; adult S–L. Sleeveless eczema. To assess and diagnose a variety of skin lesions. Emollient Price single-use tubes onychomycosis caused by dermatophytes and/or Price vests: 6 months–14 years; adult S–L. Short sleevethe DermLite Sizes Basic aids the early detection of Price Dermal Laboratories Ltd Alliance Pharmaceuticals Ltd £32.90 Price melanoma by enhancing visualisation of pigmented Description Description yeasts. Sporanox is also indicated for the treatment £4.99 (RRP) vests: 6 months–14 years; adult S–L. Mittens: 0–14 Premature: 6–24 months; 2–5 years; 5–8 years;£925.00 ex. VAT £65.00 skin lesions. of candidosis (vaginal and oral), histoplasmosis and years. Tubular sleeves: 33cm long; 50cm long. 8–11;11–14 years; child S–L and adult S–L Dermalo Bath Emollient contains 65% liquid Hydromol Bath & Shower Emollient is a water- Metvix Cream Indications systemic fungal conditions. Mizollen Socks: 6 months–14 years (regular); child S–L (knee Price DermLite DL4W paraffin and 5% acetylated wool alcohols, which dispersible bath additive resulting in an emulsion Galderma (UK) Solaraze For the new user to assess and diagnose a variety of Sizes Sanofi UK length); adult S–XL. Gloves: child S–L; adult S–L. Body suit: £16.18 (premature); £16.18 (up to Schuco International (London) have moisturising and skin-softening properties. of dispersed oils together with a homogenised Description Almirall Ltd skin lesions. Description Capsules: 100mg. Oral liquid: 10mg/ml (150ml) Description Knee-length sock: child S–L; adult S–XL 3 months); £16.18 (3–6 months); £18.21(6-12 It is specially formulated to facilitate dispersion in film on the surface. The oils are deposited on the After topical application of Metvix (methyl Description Sizes Price Mizollen contains mizolastine, which possesses Price months).Clava: £6.74 (6 months–5 years); £7.73The (5– newest fourth generation DermLite achieves bath water and for ease of application after a shower. skin surface during bathing, reducing moisture aminolevulinate), porphyrins accumulate Solaraze contains diclofenac, a non-steroidal One size Contact supplier antihistamine and anti-allergic properties due to Clavas: £14.80 (6 months–5 years); £14.80 (5–14 14 years). Vest long sleeve: £10.48 (6–24 months);brighter white illumination in both the polarised Indications loss, providing antipruritic action, lubricating and intracellularly in the treated skin lesions. The antiinflammatory. The mechanism of action of Price a specific and selective antagonism of peripheral years). Leggings: £25.28 (6–24 months); £28.39 £13.74 (2–5 years); £15.52 (5–8 years); £17.20and (8–11 non-polarised modes. With its smooth, For symptomatic relief of contact dermatitis, atopic softening the skin. This emollient is particularly intracellular porphyrins (including PplX) are diclofenac in actinic keratosis is not known but may histamine H1 receptors. £299 (ex. VAT) ergonomically optimised all-aluminum design that dermatitis, senile pruritus, ichthyosis and related suitable for infant bathing. The preparation can alsoAntihistamines photoactive, fluorescing compounds and, on be related to the inhibition of the cycloxygenase (2–5 years); £29.90 (5–8 years); £32.70 (8–11 years); years); £17.20 (11–14 years); £21.27 (small adult); Indications £35.90 (11–14 years); £69.99 (adult small); £71.99 £23.20 (medium adult); £25.13 (large adult). Vestcomfortably molds to your hand, DermLite DL4W dry skin disorders. be used as a cleanser and is indicated for use directly light activation in the presence of oxygen, singlet pathway leading to reduced prostaglandin E2 DermLite Carbon Atarax 10mg & 25mg Film- For the symptomatic relief of seasonal allergic (adult medium); £73.72 (adult large). Vest long- short sleeve: £10.38 (6–24 months); £13.63 (2–5provides phenomenal versatility, the largest optics Sizes onto the skin as a soap substitute. oxygen is formed, which causes damage to cellular (PGE2) synthesis. Schuco International (London) Coated Tablets rhinoconjunctivitis (hay fever), perennial allergic sleeved: £44.46 (6–24 months); £47.49 (2–5 years); years); £15.36 (5–8 years); £17.09 (8–11 years);of any pocket-size DermLite, and instant on/off 500ml Indications compartments, in particular the mitochondria. Indications Description Alliance Pharmaceuticals Ltd rhinoconjunctivitis and urticaria. £49.51 (5–8 years); £51.54 (8–11 years); £52.54 £17.09 (11–14 years); £21.16 (small adult); £23.10control. Price For the treatment of dry skin conditions such as Light activation of accumulated porphyrins leads to For the treatment of actinic keratosis. The DermLite Carbon provides instant toggle Indications Description Sizes (11–14 years); £69.99 (adult small); £71.99 (adult (medium adult); £25.03 (large adult). Vest sleeveless: £3.44 eczema, ichthyosis and senile pruritus. a photochemical reaction and thereby phototoxicity Sizes control over lesion visualisation, from the superficial To assess and diagnose a variety of skin lesions. Atarax is unrelated chemically to benzodiazepines, 10mg medium); £73.72 (adult large). Baby grow: £35.81 £10.38 (6–24 months); £13.63 (2–5 years); £15.42 Sizes to the light-exposed target cells. 50g structures to deeper pigmentation, by activating two Price phenothiazines, reserpine and meprobamate. Its Price (premature); £35.81 (0–3 months); £35.81(3–6 (5–8 years); £17.09 (8–11 years); £17.09 (11–14 Doublebase Emollient Bath 350ml, 500ml, 1000ml Indications Price groups of LEDs, each with distinct polarisation. The £1045.00 ex. VAT antihistamine effects have been demonstrated £6.92 (x30 pack) months); £37.87 (6–12 months). Shorts: £19.99 (6– years); £21.16 (small adult); £23.10 (medium adult); Additive Price For the treatment of thin or non-hyperkeratotic £38.30 first group of 8 LEDs produces cross-polarised light experimentally and confirmed clinically. It is highly 24 months); £19.99 (2–5 years); £19.99 (5–8 years); £25.03 (large adult). Gloves: £5.29 (small child); Dermal Laboratories Ltd £3.88 – 350ml, £4.42 – 500ml, £8.80 – 1000ml and non-pigmented actinic keratoses on the face ideal for visualising deep structures, whereas the DermLite Hybrid effective in alleviating pruritus. NeoClarityn Zyclara £19.99 (8–11 years); £21.99 (11–14 years); £37.99 £5.34 (medium child); £5.34 (large child); £5.29 Description and scalp when other therapies are considered less second set of 8 LEDs is linearly polarised, creating a Indications Merck Sharp & Dohme Ltd (adult small); £38.49 (adult medium); £38.99 (adult (small adult); £5.34 (medium adult); £5.34 (largeSchuco International (London) Doublebase Emollient Bath Additive contains 65% LPL 63.4 Fragrance Free Bath appropriate. Only for treatment of superficial and/ Meda Pharmaceuticals clear rendition of the skin surface. Description For the management of pruritus associated with Description Description large). Vests sleeveless: £42.29 (child 6–24 months); adult). Knee-length shorts: £10.38 (6–24 months); liquid paraffin, which has moisturising and skin- Emollient or nodular basal cell carcinoma; unsuitable for other Indications The DermLite II Hybrid is the first dermatoscope acute and chronic urticaria, including cholinergic NeoClarityn contains desloratadine, which is a £42.79 (child 2–5 years); £43.29 (child 5–8 years); £13.63 (2–5 years); £15.42 (5–8 years); £17.09 (8–11 softening properties, and is specially formulated to Huxley Europe available therapies due to possible treatment-related Imiquimod is an immune response modifier. It For the infrequent user, to assess and diagnose a that combines non-polarised illumination for and physical types, and atopic and contact non-sedating, long-acting histamine antagonist with £43.79 (child 8–11 years); £44.11 (child 11–14 years); £17.09 (11–14 years); £21.16 (small adult); disperse in bath water. Description morbidity and poor cosmetic outcome, such as is the lead compound of the imidazoline family. variety of skin lesions. immersion fluid dermoscopy with dry, cross- dermatitis in adults and children. selective peripheral H1-receptor antagonist activity. years); £67.49 (adult small); £68.99 (adult medium); £23.10 (medium adult); £25.03 (large adult). Knee Indications Fragrance-free emollient bath additive. lesions on the mid-face or ears, lesions on severely Zyclara contains 3.75% imiquimod. Sizes polarised dermoscopy, with or without skin contact. Sizes After oral administration, desloratadine selectivelyIndications £69.99 (adult large). Short sleeve vests: £43.39 (6–24 sock: £13.94 (small child 0–1); (medium child 1–2) For the symptomatic relief of contact dermatitis, Indications sun damaged skin, large lesions, or recurrent One size Palm-sized, this versatile device offer high light 10mg, 25mg blocks peripheral histamine H1-receptors because months); £44.49 (2–5 years); £44.99 (5–8 years); £13.94; £13.94 (large child 2–4); £13.94 (small adult atopic dermatitis, senile pruritus, ichthyosis and An emollient is suitable for use as part of complete Zyclara is indicated for the topical treatment Price output, large 25mm lens and camera adaptability as Price the substance is excluded from entry to the central £45.11 (8–11 years); £45.49 (11–14 years); £68.99 related dry skin disorders. emollient therapy. 40 £449 (ex. VAT) 2017-2018well as integrated rechargeable lithium-ion battery. Sizes Sizes £1.20 – 10mg (84 tab), £0.62 – 25mg (28 tab) nervous system. Dermatology Handbook Indications Dermatology Handbook Indications 500ml 500ml 2017-2018 24 DermLite DL3N For the advanced practitioner, to assess and Benadryl Allergy NeoClarityn 5mg film-coated tablets are indicated Schuco International (London) diagnose a variety of skin lesions. McNeil Products Topical treatmentsin NEW.indd adults and 40 adolescents over the age of 12 years Description Sizes10/03/2017 11:16 Dermatology Handbook 2017-2018 Description7 for the relief of symptoms associated with allergic rhinits and urticaria. NeoClarityn oral solutionis 10/03/2017 11:24 Adjuvant treatments NEW.indd 24 The DermLite DL3N contains refined optics and One size Benadryl Allergy contains acrivastine which improved visualization of both pigmented and Price provides provides symptomatic relief in conditions indicated in adults, adolescents and children vascular structures. Precision-engineered and £900 (ex. VAT) Emollients NEW.indd 7 10/03/2017 11:18 over the age of 1 year for the relief of symptoms crafted from recyclable aluminum, it features a 2017-2018 8 Dermatology Handbook Dermatology Handbook 6 2017-2018

10/03/2017 11:17 Oral treatments NEW.indd 8

10/03/2017 11:23 Diagnostics NEW.indd 6 or to advertise please contact Ed Croome 020 7333 1741 [email protected] Contents

Introduction ...... 4 Hyfrecators ...... 105 All Party Parliamentary Group on Skin...... 6 Iontophoresis ...... 106 British Skin Foundation ...... 8 MED testing equipment ...... 107 Dermatology Council for England ...... 10 Narrowband UVB and UVA ...... 107 Primary Care Dermatology Society ...... 14 Photodynamic therapy ...... 108 Scottish Dermatological Nursing Society ...... 16 Systemic treatments ...... 110 Adjuvant treatments ...... 18 Acne oral treatments ...... 112 Adhesive removers ...... 20 Alopecia treatments ...... 113 Anaesthetics and antipruritics ...... 20 Antifungals (oral) ...... 113 Antiperspirants...... 22 Antihistamines ...... 113 Barrier preparations ...... 22 Antivirals (oral) ...... 115 Body wraps ...... 28 Biologics (atopic eczema) ...... 116 Bandages ...... 29 Biologics (psoriasis and psoriatic arthritis) ...... 116 Camouflage ...... 30 Immunosuppressants ...... 120 Laundry products ...... 32 Psoriasis (oral) ...... 120 Scar treatment ...... 33 Retinoids (oral) ...... 121 Physical debridement pads ...... 35 Topical treatments ...... 124 Sun protection ...... 36 Acne treatments ...... 126 Therapeutic clothing ...... 40 Alopecia treatments ...... 130 Dermocosmetics ...... 46 Antibacterials (antiseptics and antibiotics) ...... 130 Acne ...... 48 Antifungals (topical) ...... 132 Eczema treatments ...... 50 Antivirals (topical) ...... 135 Hyperpigmentation ...... 51 Corticosteroid compounds ...... 136 Rosacea treatments ...... 54 Corticosteroid scalp preparations ...... 136 Diagnostics ...... 58 Corticosteroid/antibacterial combinations ...... 138 Dermoscopy ...... 60 Corticosteroids ...... 143 Patch testing ...... 62 Eczema treatments ...... 147 Emollients ...... 64 Hirsutism treatments ...... 147 Bath additives with antimicrobials ...... 66 Hyperhidrosis ...... 148 Bath oils and additives ...... 66 Insecticides and parasiticidals ...... 148 Bath oils with antipruritics...... 70 Keratolytics...... 150 Emollient washes (including shower preparations) 71 Psoriasis treatments ...... 150 Moisturisers ...... 73 Rosacea treatments ...... 153 Moisturisers (humectants) ...... 87 Shampoos ...... 155 Moisturisers with anti-inflammatories...... 98 Skin cancer (and actinic keratoses) treatments ..... 157 Moisturisers with antimicrobials ...... 98 Wart and callus treatments ...... 159 Moisturisers with antipruritics ...... 100 Company details ...... 162 Washes & shower preparations with antimicrobials .100 Products by company ...... 174 Medical equipment ...... 102 Product index ...... 184 Cryotherapy ...... 104 Notes...... 190

Editor Julie Van Onselen | Head of Projects Camila Fronzo | Associate Publisher (Medical Education) Tracy Cowan | Associate Publisher Sophie Gardner | Publishing Director Andrew Iafrati | Commercial Manager Edward Croome | Production Managers Jamie Hodgskin, Kyri Apostolou | Managing Director Anthony Kerr | TheDermatology Handbook is distributed free to subscribers of the British Journal of Nursing and Nursing and Residential Care. Extra copies are available from MA Healthcare Ltd (call 0800 137 201 for details). Prices have been checked at March 2021. While every effort has been made to ensure the accuracy of the information provided, no liability can be accepted by the publisher or printer for any errors or omissions. The information provided is deliberately concise, and it is the responsibility of readers to refer to the summary of product characteristics or health professional information supplied by the product manufacturer. ISSN 2043-9482. ©MA Healthcare Ltd 2021. No part of this publication may be reproduced without permission in writing from the publisher. Published by MA Healthcare Ltd, St Jude’s Church, Dulwich Road, London SE24 0PB. Tel: +44 (0)20 7738 5454. Printed by Pensord, Blackwood, Gwent.

Dermatology Handbook 2021–2022 3 Dermatology Handbook Introduction

elcome to the 2021–2022 edition of Information on the products, appliances and the Dermatology Handbook. This tenth equipment includes description, indications and edition has been fully updated to include prices. The information for the POMs has been newW products that were added to formulary since sourced from the electronic Medicines Compendium last year. (eMC).1 Specific product characteristics (SPCs) Generally, common skin conditions are long- and patient information leaflets (PILs) are available term and self-managed, so product choice is on the eMC for all UK licensed medicines. The very important. Therefore, this guide to product product descriptions and indications have been selection in dermatology is designed to help health taken from the summary of SPC, which informs professionals in primary and secondary care health professionals such as doctors, pharmacists understand the range of treatment choices for people and nurses how to prescribe, and offers the product with skin conditions. It is an accessible information PILs as package information to help the patient source on a comprehensive range of dermatology understand how to use a medicine (or topical products. treatment) correctly. An SPC is based on the clinical The handbook is logically divided into seven trials that a pharmaceutical company has carried chapters covering each of the main therapeutic out, and gives information about dose, use and areas. Each chapter is preceded by an evidence- possible side effects. SPCs are checked and approved based foreword on treatment updates. The by either the UK or European government agencies handbook includes the full range of prescription which license medicines—the UK Medicines and only medications (POMs) and pharmacy (P) Healthcare products Regulatory Agency (MHRA) products, which are listed in both the British and, for some medicines, the European Medicines National Formulary (BNF) and the Monthly Index Agency (EMA). of Medical Specialities (MIMS). The Emollients The eMC also contains PILs for licensed chapter includes some products that are listed as medicines. Written for patients, these are included in medical devices or bought over the counter (OTC). the pack with a medicine and summarise the SPC. The Dermocosmetics chapter presents OTC skin When there is new information about a medicine, solutions (including some medical devices) rather or a new medicine is launched, the pharmaceutical than cosmetic beauty products. For patients with company should update the eMC website within 30 mild skin conditions, this offers more choice for self- days of the UK or European medicines authority management. approving the change.1 I am delighted that the All Party Parliamentary The information on preparations available, sizes Group on Skin (APPGS), British Skin Foundation and prices has been sourced from the BNF2 and (BSF), Dermatology Council for England (DCE), the individual pharmaceutical companies (where Primary Care Dermatology Society (PCDS) and available). The NHS Drug Tariff prices sourced from Scottish Dermatological Nursing Society (SDNS) the BNF online are net prices, giving an indication have once again supported the Dermatology of relative costs; these prices have generally been Handbook. The association forewords give the reader calculated from the net cost used in pricing NHS more information on their valuable work in the prescriptions (Joint Formulary Committee, 2021). dermatology field, and the DCE forward includes a Some prices in the handbook may not correlate list of dermatology patient support groups (these can exactly with the BNF March 2021 prices; any price also be accessed via the BSF website at http://www. discrepancy is due to individual pharmaceutical britishskinfoundation.org.uk, which is an excellent companies providing their specific product prices, source of information and advice for patients and which represents the actual price that their products health professionals). are sold to the NHS. Please be aware that OTC

4 Dermatology Handbook 2021–2022 Introduction

prices can also differ from NHS prices. Information on diagnostics and medical equipment has been sourced directly from the pharmaceutical or medical device companies. We are indebted to the medical information departments, regulatory officers and product managers from the many pharmaceutical and medical device companies who have been invaluable guides in the compilation of this resource. This handbook does not contain information on adverse effects, contraindications and cautions for the products listed. These can be found in full by accessing the product licence with the SPC; the information source for all POM products is the eMC, which can be accessed at http://emc.medicines.org.uk. The Dermatology Handbook enables all practitioners to learn more about the range of dermatology treatment options and recent product developments. All healthcare professionals should give patients choice on the products; this is especially important in dermatology, as formulations differ and what suits one patient does not necessarily suit another individual. The information contained in the handbook is no substitute for detailed product knowledge. All health professionals caring for people with skin conditions have a responsibility to familiarise themselves with the most recent product evidence and application techniques. I would value your feedback on the tenth edition of the Dermatology Handbook, especially suggestions for other products and information that should be included in the next edition. I do hope you will find it a valuable, informative and useful resource for clinical practice.

Julie Van Onselen Dermatology Handbook Clinical Editor, Dermatology Lecturer Practitioner, Dermatology Education Partnership Ltd www.educationindermatology.com

References 1 Electronic Medicines Compendium (eMC). About the eMC. http://bit.ly/2mEtXbO (accessed March 2021) 2 Joint Formulary Committee. Skin British National Formulary. British National Formulary. https://bit. ly/3clt1RR (accessed March 2021)

Dermatology Handbook 2021–2022 5 Dermatology Handbook All Party Parliamentary Group on Skin

A group comprising members from all political parties, health professionals and patients which aims to increase understanding of skin care issues and improve treatment

he All Party Parliamentary Group on Skin • To advise and make recommendations to (APPGS) was established in 1994 with an aim government on improving patient care and the to increase understanding about skincare design of commissioning frameworks. Tissues in Parliament, and to achieve improvements in the treatment and management of patients with Supporters skin disease in England. It also provides an unbiased The APPGS has a large and diverse supporter means of responding to threats to dermatology base, consisting of patient organisations, health services and acts as a forum for partners in skincare professionals, trade associations, charities, industry to engage with politicians with an interest in representatives and individuals with an interest the issue. in skincare. Supporters can sign up to a mailing The APPGS has a large and active membership list for monitoring reports, news alerts and event that includes MPs from all political parties, members invitations. of the House of Lords, health professionals, patient Event attendees are able to meet representatives groups and industry representatives. The APPGS from other organisations that have an interest in benefits from input from its advisory group, which dermatology and any MPs and peers that are present. holds three to four meetings per year. The activities Policy officials are also typically invited to speak or of the advisory group are subject to the approval of observe meetings, offering an excellent opportunity the group’s parliamentary officers and, in particular, to question those who directly impact upon policy. the group’s parliamentary chairman, Sir Edward Leigh MP. Publications As with every other All Party Parliamentary Since 1997, the APPGS has published 13 reports on Group, the activities of the APPGS do not reflect the aspects of dermatological care. These include reports views of Parliament and neither do they constitute such as The Psychological and Social Impact of Skin official parliamentary business. Disease on People’s Lives (2013), the Inquiry into Sunbed Regulation in England (2014) and, more Aims recently, an Audit of UK Dermatology Coverage The APPGS maintains the following broad set of (2019). Every report is available to download via the aims: group’s website. • To raise awareness of skin-related issues in Parliament Work and priorities • To improve the treatment and management of The APPGS continues to raise awareness of skin patients with skin conditions issues via formal events, meetings, debates, and • To provide an unbiased means of responding to parliamentary questions. threats to dermatology services Its latest inquiry was into mental health and skin • To provide a forum for all skin interested disease, published in late 2020. More than a dozen stakeholders leading healthcare professionals specialising in

6 Dermatology Handbook 2021–2022 Association foreword

dermatology and mental health led the report, as well as patient organisations and the dermatology specialist groups, the British Association of Dermatologists, the Primary Care Dermatology Society, and the British Dermatological Nursing Group. The report raised concerns that access to specialist mental health support for people with skin disease is limited throughout the UK, despite a growing need for such services. Mandatory psychodermatology training, an increase in dermatology training numbers, and comprehensive dedicated psychodermatology services in each region of the UK were all identified as key recommendations for improving services. In addition, the report found that there is a need for all dermatology units to have named, dedicated staff either to manage patients with skin and mental health disease or refer patients to a nearby regional service. APPGS reports and all future activity of the Group can be found on the APPGS website: https://www. appgs.co.uk/

Dermatology Handbook 2021–2022 7 Dermatology Handbook British Skin Foundation

The British Skin Foundation funds research into all kinds of skin disease, including skin cancer.

stablished in 1996, the British Skin please contact events@britishskinfoundation. Foundation (BSF) was set up to raise money org.uk for research into skin disease and skin cancer. • Campaigning. Although our main aim is to EOur mission is to find cures and better treatments for fund research, we also believe it is important all skin conditions. We receive no statutory funding, to campaign about important skin matters, in so fundraising is crucial to our work and has helped order to both raise awareness of the problems us to give out more than £16,000,000 in grants to people face and to educate the general public. In top-quality skin research. recent times, we have focused on life and death At the BSF we know that skin disease does not matters, such as melanoma skin cancer, to the just affect the skin. It can have a huge impact on dangers of sensitivity to para-phenylenediamine a person’s day-to-day life, crush self-confidence, from so-called black henna temporary tattoos restrict movement, lead to depression and put a huge • We will fight for change, institutionally and strain on families as well as personal relationships. behaviourally, for the good of skin disease By raising awareness of common skin conditions, we sufferers. Keep up with our latest campaigns on hope to expand the nation’s understanding of skin Facebook, Twitter and Instagram (@BSFcharity) disease and promote acceptance. • Awareness. We aim to give the public a better Around 60% of the UK population has suffered understanding of what skin disease is and or currently suffers with a skin disease—a stark why our research is so important. We believe reminder that our work is not over yet. that education is the key to breaking down the stigma of skin conditions and promoting We have a number of aims to work towards: acceptance. We also hope to educate the public • Research. We fund research to further our on the importance of sun safety and regularly understanding of the different types of skin checking moles and the skin disease with the goal of finding cures and better • Community. Using our social media and treatments for all of them. From conditions that forums, we aim to encourage those with skin can impact everyday life, like acne and eczema, conditions to share their experiences with one to potential killers, such as melanoma another, so they do not have to suffer in silence. • Fundraising. Research does not fund itself, We run regular ‘Ask the Expert’ sessions for the which means all of our fundraising events and public with dermatologists via talkhealth: www. donations are crucial to enabling us to continue talkhealthpartnership.com/online_clinics/ our work. There are a number of ways we receive support at the BSF: corporate fundraising; legacy More about the research we fund gifts; trusts and major donors; donations from Our research includes: the public such taking part in sporting events or • Infection and inflammatory mechanisms. challenges; events such as a bake sales, among The BSF has been influential in supporting others. For more information and inspiration outstanding research into inflammatory mechanisms in skin disease, most notably

8 Dermatology Handbook 2021–2022 Association foreword

the seminal work into the role of filaggrin in The BSF invites applications for funding of ichthyosis and atopic eczema. The scope of our the above projects between April and August. research programme has extended to other Each application is examined by the foundation’s major inflammatory skin diseases. In psoriasis, Grants Advisory Committee, which consists of sponsored research has investigated factors dermatologists and medical research specialists. controlling the induction of therapy-induced Each application is also sent to two external referees remission and the mechanisms of drug action. for review, the proposed project being matched to In the bullous disorders, skin viral infections and the referees’ field of expertise. A decision on which cutaneous drug allergy, our investigators have projects will receive support is made at a final examined the role of cell-mediated immunity in meeting of the committee in December. Applicants the induction of these diseases are advised by the end of December. • Population genetics and epidemiology. We recognise that studies on populations can BSF small grant contribute much to our knowledge of disease The BSF invites applications for small grant funding causation and morbidity. Our researchers have between January and April. Each application is been active in this area in a variety of ways. examined by the foundation’s Grants Advisory They have investigated the genetic markers for Committee, which consists of dermatologists and inherited hyperkeratotic skin diseases, studied medical representatives. A decision on which filaggrin gene mutations in atopic dermatitis, projects will receive support is made at a final and defined important aspects indicating meeting of the committee in early July. Applicants genetic susceptibility to psoriasis. The role of are advised by the end of July. More information on gut bacteria in the inflammatory skin diseases, grants can be found on our website or by contacting notably atopic dermatitis, is a topic of particular [email protected] current significance • Cancer treatments and mechanism. The Log on or direct patients to our website (www. increasing prevalence of skin cancer and the britishskinfoundation.org.uk) for more information, concern of patients for effective treatments or visit https://knowyourskin.britishskinfoundation. are recognised by the BSF through our org.uk/ for an A-Z of different skin diseases. We also funding of a full programme of research, have information on sun safety, mole checking and spanning both mechanistic and therapeutic other useful links and resources. themes. BSF-sponsored investigators have highlighted new information on the role of Find us human papilloma viruses in non-melanotic Facebook.com/BSFcharity skin cancers and the molecular mechanisms Twitter.com/BSFcharity that are involved in the induction of skin Instagram.com/BSFcharity tumours. In malignant melanoma, researchers www.britishskinfoundation.org.uk have looked at the role for vitamin D and other factors that are involved in cancer Media enquiries progression, and have been instrumental in [email protected] the design of new therapeutic approaches to the disease. BSF funding opportunities The BSF Research Awards include: • BSF Research Award • BSF Studentship Award • BSF Fellowship Award • BSF Young Investigator Award

Dermatology Handbook 2021–2022 9 Dermatology Handbook Dermatology Council for England

Bringing together dermatology health professionals to raise awareness of and address the needs of patients with skin conditions

he Dermatology Council for England (DCE) its finding and recommendations in 2021. Hopefully, was established at an inaugural meeting at the positive implementation will start to alleviate some of British Association of Dermatologists (BAD) in the problems. T2009. The DCE was formed because of a critical need In addition to the workforce issues, every-day for the dermatology voice to be heard and to address problems for patients are further exacerbated by cost the needs of patients. The DCE has a large and diverse saving exercises; some led by NHS England, others membership with representatives from almost every by CCG’s which target and trivialise some areas of relevant patient support group, as well as from medical, dermatology disease and make it much more difficult nursing and political groups, and the pharmaceutical for patients to receive the treatments clinicians deem industry. Membership of the council is entirely voluntary necessary for their care, or force them into purchasing and there are no paid employees; the BAD provides a in order to maintain the quality of care they require. base for meetings and administrative support. This causes further stress and hardship for patients. The role of the chair and secretary is to ensure the These issues go to the very core of the principles of the decision makers in the health service listen to our NHS: free at the point of delivery and available to all. concerns. The broad membership gives the DCE the The council is here to offer support, experience and authority to raise these concerns within parliament knowledge. Its mission is to help to disseminate best and the NHS, and to campaign vigorously to improve practice within the dermatology community and is keen the care of patients with skin disorders. The NHS to hear of any issues that dermatology professionals feel continues to face unprecedented stresses that threaten might impact on the care of patients with skin disease. to undermine its very survival; there is a serious risk If you require more information, please do visit: www. that the really important issues facing patients with dermatologyengland.org.uk skin diseases might be dismissed or simply ignored by our politicians. Leadership and membership One of our concerns is the lack of emphasis on of Dermatology Council for dermatology for both undergraduate teaching in England: medical schools and GP specialist training programmes. As a consequence, many doctors, including GPs, have Leadership: had virtually no education in dermatology. Not only Chair: Geoff Holmes does this result in poor treatment in primary care, but (May 2018–May 2021) it is also an unnecessary burden on secondary care and Secretary: Sebastian Guterres commissioners. Patients often recognise that the care (May 2018–May 2021) they receive for their skin conditions from their family doctor is not meeting their needs and therefore need to Membership: turn to their relevant patient support group for advice. The DCE has a large and diverse membership, On a positive note, the problems in dermatology consisting of patient groups, professional provision are being investigated by the Getting It Right organisations, medical groups, nursing groups, First Time (GIRFT) programme, which is due to report political groups and pharmaceutical industry

10 Dermatology Handbook 2021–2022 Association foreword

representatives. A membership of the council is on British Society for Skin Care in a voluntary basis and meetings are held on a twice- Immunocompromised Individuals (BSSCII) yearly basis. www.bsscii.org.uk As a national umbrella body, the DCE strives to British Society for the Study of Vulval Disease (BSSVD) foster an environment that encourages collaboration www.bssvd.org and discussion. All members are given the chance British Teledermatology Society (BTS) to input into policy discussions, whether that is at www.teledermatology.co.uk meeting or via the online forum. Caring Matters Now www.caringmattersnow.co.uk Current membership: Changing Faces All Party Parliamentary Group on Skin (APPGS) www.changingfaces.org.uk/Home www.appgs.co.uk DEBRA Primary Care Dermatology Society (PCDS) www.debra.org.uk www.pcds.org.uk Ectodermal Dysplasia Society British Dermatological Nursing Group (BDNG) www.ectodermaldysplasia.org www.bdng.org.uk/about Ehlers Danlos Support UK British Association of Dermatologists (BAD) www.ehlers-danlos.org www.bad.org.uk Gorlin Syndrome Group Allergy UK www.gorlingroup.org www.allergyuk.org Herpes Viruses Association Alopecia UK www.herpes.org.uk www.alopeciaonline.org.uk Hidradenitis Suppurativa Trust British Association of Plastic, Reconstructive and www.hstrust.org Aesthetic Surgeons (BAPRAS) HITS Worldwide Family Support Network www.bapras.org.uk (Hypomelanosis of Ito Syndrome) Behcet’s Syndrome Society www.e-fervour.com/hits/ http://behcets.org.uk/ Hyperhidrosis UK British Association of Skin Camouflage (BASC) www.hyperhidrosisuk.org www.skin-camouflage.net Ichthyosis Support Group British Cosmetic Dermatologic Group (BCDG) www.ichthyosis.org.uk www.bcdg.info Institute of Trichologists British Photodermatology Group (BPG) www.trichologists.org.uk www.bpg.org.uk Latex Allergy Support Group British Skin Foundation (BSF) www.lasg.org.uk www.britishskinfoundation.org.uk Let’s Face it British Society for Cutaneous Allergy (BSCA) www.lets-face-it.org.uk www.cutaneousallergy.org Association for Lichen Sclerosus & Vulval Health British Society for Dermatological Surgery (BSDS) http://lichensclerosus.org/about/ www.bsds.org.uk LUPUS UK British Society for Dermatopathology (BSD) www.lupusuk.org.uk www.britsocdermpath.co.uk Lymphoedema Support Network British Society for Investigative Dermatology (BSID) www.lymphoedema.org www.bsid.org.uk Lymphoma Association British Society for Medical Dermatology (BSMD) www.lymphomas.org.uk www.medderm.org.uk Marfan Association UK British Society for Paediatric Dermatology (BSPD) www.marfan-association.org.uk http://bspd.org/ Mastocytosis Support Group www.ukmasto.org

Dermatology Handbook 2021–2022 11 Dermatology Handbook

Myositis Support Group XP Support Group www.myositis.org.uk http://xpsupportgroup.org.uk/ National Eczema Society www.eczema.org The Neuro Foundation www.nfauk.org Nodular Prurigo International www.nodular-prurigo.org.uk Pemphigus Vulgaris Network www.pemphigus.org.uk Psoriasis & Psoriatic Arthritis Alliance (PAPAA) www.papaa.org Psoriasis Association www.psoriasis-association.org.uk Psoriasis Help Organization (PSO) www.psoriasis-help.org.uk PXE Support Group www.pxe.org.uk Raynaud’s & Scleroderma Association (RSA) www.raynauds.org.uk Skcin www.skcin.org Scleroderma Society www.sclerodermasociety.co.uk Senior Skin Group (SSG) http://senior-skin.org.uk/ Shingles Support Group www.shinglessupport.org Skin Camouflage Network (SCN) www.skincamouflagenetwork.org.uk Staff and Associate Specialist Doctors (SAS) www.bad.org.uk/healthcare-professionals/sas- doctors Telangiectasia Self Help Group www.telangiectasia.co.uk Tuberous Sclerosis Association www.tuberous-sclerosis.org UK Dermatology Clinical Trials Network www.ukdctn.org UK Lichen Planus www.uklp.org.uk UK Teachers of Dermatology www.bad.org.uk/healthcare-professionals/ education/dermatology-teachers-and-trainers Vitiligo Society www.vitiligosociety.org.uk Wessex Cancer MARCS Line http://wessexcancer.org.uk/

12 Dermatology Handbook 2021–2022 Association foreword

The specialist journal for district and community nurses

www.bjcn.co.uk

Clinical education dedicated to nursing in the home The only monthly journal dedicated to nursing in the home British Journal of Community Nursing is the leading peer-reviewed Hopelessness, life dissatisfaction journal for district and community nurses, sharing the latest evidence-based and boredom among older peoplewww.bjcn.co.uk clinical expertise and primary care research. Providing a wide range of professional information, it helps readers to re ect on their practice and update their skills, manage cases more e ectively, and gain a greater understanding of care delivery. The only monthly journal dedicated to nursing in the home Why choose us? Quality: articles are peer-reviewed and evidence based Quantity: unrivalled range of content – more than 3,300 available articles Supporting student nurses on their Accessibility: easy to understand information, fully-searchable by topic first clinical placement CARE OF THE OLDER PERSON Assessment and management of skin conditions Relevance: written by healthcare professionals for reference in daily practice CARE OF THE OLDER PERSON Nutritional considerations PALLIATIVE CARE Responding to emotionsPALLIATIVE experienced CARE Rethinking by respite patients care in palliative care settings

PROFESSIONAL How will the new NMC standards affect community nurses? PROFESSIONAL Organisational impact of the V150 nurse prescribing qualification

From £13.25 per month BJCN_2018_23_9_cover.indd 1 23/08/2018 09:20

BJCN_2018_23_7_313_cover5.indd 1 24/07/2018 16:00 Three easy ways to subscribe

magsubscriptions.com/bjcn 0800 137 201 (UK only) [email protected] Dermatology Handbook 2021–2022 13 Monthly prices start from £13.25. Annual subscriptions start from £141.00. Includes 30-day money-back guarantee. Dermatology Handbook Primary Care Dermatology Society

A national society for GPs, GPwERs, nurses, clinical pharmacists, community pharmacists, podiatrists and any primary health care team member, which aims to develop skills and progress clinical research in this field of medicine.

he Primary Care Dermatology Society The Society is affiliated to the British Association (PCDS) is the leading national society for of Dermatologists and has close links with the British Primary Care Health Care Professionals with Dermatological Nursing Group, Dermatology Council Tan interest in dermatology and reflects the growing for England, All Party Parliamentary Group on importance that GPs and their colleagues in the Skin and a host of patient groups and associations. community are attaching to this speciality. The PCDS Membership costs £50 per year and is free for GP was formed in 1994 by a group of GP skin specialists Registrars. The fee for other Primary and Community who recognised the need for a forum in which GPs Health Care Professionals is £30 annually. Meetings for could exchange views on primary care dermatology, 2021 include: develop skills and progress clinical research in this exciting field of medicine. Dermoscopy for absolute beginners: Today around 25% of the primary care workload Wednesday 14th April 2021 involves dermatology, and many common skin Online Zoom Event conditions are managed entirely within the practice. Thursday 29th April 2021 This workload is also likely to increase as ongoing Online Zoom Event changes in funding and the NHS structure move more Wednesday 23rd June 2021 patient care into the community. Thus, in collaboration Crowne Plaza Birmingham City Centre with the consultant dermatologist, GPs, practice Wednesday 30th June 2021 nurses, pharmacists and podiatrists will be increasingly Cavendish Conference Centre, London involved in the management of chronic skin diseases. Wednesday 6th October 2021 As such, the Society opened membership to associated Cavendish Conference Centre, London professionals in Primary and Community Care in 2019. Wednesday 13th October 2021 The PCDS successfully represents the membership Manchester Conference Centre and the Society’s objectives in the UK. In addition, the Wednesday 24th November 2021 continuing development of GPs with a special interest Cavendish Conference Centre, London (GPwSIs) and now GPs with extended roles (GPwERs) in dermatology require a voice and forum for support and discussion, which the PCDS is ideally placed to Dermoscopy for intermediates: provide. Friday 26th March 2021 Education is the primary objective of the Society, Online Zoom Event and the website details all courses which are open to Wednesday 19th May 2021 any member of the primary healthcare team and can Doubletree by Hilton Sheffield Park be booked online: www.pcds.org.uk Thursday 27th May 2021 Crowne Plaza Liverpool City Centre

14 Dermatology Handbook 2021–2022 Association foreword

Thursday 23rd September 2021 Manchester Conference Centre Thursday 21st October 2021 Cavendish Conference Centre, London Thursday 18th November 2021 Leicester Hilton

Essential dermatology (series 1): Wednesday 24th March 2021 Online Zoom Event Wednesday 28th April 2021 Online Zoom Event Friday 22nd October 2021 Cavendish Conference Centre, London

Essential dermatology (series 2): Thursday 9th September 2021 Leeds Marriott Friday 17th September 2021 Cavendish Conference Centre, London Thursday 4th November 2021 Crowne Plaza Birmingham City Centre

The PCDS also runs Advanced Dermoscopy courses in association with Dermoscopy UK, as well as an International Virtual Dermoscopy Day, Surgical courses, three one-day and one weekend meetings on wider dermatological issues. See the PCDS website for more information and course details: http://www.pcds. org.uk

Dr Angelika Razzaque Executive Chair, PCDS

Dermatology Handbook 2021–2022 15 Dermatology Handbook Scottish Dermatological Nursing Society

Committed to professional development of nurses and healthcare workers in dermatology, thereby promoting optimum standards of care

he Scottish Dermatological Nursing Society ordinated Approach to Tissue Viability Programme, (SDNS) was founded in 2003 by Barbara SCCS Community Nurse-led Project and the SDNS Page MBE, and is affiliated with the British Psychosocial Aspects of Care Masterclass. TDermatological Nursing Group (BDNG) and the Dermatology nursing has continued to gain Scottish Dermatology Society (SDS). Its main purpose is recognition as a clinical specialty through the SDNS to provide a forum for the exchange of knowledge and and BDNG to ensure dermatology nursing care is skills for nurses (and allied health professionals) with a delivered by appropriately trained nurses with the special interest in dermatology. knowledge and skills to support self-management. The SDNS promotes the development of the nurse’s In general, dermatology is not included in the role in dermatology in primary and secondary care undergraduate nursing curriculum, despite the skin to ensure the highest standard of care is delivered being the largest vital organ of the body. As the most to patients living with skin conditions. Professional visible organ, skin problems can have considerable development is supported by the SDNS via an active psychosocial impact on an individual’s life. website, annual educational events, travel grants Therefore, it is paramount all nurses and other health and research awards. With the exception of 2020, care workers are offered education and guidance on SDNS educational events have been held each year skin conditions and their managements so that they with presentations from clinical nursing, medicine may adopt a holistic and compassionate approach. and psychology, providing up-to-date evidence to Increasingly, non-medical prescribers are support practice. In addition to this, we have also in developing autonomous practice, making the past held joint SDNS/BDNG regional study days, prescribing decisions and initiating treatments. but sadly the Covid-19 pandemic has put most of the Nurses wishing to specialise in dermatology must educational meetings on hold for the time being. It is also have this knowledge and the skills necessary to envisaged these educational meetings will resume as be able to complete an assessment, plan, deliver and soon as possible, either as traditional gatherings or evaluate care which is essential in the management virtual meetings. of chronic skin conditions. Lifestyle and individual On a wider platform, the SDNS continues to needs of patients will also need to be considered have representation on the British Dermatological within the treatment options available and nursing Nursing Group, the Irish Dermatological Nurses’ interventions tailored accordingly. A thorough Association, All Party Parliamentary Group on Skin understanding of these treatment options is critical to (UK), the Dermatology Council for Scotland, the optimise patient experiences and outcomes. Nurses Scottish Access Collaborative and GAND, the Global in the UK and Ireland will continue to have access to Alliance for Nurses in Dermatology. specialist dermatology education via organisations Over the last few years the SDNS has been actively such as SDNS, BDNG, IDNA and British Association involved in a number of quality improvement of Dermatologists, as well as via UK universities initiatives. These include Skin Action Scotland, which offer specific learning modules at degree and Centre for Change and Innovation projects, Co- master’s levels. This revisedDermatology Handbook

16 Dermatology Handbook 2021–2022 Association foreword

complements the current education available and explains therapeutic options. It is regarded as an important reference tool for every-day practice.

Polly Buchanan Queen’s Nurse Chair, Scottish Dermatological Nursing Society Community Dermatology Nurse Practitioner, NHS Fife

Cardenden Medical Practice Wallsgreen Road, Cardenden Fife, KY5 0JE Scotland [email protected] www.sdns.co.uk

Dermatology Handbook 2021–2022 17 Dermatology Handbook Adjuvant treatments

These are used alongside topical therapies, or to increase comfort or protection for a person with a skin condition and for sun protection. Included is camouflage for those who wish to cover disfigurement.

djuvant treatments in dermatology can However, silk clothing does provide a comforting enhance the effectiveness of current therapy layer next to irritated skin and helps prevent the or provide patient comfort and/or scratch-itch-damage cycle. Aprotection. The adjuvant treatments in this chapter Barrier preparations are extremely important to include a range of additional options, for example: protect skin form moisture, irritation, chaffing and barrier preparations and body wraps may provide contamination with yeasts or bacteria. The barrier comfort and reduce damage limitation for patients preparation needs to be matched to the patient, with fragile skin; scar treatments to reduce scarring; their age and skin condition. They are generally cosmetic camouflage may enhance body image used for irritant dermatitis, napkin dermatitis in for patients with disfiguring skin conditions; and infants, and incontinent dermatitis in adults— sun care products to protect photosensitive skin, particularly, for people with physical disabilities and due to photodermatoses or where pigmentation older people who suffer from incontinence. Medical may be lost owing to a skin condition, such as antiperspirants also protect against the physical and vitiligo. A small number of wound care products are psychological effects of excessive perspiration and included in this chapter, with a large range included sweating, a condition called hyperhidrosis. in The Wound Care Handbook, also published Skin camouflage is an adjuvant treatment that by Mark Allen Healthcare and available at: www. requires great skill and training in therapeutic woundcarehandbook.com application and patient support. Skin camouflage Medical devices, such as paste bandages, viscose topical preparations are designed to replicate the and silk garments, are often used in eczema and colour of skin and differs from corrective beauty other pruritic skin conditions to help break the aids, in that the creams are specifically formulated scratch-itch cycle and protect the skin from damage. to give the necessary covering power yet require They are used in conjunction with other topical only a thin application. Once set with loose powder, eczema treatments, especially emollients (medical the camouflage becomes waterproof and smudge moisturisers) and can help control flare-ups in proof, lasting up to 2 days. Topical medication moderate-to-severe eczema, but should not be can be applied before the camouflage application; used if infection is present. Paste bandages require sun protection can be applied under and over the a precise pleating application technique, which is camouflage; and make- up can be applied over set demonstrated in a booklet produced by The National camouflage.3 Eczema Society.1 Within the available brands, there is a vast Medical-grade silk garments are bonded with choice of pre-mixed coloured creams and microbe shield technology and polymer coating, and complementary colours. A complementary colour are based on the same technology used for contact is sometimes needed as an undercoat to conceal lenses, making the silk non-stick. A randomised hyperpigmentation before the skin match is applied. trial on the use of silk clothing in childhood eczema There is a difference in cream texture, slip, durability compared with standard care showed no differences and SPF between the brands, which means one between the two groups.2 Therefore, with a lack product may be better than another for a certain type of reliable evidence, the NHS has recommended of skin and condition, as well as being preferable for stopping or reducing the prescribing of silk clothing3. the person’s lifestyle. While it is recommended that

18 Dermatology Handbook 2021–2022 Adjuvant treatments

References people remove their facial camouflage on a daily 1 National Eczema Society. Paste bandages and wet wraps. basis, camouflage to trunk and limbs may stay in 2018. NES. https://bit.ly/3qCwS2b (accessed March 2021) place for a longer period. Skin camouflage cannot 2 Thomas KS, Bradshaw LE, Sach TH et al. Randomised alter the texture of the skin, but the immediate visual controlled trial of silk therapeutic garments for the management of atopic eczema in children: the CLOTHES effect does help the person to regain self-esteem and Trial. Health Technology Assessment 2017; 21(16) confidence. 3 PresciQIPP. Silk and antimicrobial garments. B160. 2017. People are strongly advised to seek further medical https://bit.ly/3rQ0zhq (accessed March 2021) 4 Allan E Cover—the principles and art of para- medical diagnosis should they observe any changes to the skin camouflage. British Association of Skin Camouflage. condition of their skin, dermatoses or to any mole, Author House Publishers. 2010 and to discontinue skin camouflage application until permission to continue has been given by the medical Footnote 2 For further information on camouflage services in your area adviser. The British Association of Skin Camouflage and training courses, please contact Changing Faces (www. (BASC) and Changing Faces provide camouflage changingfaces.org.uk/skin-camouflage) or The British association services within the NHS (as a voluntary service) of Skin camouflage (BASC) (www.skin-camouflage.net) and trains volunteers (https://www.changingfaces. org.uk/skin-camouflage/volunteering-training). NHS HCPs can refer patients directly to Changing Faces, via their website. Changing Faces will train volunteers who apply, while BASC provides training for health care professionals only (https://skin- camouflage.net/). Skin camouflage adjuvant treatments are listed by the Advisory Committee on Borderline Substances (ACBS), meaning that these products can only be prescribed on the basis that they are required for specific individual requirements.

Non-proprietary adjuvant treatments include: • Barrier preparations: zinc cream, zinc ointment, zinc and castor oil ointment • Topical antipruritic: calamine (aqueous cream, lotion and oily lotion), oxidisers (potassium permanganate) • Tubular bandages and garments: cotton stockinette, ribbed cotton and viscose surgical tubular stockinette • Medicated bandages: zinc paste bandages, zinc paste and calamine bandages, zinc paste and ichthammol bandages.

Dermatology Handbook 2021–2022 19 Dermatology Handbook Adjuvant treatments

Adhesive removers Sizes 50ml spray; 30 wipes Lift Plus Medical Adhesive Price Remover Non-sting £9.14; £15.15 (DT) Opus Healthcare Description Peel-Easy Lift Plus is an alcohol-free, non-sting adhesive CD Medical remover containing aloe vera to promote healthy Description skin. No-sting, non-cold, silicone-based medical adhesive Indications remover wipes and spray. Available as aerosol spray To minimise the pain associated with the removal of and wipes. stoma fl anges and pouches . Indications Sizes For the pain-free removal of adhesive dressings, 30 wipes, 50ml spray tapes, fi xings, stoma appliances, as well as adhesive Price residue. To minimise the risk of Sachets (citrus x30, original x30), Spray 360 50ml medical adhesive related skin (citrus, original), Spray 50ml (citrus, original) (DT) injury. Sizes Lifteez Medical Adhesive 50ml spray; 30 wipes Remover Price Medicareplus International £7.18; £11.66 Description Non-sting medical adhesive remover containing certifi ed health-care grade silicone ingredients. Anaesthetics and Available as wipes and aerosol . antipruritics Indications For ease of removal of adhesive dressings, pouches Boots Derma Care Itch Relief and medical devices and to minimise the potential Boots UK for skin stripping and pain on removal. Description Sizes Boots Derma Care Itch Reliefcream contains Wipes (x30). Aerosol: 50ml crotamiton for eff ective relief of itching and works Price for 10 hours . Wipes: £8.50. Aerosol: £5.60 Indications For itching and skin irritation. Niltac Sting Free Medical Sizes Adhesive Remover 30g ConvaTec Price Description £2.50 (DT) Silicone medical adhesive remover . Indications Subscribe to For pain-free removal of adhesive products (wound dressing, stoma pouch, external sheath catheter) or Journal of Aesthetic Nursing for atraumatic removal of medical adhesives. www.magsubscriptions.com

20 Dermatology Handbook 2021–2022 Adjuvant treatments

Cala Soothe Magicool Plus Ennogen Pharma Ltd FranceMed Pharma Description Description Cala Soothe helps pruritus and contains Bentonite Magicool is an instant body and face cooling spray Calamine, glycerol, phenol liquefied, sodium citrate for adults and children. This spray, successfully and zinc oxide. formulated by scientists, is self-chilled and works Indications without refrigeration. Cools, hydrates and calms For itchy and irritated skin. skin. Sizes Indications 200ml For itchy skin, prickly heat and sunburn. Price Sizes £18.50 (cream), £19.50 (lotion) 150ml Price Care ViraSoothe £5.85 Thornton & Ross Description Xclair ViraSoothe Chickenpox Relief Cooling Gel Sinclair IS Pharma PLC and Spray help relieve the irritating symptoms Description of chickenpox. Effectively cooling the skin, the Xclair conatins sodium hyaluronate to soothe treatment stops the itch-scratch cycle. Its formula irritated skin. protects the skin’s natural environment to allow the Indications skin to heal naturally which can help reduce long- For the relief of irritation associated wit radiation term scarring. and dermatitis. Indications Sizes For the treatment and relief of irritation for 50g chickenpox over 6 months of age. Price Sizes £17.00 50g and 75g (gel); 60ml (spray gel) Price Xepin £3.34 and £5.03; £4.74 Cambridge Healthcare Supplies Ltd Description Eurax Cream Xepin cream contains the active ingredient doxepin Thornton & Ross hydrochloride. Doxepin is a medicine that is related Description to the tricyclic antidepressants. However, when Formulated to stop itching fast and provide doxepin is applied to the skin it can relieve itching. soothing relief that lasts up to 10 hours. Doxepin cream is thought to work by blocking Indications histamine receptors in the skin, therefore reducing Suitable for a range of skin itches and irritations, some of the reactions that cause itching associated including itchy dermatitis, dry eczema, allergic with eczema. The medicine is also absorbed through rashes, hives, nettle rashes, chickenpox, insect bites the skin into the bloodstream and can cause some and stings, heat rashes, and sunburn. drowsiness. This may also help to relieve the itch of Sizes eczema. 30g; 100g Indications Price For the relief of pruritus associated with eczema. £2.50; £4.35 Sizes 30g (cream) To advertise call 020 7333 1741 Price £13.66

Dermatology Handbook 2021–2022 21 Dermatology Handbook

Antiperspirants Robinul Amdipharm Mercury Company Ltd Anhydrol Forte Description Dermal Laboratories Ltd Robinul contains glycopyrrolate, which is a Description quaternary ammonium compound and, as such, is Anhydrol Forte contains aluminium chloride absorbed through the skin in negligible amounts hexahydrate, which is believed to denature the only. protein content of sweat issuing from eccrine Indications glands, and to combine with the intraductal For the iontophoretic treatment of the plantar and keratin fibrils, producing a functional closure. palmar skin for idiopathic hyperhidrosis. The antibacterial action of the aluminium ion also Sizes precludes the development of miliaria. Accordingly, 3g there is no secondary inflammation. The Price intraluminal pressure rises to the point where it acts Contact supplier as a feedback system, shutting off acinar secretion. Indications For the topical treatment of hyperhidrosis Barrier preparations specifically involving axillae, hands or feet. Sizes AproDerm Barrier Cream Roll on—60ml Fontus Health Price Description £2.51 A non-greasy barrier cream that protects against irritation due to bodily fluids while moisturising Driclor the skin. AproDerm Barrier Cream has been GSK Consumer Healthcare specially formulated with both Dimethicone and Description Trimethylsiloxysilicate, and as well as having barrier Driclor acts locally, in the stratum corneum and the function, it also has humectant and skin conditioning terminal duct to relieve hyperhidrosis. Aluminium actions. Free from SLS, parabens, metals, alcohol, chloride hexahydrate is acidic and is thought to fragrances and colours, AproDerm Barrier Cream act by diffusing into the sweat ducts where on is suitable to be used with incontinence pads and neutralisation it forms gelatinous hydroxides which hydrocolloid dressings. Safe to use from birth and with obstruct the flow of sweat. The antiperspirant only a small amount required for each application. effect of aluminium chloride hexahydrate is partly Indications explained by production of mechanical blockage Suitable from birth, AproDerm Barrier Cream in the eccrine sweat duct. Following application, protects the skin from being damaged by fluids aluminium is found in the stratum corneum and due to incontinence and associated symptoms by intra-luminally in the terminal duct. providing a long-lasting barrier. It can also be used Indications in wound care and to moisturise and condition skin, For the treatment of hyperhidrosis of the armpits as well as by those affected by eczema, dermatitis (axillae), the hands and the feet. and other dry skin conditions. Sizes Sizes 20ml, 60ml, 75ml 30g; 100g Price Price £6.49, £8.89, £6.25 £2.50; £5.50

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22 Dermatology Handbook 2021–2022 Adjuvant treatments

Care Zinc & Castor Oil Cream wash-off to provide long-lasting protection from Th ornton & Ross skin breakdown. Safe to use on injured skin . Description Indications Care Zinc & Castor Oil Cream soothes nappy rash As a barrier against irritation from body fl uid, to and treats dry chapped skin. Provides a protective prevent skin damage associated with incontinence, water resistant barrier for dry skin conditions. as a moisturiser for severely dry or chapped skin . It also acts to provide a mildly antiseptic water Apply sparingly. Can increase adherence of some resistant emollient barrier for dry skin conditions adhesive products, so should be avoided under and nappy rash . adhesive products in people with fragile skin. Indications Sizes Suitable for use on adults, the elderly and children. Tube: 28g; 92g. Sachet: 2g (x20) Pregnant women should speak to a healthcare Price professional before using the product. A doctor £3.28 (28g); £6.55 (92g); £6.40 (2g x20) (Drug should be consulted before use if anyone intending Tariff ) to use this product is having an x-ray, as this medicine may mask x-ray pictures. Cavilon No Sting Barrier Film Sizes 3M United Kingdom 100g Description Price An alcohol-free liquid barrier fi lm that dries quickly £1.45 to form a breathable, transparent coating on the skin. It is designed to protect intact, damaged or Cavilon Continence Care ‘at-risk’ skin from urine, faeces, other body fl uids, Wipes adhesive trauma and friction. It lasts for up to 72 3M United Kingdom hours, and will not sting when applied to broken Description skin. No-rinse skin wipes for the treatment of Indications incontinence-associated dermatitis (IAD) to cleanse, Acts as a primary barrier against fl uids for moisturise and protect the skin. Wipes contain 3% continence care, protective barrier against medical dimethicone and are biodegradable, pH balanced, devices, skin protection around stomas and peri- perfume and parabens free, soft and hypoallergenic . wound protection from exudate . Indications Sizes As a barrier against irritation from body fl uid, Foam applicator—1ml, 3ml (x5 box); pump to cleanse, moisturise and protect skin at risk of spray—28ml; stoma wipes—30sachets damage associated with incontinence. Can be used Price on intact or broken skin. For external use only. £4.05 (1ml x 5), £6.55 (3ml x 5), £5.79 (28ml), Avoid contact with the eyes. Not intended for skin £23.50 (1ml wipe x 30) (DT) disinfection. Sizes Clinifi lm Pack of 8 wipes (20x30cm) CD Medical Price Description Not available on Drug Tariff . £2.06 (pack of 8 wipes) A no-sting barrier fi lm to protect the skin from (via NHS Supply Chain) harmful eff ects of urine, faeces, wound exudate and medical adhesives. Available as Cavilon Durable Barrier Cream aerosol spray and wipes . 3M United Kingdom Indications Description In stoma care, it protects the skin Highly concentrated barrier cream to protect from harmful body fl uids. Protects against bodily fl uids and moisturise skin. Resists against incontinence-associated

Dermatology Handbook 2021–2022 23 Dermatology Handbook

dermatitis. Protects skin vulnerable to medical Price adhesive removal injury. Protects peri-wound skin Contact supplier from wound exudate. Sizes LaVera Barrier Cream 50ml spray; 30 wipes Opus Healthcare Price Description £9.36; £19.50 Contains lavender and aloe vera. Protects skin from harmful body waste including intestinal contents Conotrane and urine. Astellas Pharma Ltd Indications Description Excoriated skin. Conotrane is a cream for topical application Sizes containing 22.0% dimeticone and 0.1% Sachets (2g x30), Tube (100g) benzalkonium chloride. Dimeticone is water Price repellent, allowing transpiration of water vapour £12.08, £10.74 (DT) from the skin. Benzalkonium chloride is a quaternary ammonium compound, which is active Medi Derma-S Total Barrier against bacteria and yeasts. Cream – Non-sting Indications Medicareplus International For protection of the skin from moisture, irritants, Description chafi ng and contamination with bacteria or yeasts. Non-sting barrier cream providing transparent It may be used in situations such as the prevention/ long-lasting protection from moisture-associated treatment of napkin rash, the prevention of pressure skin damage on intact and mildly damaged skin. ulcers and the management of incontinence . Moisturises and helps to restore skin integrity. Sizes Indications 100g, 500g Prevention and protection of intact and mildly Price damaged skin from incontinence, wound exudate £0.88, £3.51 and/or irritation from adhesive products. Sizes Drapolene 2g sachets (x20). Tube: 28g, 90g Omega Pharma Price Description Sachets: £5.85. Tube: £2.98, Drapolene contains benzalkonium chloride and £5.95 cetrimide, which are both quaternary ammonium disinfectants with properties that are typical of Medi Derma-S Total Barrier cationic surfactants. Th is preparation is useful Film – Non-sting in the treatment and prevention of nappy rash. Medicareplus International It suppresses the development of ammonia- Description producing organisms usually associated with this Non-sting barrier fi lm providing transparent, condition. long-lasting protection (up to 72h) from moisture- Indications associated skin damage on intact and moderately For the relief of nappy rash and for use as an adjunct damaged skin. to baby care hygiene for the prevention of nappy Indications rash, the prevention of incontinence rash and the Prevention and protection of intact and symptomatic relief of minor burns, limited sunburn moderately damaged skin from and the eff ects of weather. incontinence, wound exudate, Sizes perspiration and/or irritation 100g, 200g, 350g from adhesive products. Skin

24 Dermatology Handbook 2021–2022 Adjuvant treatments

For more information, visit our website: medicareplus.co.uk

The frequency of reapplication should beReference: assessed on P. Dykes,the needs S. Bradbury. of each patient. Comparing In cases the ofEffectiveness excessively wetand skin,Wash-off use you Resistance own clinical of Skin judgement Barrier Creams: to determine when reapplication is required. Dermatology Handbook 2021–2022a Healthy Volunteer Study. Journal of Wound Care Vol 26, No. 9, September 2017. MPL975/MD-S/JWCH/02.2125 Dermatology Handbook

protection in skin folds, periwound and around Price stoma site. Sachet—£6.00; tube—£4.80 Sizes Wipes (x30). Aerosol: 50ml. Pump spray: 30ml. Remedy Moisturising Barrier Foam applicator (x5): 1ml, 3ml Cream Price Medline Industries Wipes: £19.40. Aerosol: £8.95. Pump spray: £5.35. Description Foam applicator: £3.70, £5.95 Moisturises the skin while providing a protective breathable barrier. Contains a 24% silicone blend, Medi Derma-Pro Skin with both emollients and humectants. Other Protectant Ointment – Non- ingredients includevitamins and nutrients derived sting from natural ingredients including saffl ower, Medicareplus International greentea, blue green algae, clove, soya, and corn. Description Sulphate and fragrance free. Non-irritating and Viscous, non-sting ointment providing a long- non-sensitizing, CHG compatible and dermatologist lasting protective waterproof barrier to skin severely tested . damaged from incontinence. Indications Indications Adults and children over the age of 3 years.Can be Protection of intact, injured and used to protect intact and injured skin from bodily at-risk skin from severe irritation fl uids such as those resulting from incontinence . due to incontinence. Sizes Sizes 2ml, 30ml, 118ml 115g tube Price Price £0.33, £3.50, £7.50 £8.50 Remedy Moisturising Cream Medihoney Barrier Cream Medline Industries Integra Life Sciences Description Description Cream that moisturises and nourishes skin, Medihoney Barrier Cream contains active helping restore its natural moisture balance and Medihoney antibacterial honey. Helps to reduce barrier properties. Can be used on the entire infl ammation, prevent maceration, excoriation and body, including the face. Contains proteins, irritation resulting from the eff ects of incontinence vitamins, essential fatty acids and carbohydrates; and diarrhoea. Can be applied to injured skin, peri- rich in natural oils, antioxiants and natural wound areas, pressure areas and skin folds. Provides emmolients; hypoallergenic, pH-balanced and moisturising and protection to dry skin. dye-free . Indications Indications Protects at-risk skin from breakdown. Protects Nourish, hydrate and condition dry skin . wound margins from exudate damage. Protects Sizes skin from damage caused by friction or shear. 118ml Treatment of incontinence-associated dermatitis Price and atopic eczema. Treats blistered skin. Contact supplier Prevention and treatment of maceration and excoriation. Helps maintain the skin pH. Suitable Sensi-Care Sting Free for all skin types, including neonates, children and Protective Skin Barrier older people. ConvaTec Sizes Description Sachet—pack of 20; tube—50g Silicone sting-free skin barrier.

26 Dermatology Handbook 2021–2022 Adjuvant treatments

Indications SkinSafe Provides a barrier to protect vulnerable skin from Opus Healthcare bodily fluids and friction, and a physical barrier to Description prevent irrigation/damage from medical adhesives. Alcohol-free, no-sting silicone barrier film. Sizes Indications Foam applicator: 1ml (x5), 3ml (x5); pump spray: To form a barrier between the skin around the 28ml stoma and the adhesives incorporated into flanges Price and pouches to help prevent skin damage such as Foam applicator: £4.63, £6.74. Pump spray: £5.79 skin stripping.Also protects the skin around the (DT) stoma against bodily fluids. Sizes Silesse Sting Free Skin Barrier Wipes (pack of 50 sachets); spray (50ml) Wipes Price ConvaTec £41.85 (wipes), £8.49 (spray) (DT) Description Silicone sting-free barrier. Available in a spray or a Sorbaderm Barrier Cream wipe. Aspen Medical Europe Indications Description Designed for frequent use to protect vulnerable A white concentrated cream that provides the skin skin from the effects of faeces, urine, exudate, with protection from body fluids.It also protects dry, perspiration etc. Also designed to provide a physical chafed, red, or irritated skin by moisturising it and barrier to prevent irritation/damage from medical providing a long lasting barrier.Use of this cream still adhesives such as wound dressings, ostomy or allows adhesive products to stick to the skin. continence appliances. Indications Sizes It is for the protection of intact skin areas at 50ml spray; 30 wipes risk from damage and irritation. Maintains and Price preserves intact skin from damage associated £11.86; £22.53 with chronic incontinence. May also be used to moisturise and protect severely dry skin. Sorbaderm Siopel Barrier Cream should not be used on infected skin. Derma UK It should not be used where there is known allergic Description sensitivity to the ingredients. A water-repellent barrier cream with antiseptic Sizes properties. It contains cetrimide 0.3% w/w, an Tube—28g, 92g; sachet (pack of 20)—2g effective antiseptic used for wound cleansing. It also Price contains Dimeticone 1000 10 % w/w, which binds Tube: £3.56 (28g), £7.19 (92g); sachet: £6.66 firmly to the skin surface and forms a protective barrier. The cream also contains arachis (peanut) oil. Sorbaderm No-Sting Barrier Indications Film Useful whenever the skin needs to be protected Aspen Medical Europe from water-soluble irritants. Description Sizes A polymeric solution which forms a uniform film 50g when applied to the skin. It is a non stinging solvent, Price transparent and vapour permeable. £4.65 (DT) Indications It is intended for external use as a film forming www.dermatologyhandbook.co.uk product that upon application to intact or damaged skin forms a long lasting waterproof barrier. Acts

Dermatology Handbook 2021–2022 27 Dermatology Handbook

as a protective interface between skin and bodily Body wraps fluids, adhesive products and friction. Not to be used on infected skin. ActiFast Tubular Bandages Sizes L&R Medical UK Ltd Spray (28ml); foam applicator (pack of 5) (1ml, Description 3ml) ActiFast is a versatile, cotton, 2-way stretch tubular Price bandage range that is soft to the touch and has Spray: £5.99; foam applicator: £4.45—1ml, low sensitivity. It can be used in a variety of skin £7.20—3ml conditions, including the acute management of atopic eczema, by means of the wet wrapping Sprilon technique. The bandage is easy to apply, can be Ayrton Saunders Ltd cut to size and shape, and is safe to use where Description compression is contraindicated. ActiFast also Zinc Oxide 12.5% w/w/Dimeticone 1.04% w/w provides a suitable protective layer under Cutaneous Spray. compression bandages or wraps. Indications Indications Sprilon is used for the prevention and treatment For a variety of skin conditions including atopic of pressure sores, and skin damage from contact eczema (for wet wrapping) and for dressing retention. with body fluids, e.g. around the perineum, fistulae, Sizes colostomies, ileostomies eczematous areas etc. It Small limb (red line)—3.5cm x 1m; Medium limb is also used for the protection and treatment of (green line)—5cm x 1m, 5cm x 3m, 5cm x 5m; fissures and leg ulcers, and the protection of skin Large limb (blue line)—7.5cm x 1m, 7.5cm x 3m, beneath plaster casts. 7.5cm x 5m; Child trunk (yellow line)— 10.75cm Sizes x 1m, 10.75cm x 3m, 10.75cm x 5m; Adult trunk 115g (beige line)—17.5cm x 1m; Large adult trunk Price (purple line)—20cm x 1m, 20cm x 5m £8.90 Price Red line—£0.56; Green line—£0.58, £1.63, £2.83; Blue Sudocrem Antiseptic Healing line—£0.78, £2.15, £3.55; Yellow line—£1.21, £3.52, £5.74; Cream Beige line—£1.85; Purple line—£3.23, £15.90 (DT) Teva UK Description ComfiFAST MultiStretch Sudocrem Antiseptic Healing Cream contains Zinc Tubular Bandage oxide, benzyl alcohol, benzyl benzoate, benzyl Vernacare Ltd cinnamate, lanolin (hypoallergenic), and sodium Description benzoate. ComfiFAST MultiStretch tubular bandages have Indications been developed using MultiStretch technology, For napkin rash, eczema, bedsores, acne, minor enabling the bandage to stretch in multiple burns, surface wounds, sunburn, and chilblains. directions—radial, longitudinal and diagonal, Sizes designed to provide complete freedom of movement 60g, 125g, 175g, 250g, 400g and enhance patient comfort. Price Indications Contact supplier For dressing retention, wet and dry wrapping or patch wrapping for atopic eczema. Sizes Subscribe to BJN visit Small limb (red line)—3.5cm x 1m; Medium limb www.magsubscriptions.com (green line)—5cm x 1m, 5cm x 3m, 5cm x 5m; Large limb (blue line)—7.5cm x 1m, 7.5cm x 3m,

28 Dermatology Handbook 2021–2022 Adjuvant treatments

7.5cm x 5m; Child trunk (yellow line)—10.75cm line—10.75cm x 1m), £3.49 (Child trunk, yellow x 1m, 10.75cm x 3m, 10.75cm, x 5m; Adult trunk line—10.75cm x 3m), £6.04 (Child trunk, yellow (beige line)—17.5cm x 1m line—10.75cm, x 5m), £1.83 (Adult trunk, beige Price line—17.5cm x 1m). Alternative Supply Chain £0.61 (Small limb, red line—3.5cm x 1m), £0.63 prices are also available (Medium limb, green line—5cm x 1m), £1.75 (Medium limb, green line—5cm x 3m), £3.03 Easifast (Medium limb, green line—5cm x 5m), £0.83 Easigrip (Large limb, blue line—7.5cm x 1m), £2.30 (Large Description limb, blue line—7.5cm x 3m), £3.95 (Large limb, Easifast is an elasticated stockinette, which can blue line—7.5cm x 5m), £1.30 (Child trunk, yellow be used for dry and wet wrapping in eczema. line—10.75cm x 1m), £3.77 (Child trunk, yellow Can also hold primary dressings in place without line—10.75cm x 3m), £6.45 (Child trunk, yellow compression and constriction. line—10.75cm, x 5m), £2.49 (Adult trunk, beige Indications line—17.5cm x 1m). Alternative Supply Chain For the treatment of paediatric eczema. prices are also available Sizes Red (small limb): 3.5cm x 1m. Green (medium ComfiFAST Tubular Bandages limb): 5cm x 1m; 5cm x 3m; 5cm x 5m. Blue (large Vernacare Ltd limb): 7.5cm x 1m; 7.5cm x 3m; 7.5cm x 5m. Description Yellow (child trunk): 10.75cm x 1m; 10.75cm x 3m; ComfiFAST Tubular Bandages are specially 10.75cm x 5m. Beige (adult trunk): 17.5cm x 1m designed from a light breathable fabric, allowing Price complete freedom of movement. They are used for Red (small limb): £0.65. Green (medium limb): dressing retention, wet and dry wrapping and for £0.69; £1.95; £3.40. Blue (large limb): £0.94; £2.60; patch wrapping atopic eczema. They are simple and £4.50. Yellow (child trunk): £1.50; £4.25; £7.20. easy to apply, and come in five colour-codes that Beige (adult trunk): £1.90 are available in different lengths for community and hospital use, with a double stripe for easy identification. They are also cost-effective, as they Bandages are washable and reusable. Indications Ichthopaste Bandage For dressing retention, wet and dry wrapping or Evolan Pharma patch wrapping for atopic eczema. Description Sizes Zinc Oxide paste and ichthammol bandage BP. Small limb (red line)—3.5cm x 1m; Medium limb Indications (green line)—5cm x 1m, 5cm x 3m, 5cm x 5m; For the treatment and management of chronic skin Large limb (blue line)—7.5cm x 1m, 7.5cm x 3m, conditions such as eczema and dermatitis. May 7.5cm x 5m; Child trunk (yellow line)—10.75cm also be used to treat venous leg ulcers and their x 1m, 10.75cm x 3m, 10.75cm x 5m; Adult trunk associated skin conditions (eg, varicose eczema (beige line)—17.5cm x 1m and hyperkeratosis). It can be used as a primary Price contact layer under compression therapy systems £0.56 (Small limb, red line—3.5cm x 1m), £0.58 where venous (Medium limb, green line—5cm x 1m), £1.62 insufficiency (Medium limb, green line—5cm x 3m), £2.81 exists. (Medium limb, green line—5cm x 5m), £0.77 Sizes (Large limb, blue line—7.5cm x 1m), £2.13 (Large 7.5cm x 6m limb, blue line—7.5cm x 3m), £3.74 (Large limb, Price blue line—7.5cm x 5m), £1.20 (Child trunk, yellow £3.87

Dermatology Handbook 2021–2022 29 Dermatology Handbook

Viscopaste PB7 Bandage Covermark Finishing powder. It comes in a range of Evolan Pharma 20 premixed skin tones plus neutralising whitepos and Description yellow tones, and one translucent finishing powder. Zinc Oxide paste bandage. Covermark Foundation has a solid texture and is Indications water and sweat-proof, lasting 24 hours withoutpos the For the treatment and management of chronic skin use of a finishing powder. It also provides SPF 30 conditions such as eczema and dermatitis. May with natural filters, which are suitable for sensitive also be used to treat venous leg ulcers and their skin. associated skin conditions (eg, varicose eczema and Indications cellulitis). It can be used as a primary contact layer For camouflage of any skin imperfection includingneg under compression therapy systems where venous birthmarks, vitiligo, scarring and non-contagious insufficiency exists. skin lesions. Sizes Sizes neg 7.5cm x 6m 15ml (foundation cream); 25g (finishing powder) Price Price £3.84 £11.86 (DT) Zipzoc Dermablend Evolan Pharma Vichy Description Description Zinc Oxide impregnated medicated stocking. Ultra corrective foundation. Indications Indications For the treatment and management of skin Medical camouflage. conditions, such as eczema and dermatitis, and Sizes for the treatment of venous leg ulcers and their Five shades Dermablend 3D foundation (30ml); 5 associated skin conditions. Can be used as a primary shades Dermablend Compact Crème (10g); 5 shades contact layer under compression therapy systems Dermablend Corrective Stick (4.5g); 5 shades where venous insufficiency exists (refer to prescribing Dermablend smooth (30ml) information in the Price Pantone 151 C company website and Contact supplier literature). Sizes Dermacolor Pantone 151 C One size Kryolan UK Price Description £13.88 (pack of 4) and Dermacolor is a high-pigmented cream that is set £34.70 (pack of 10) with fixing powder. It can camouflage conditions on face and body, such as vitilgo, hyperpigmentation, dark circles, scarring, bruising, psoriasis, rosacea, Camouflage acne, liver spot, spider and varicose veins, port wine stains, sun damage and more. There are over 200 Covermark premixed skin tones and complementary colours, Derma UK plus one colourless powder and six skin tone colour Description powders. It has a solid cream texture and is smudge Covermark is a specialised camouflage make- proof when set (not rub up, which contains substantially more pigments proof). in its preparation compared with ordinary fluid Indications foundations. Covermark is a high-pigmented For the camouflage of non- foundation cream that can be applied before contagious skin lesions.

30 Dermatology Handbook 2021–2022 Adjuvant treatments

neg Eective treatment for people with skin conditions using the benefits of Zinc Oxide and Ichthammol.

Komplementfärger, plattor mm

Pantone 151 C Pantone Warm Red C

Zipzoc 20% Zinc Oxide

Viscopaste 10% Zinc Oxide

Ichthopaste 6.32% Zinc Oxide NHS Catalogue Order Code 2% Ichthammol Ichthopaste 7.5cm x 6m EFA 051 Viscopaste 7.5cm x 6m EFA 011 Zipzoc Stocking EFA 029 FP10 Drug Tarrif PIP Code Ichthopaste 7.5cm x 6m 033-2668 Evolan Pharma AB Viscopaste 7.5cm x 6m 033-2734 www.pastebandagesevolan.com Zipzoc Stocking (4’s) 234-3739 e-mail. [email protected] Zipzoc Stocking (10’s) 234-3747 tel.+44 (0)7554133321

ZIPZOC (zinc impregnated medicated stocking) Abbreviated prescribing information. Refer to summary of product characteristics before prescribing. Composition: A sterile rayon stocking impregnated with an ointment containing 20% Zinc Oxide. Each stocking (80cm x 7cm) contains about 41.5g of ointment. Therapeutic indications: Aid to the treatment of chronic leg ulcers and other associated skin conditions. Where chronic venous insu ciency exists, the medicated stocking can be used as a primary contact layer under compression bandaging or hosiery. Method of Administration: Because ZIPZOC is preservative free, it must be changed no less frequently than weekly. For topical application, ZIPZOC should be applied to cover the lower leg from the base of the toes to below the knee. All folds should be smoothed out. To protect clothing, a suitable outer bandage should be worn. If chronic venous insu ciency exists, ZIPZOC may be used as a primary contact layer under compression therapy and may be left in situ for one week, before re-application. Contra-indications: Arterial leg ulcers. Known hypersensitivity to zinc oxide or the excipients in the ointment. Special Warnings and Special Precautions: None known. Interactions: None known. Pregnancy and Lactation: There is no evidence to suggest ZIPZOC should not be used during pregnancy. Undesirable Eects: The skin of leg ulcer patients is easily sensitised to some topical medications. ZIPZOC contains no preservatives thereby reducing the risk of skin reactions. Reported reactions include, rash, erythema, itching and maceration of the wound edge. If the outer bandage is inappropriate or the medicated stocking is not changed with su cient frequency it can cause the stocking to dry out. Excipients: Liquid Para n Ph. Eur. White Dermatology Soft Para n BP. Incompatibilities:Handbook 2021–2022 None reported. Shelf Life: 3 years. Storage: At or below 30°C. Keep all medicines out of the reach31 of children. Packaging: Polyethylene aluminium foil laminated pouches, each pouch containing a single medicated stocking. The outer carton will contain either 4 or 10 pouches. Legal Category: P Market authorization number: PL44616/0002 Date of first authorisation/renewal of the authorisation: 01 October 2006 Date of revision of text: 26 October 2018 Trade Mark of Evolan Pharma AB Date of preparation: October 2018 Dermatology Handbook

Sizes but temporary colour to the skin with a pigmenting 4g and 30g (cream); 20g and 60g (powder) base containing DHA and erythrulose to give Price long-lasting colour. Viticolor Gel may be used £11.50 and £24.00 (cream); £12.00 and £21.50 during the treatment period and particularly during (powder) phototherapy. Indications Keromask For the camouflage of depigmented areas of Bellava Ltd skin in vitiligo. The product is applied to the Description depigmented area of skin with an applicator every Keromask is a high-pigmented masking cream, 8 hours until the desired shade is achieved. Once which is set with the Keromask Finishing the patient is satisfied with the shade then the Powder. It comes in 21 premixed skin tones, three product is used once or twice a week to top up complementary mixer colours and four Finishing the colour. Powders, and has a liquid texture. It is useful for Sizes large areas and is smudge proof and waterproof 50ml (when set) but not rub proof. Price Indications £19.99 For the camouflage of non-contagious skin lesions. Sizes Laundry products 15ml (cream); 20g (finishing powder) Price Skinnies Laundry £12.99; £13.99 Skinnies Description Veil Cover Cream Natural laundry product (powder and liquid) Thomas Blake Cosmetic Creams containing: vegetable oil soap; aqua; glucose-derived Description detergent; ethanol; natural anionic detergents; A high-pigmented cover cream, set with a citrates; and citric acid. transluscent finishing powder. It comes in 40 Indications premixed skin tones, including four complementary Developed for those who suffer from eczema and colours. It has a soft texture, and is smudge and psoriasis. waterproof (when set) but not rub proof. Finishing Sizes powder available in translucent and dusk. 1L; 5L; 2kg bags Indications Price For the camouflage of non-contagious skin lesions. Contact supplier Sizes Cream—19g, 44g, 70g. Powder—35g (42 shades Surcare Sensitive available on prescription) McBride Price Description Cream—£22.42, £33.35, £42.10. Powder—£24.58 A laundry and washing-up liquid brand which contains no enzymes, dyes, acids or fragrances. The Viticolor Gel Surcare range includes laundry powder, laundry Espère Healthcare liquid, laundry capsules, fabric conditioner and Description washing-up liquid. Viticolor is a gel that has been designed to give a Indications gradual, semi-permanent colour to depigmented Surcare’s laundry and washing-up liquid range have skin in vitiligo.Viticolor contains a combination of been especially formulated for people with sensitive 3 approved colouring agents, which give immediate skin.

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Sizes BAP Scar Care Gel Laundry powder: 1.625kg (25 wash); laundry liquid: Espère Healthcare 980ml (28 wash); fabric conditioner: 750ml (21 Description wash); laundry capsules: 20 wash; washing-up liquid Quick drying, non-greasy, medical silicone gel (450ml) enriched with vitamin E. Produces an invisible Price matt finish, making it especially suitable for use £5.25; £1.25; £5.25; £1.25 on the face or under cosmetic camouflage. Can be applied in a single movement. Dries within seconds of application. Also available with SPF 25 UV Scar treatment protection. Indications Advasil Conform Prevention and management of keloid and Advancis Medical hypertrophic scars. Suitable for scars on the face, Description neck, joints and skin folds. Silicone gel sheet for scar management. Sizes Indications 20g, 10g (SPF 25) Reduction or prevention of hypertrophic and keloid Price scars. Not to be used on open wounds. Not to be £17.12; £11.92 used on patients with dermatological conditions and/or where the skin is broken. BAP Scar Care S Sizes Espère Healthcare 10x10cm; 10x15cm Description Price A standard (1.2mm thick) transparent, self-adhesive £5.30; £9.35 (DT) silicone dressing. Can be applied under clothing and compression therapy. Each dressing is designed to Alhydran be washed and reused for several weeks. Espère Healthcare Indications Description Prevention and management of keloid and A specialist after-care treatment for the treatment hypertrophic scars. Recommended for larger scars, and hydration of burnt, damaged or vulnerable cosmetic and reconstructive surgery, and extensive skin immediately after wound closure. Combines burns. the strength of freshly processed, pure aloe vera Sizes gel (Aruba Aloe barbadensis) and high-quality oils 5x20cm; 10x15cm; 15x20cm; specialist shapes are and ingredients such as jojoba oil, vitamin E and also available for breast and abdominal scars. Each vitamin C. Helps to prevent scar formation and pack contains up to 2 months of treatment reduces itching and redness of the skin. Hydrates Price dry, sensitive and vulnerable skin and improves the £19.64; £24.68; £34.75; contact supplier for specialist flexibility of tight, non-elastic skin affected by burns shapes and scalds. Also available with an integral SPF 30 sun block. BAP Scar Care T Indications Espère Healthcare Suitable for the aftercare of burns, skin grafts, Description donor sites and skin damaged by radiotherapy, laser Ultra-thin (0.3mm), flexible, self-adhesive thin and treatments and hypostatic eczema. transparent medical silicone dressing. Each dressing Sizes can be worn continuously for up to 7 days then 30ml; 100ml; 250ml; 59ml (SPF 30) discarded and replaced. Price Indications £19.14; £35:26; £59.43; £30.17 (DT) Prevention and management of keloid and

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hypertrophic scars. Treatment of burn scars, Dermatix surgical scars and persistent functional complaints Mylan (persistent redness, pulling, itching, restricted Description mobility at joints, discomfort and cosmetic Dermatix is available in silicone gel complaints). sheets or fabric-backed silicone gel Sizes sheets. 5x7cm; 5x30cm; 10x15cm. Each pack contains up to Indications 2 months of treatment Prevention and management of Price hypertrophic and keloid scars . £3.17; £9.07; £9.07 Sizes Silicone gel sheet: Bio-Oil square—13x13cm, Bio Oil rectangular—4x13cm, 13x25cm, 20x30cm Description Price Bio Oil has an advanced formulation, which Square—£15.79. Rectangular—£6.88, £28.53, £51.97 contains the breakthrough ingredient PurCellin Oil, making it highly eff ective for numerous skin Dermatix Silicone Gel concerns, including aging skin and dehydrated skin. Mylan Bio Oil is formualted with the following all-natural Description ingredients: vitamin A, vitamin E, calendula Dermatix is available oil, lavender oil, rosemary oil and chamomile as a silicone topical gel . Oil. Bio Oil is a non-comedogenic (acnegenic), Indications hypo-allergenic product that is suitable for use by Reduction or prevention of hypertrophic and keloid individuals with sensitive skin . scars . Indications Sizes For improving appearance of all types of scars . 15g, 60g Sizes Price 200ml £16.66—15g, £60.53—60g Price £19.99 Kelo-Cote Alliance Pharmaceuticals Ltd Cica-Care Description Smith & Nephew Healthcare A clinically-proven, topical silicone gel for the Description management and prevention of old and new scars. Self-adherent, reusable silicone gel sheet. It is self-drying and forms a bond with the outer Indications layer of skin cells to form a fl exible, breathable, Management and prevention of hypertrophic and waterproof barrier, providing hydration and keloid scars. protection to the scar. Th is creates an environment Sizes which allows the scar to mature through normalised 12x6cm; 12x15cm collagen synthesis cycles, and improves the Price physiological and cosmetic appearance of the scar. £15.03; £29.30 Kelo-Cote is available with additional UV SPF 30 for areas that require additional protection, such as face, neck and hands, and a spray, ideal for joints, Subscribe to JWC visit fl exures, hairy areas or sensitive scars such as those caused from burns . www.magsubscriptions.com Indications Management and prevention of excessive scars .

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Sizes Price Gel (6g, 15g, 60g), UV gel (6g, 15g), Spray (100ml) £13.50; £40.00; £144.00; £7.50; £19.50; £19.50; Price £31.50; £4.00; £4.00;£21.12; £39.46 £10.83, £17.88, £51.00; £11.11, £17.88; £51.00 (DT) Mepiform Physical debridement pads Mölnlycke Health Care Description Debrisoft Discreet and flexible scar dressing consisting of a L&R Medical UK Ltd laminate (polyurethane and non-woven) covered Description with a soft silicone gel. Debridement pad made from polyester, using Indications patented Monofilament Fibre Technology. Management of old and new hypertrophic and Indications keloid scars. Can also be used as a prophylactic For removal of superficial slough and debris therapy on closed wounds for the prevention of including biofilm from wounds and skin during hypertrophic or keloid scarring. wound bed preparation. The soft fibres, which Sizes gently lift, bind and remove debris, are cut at a 5x7cm; 9x18cm; 4x31cm special length and angle to reach all uneven areas Price of the skin or wound bed. Debrisoft can be used £3.54; £13.86; £11.20 (DT) to aid wound or skin assessment and to remove slough and debris (including biofilm) at dressing Scar FX change. Suitable for chronic wounds such as leg Jobskin Ltd ulcers, diabetic ulcers and pressure ulcers; acute Description wounds such as lacerations, cuts and abrasions, and Silcone gel sheet, self-adhesive and reusable. superficial epidermal and partial-thickness burns. Indications Sizes Management, reduction and prevention of all 10x10cm; 13x20cm problem scarring including hypertrophic and keloid Price scars, and scars resulting from damage to the skin £6.55; £16.38 (per pad) following burns, trauma and post-surgical scar complications. Debrisoft Lolly Sizes L&R Medical UK Ltd 10x20cm; 25.5x30.5cm; 3.75x22.5cm; 7.5cm Description diameter; 22.5x14.5cm Debridement device with a head made from Price polyester, using patented Monofilament Fibre £37.73, £111.50, £25.63, £19.47, £25.63 Technology secured to a polypropylene handle. Indications Silgel For removal of superficial slough and debris, Nagor including biofilm from wounds and skin, during Description wound bed and skin preparation. Useful for cavity Silicone gel sheet. wounds and awkward areas, such as skin folds. Indications The soft fibres lift, bind and remove debris while Manage or reduce the visibility of hypertrophic and being gentle on healthy tissue, leaving the area keloid scars. clear for healing. The soft fibres are cut at a specific Sizes angle and length to reach all uneven areas of the 10x10cm; 20x20cm; 40x40cm; 10x5cm; 15x10cm; skin or wound bed. This product can be used to 30x5cm; 10x30cm; 5cm diamter; 5.5cm diameter; improve wound or skin assessment by clearing 25x15cm; 46x8.5cm debris from the wound bed or skin in a few minutes.

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It can also be used at dressing change to remove Indications superficial slough and debris, including biofilm, Very high sun protection suitable for sensitive skin prior to the application of a new dressing. Ideal in children from 6 months of age. for use on chronic wounds such as leg ulcers, Sizes diabetic ulcers and pressure ulcers; acute wounds 100ml and 300ml (lotion); 200ml (spray); 50ml such as lacerations, cuts, abrasions and superficial (baby lotion) epidermal and partial-thickness burns. Price Sizes £16.00 (100ml lotion); £20.00 (spray); £11.00 (baby 5cm x 2.7*cm (*core width = 1.9cm) lotion) Price £5.88 (per piece); 5 pieces per box Anthelios Sun Protection La Roche Posay UCS Debridement Description medi UK Very high UVB (SPF50+) and UVA sun protection, Description specifically designed for sensitive skin and A sterile, pre-moistened, single-use cloth for clinically proven in 28 clinical trials. Contains the effective wound debridement and cleansing of the patented filtering system Mexoplex and a powerful surrounding leg area. The soft debridement cloth anti-oxidant complex with Baicalin for increased contains a mild cleansing solution that moisturises protection against long UVA damage. Very water and softens without damaging healthy cells. resistant with a non-greasy, easily absorbed texture Indications which does not leave white marks. A class 2b sterile device that is recommended Indications for use with chronic and acute wounds, all types Skin which is sensitive to the sun, providing a very of ulcer, pressure ulcers and first- or second- broad UVB and high UVA protection with long- degree burns. It acts immediately, does not inhibit lasting photostability. granulation tissue formation and is compatible with Sizes subsequent use of any type of dressing. It is also 50ml (hydrating sun cream); 50ml (ultra light fluid); effective at removing hyperkeratosis. 50ml (gel cream dry touch), anti-shine mist; 250ml Sizes lotion; 200ml (spray); 200ml (oil) Foil-sealed sterile packs (x 10). Code DT500 Price Price £17.50; £17.50; £17.50; £14; £22; £20; £20 £3.25 each Delph Fenton Pharmaceuticals Sun protection Description Delph sun care offers a range of high-quality Anthelios Baby & Kids products from SPF15 to SPF50 with superior UVA La Roche Posay and UVB protection. UVA star rating is four-star Description offering a superior protection. Delph is based on Specially formulated for children’s fragile and the original Lemon Delph fragrance blended with a sensitive skin, and suitable for the face and body. highly-developed laboratory formulation, giving full The easy-to-apply texture, together with the protection at the required sunscreen level and great patented Mexoplex filter, provides high broad water resistance properties (even after two separate spectrum sun protection that is sand, perspiration 20-minute dips in the pool). and very water resistant. The slightly white fluid Indications ensures full coverage of the child and is paraben, For sun protection. fragrance and MI-free. Sizes Lotion: SPF15, SPF30, SPF50150ml

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Price Licochalcone A to neutralise free radicals caused by £3.57 UV and HEVIS light. Sebum-regulating Oil Control technology with L-Carnitine and absorbing Elave Sensitive Sun SPF 30 micro-particles gives skin a dry touch fi nish and a Ovelle Pharmaceuticals long-lasting anti-shine eff ect of up to eight hours. It Description is unperfumed and has a light, non-greasy texture. Elave Sensitive Sun SPF30 is an EU compliant Indications broad spectrum UVA and UVB protection Sun protection for oily, sensitive and system. Contains physical and chemical sunscreen acne-prone skin. with vitamins B5, C and E. If used as directed it Sizes can prevent long-term sun damage of the skin 250ml (gel-cream) decreasing the risk of skin cancer and premature Price ageing. Elave Sensitive Sun SPF30 absorbs 97% of £14.00 UVB radiation that causes sunburn. Indications Eucerin Pigment Control Sun For sun protection. Beiersdorf UK Ltd Sizes Description 250ml A light, everyday facial sunscreen that helps to Price prevent sun-induced hyperpigmentation. It contains £18.00 broadband and UVA/UVB fi lters for high UV protection with Licochalcone A to neutralise free Eucerin Sun Allergy Protect radicals caused by UV and HEVIS light. Th e Beiersdorf UK Ltd formula is further enriched with Th iamidol, that Description acts at the root cause of hyperpigmentation. It A face and body sunscreen for skin prone to visibly reduces dark spots over time and, when used sun-induced allergies, such as Polymorphus Light regularly, prevents their reappearance. Eruption (PLE). It contains broadband and UVA/ Indications UVB fi lters for high UV protection with Sun protection to reduce sun-induced Licochalcone A to neutralise free radicals caused by hyperpigmentation. UV and HEVIS light. It also contains Alpha- Sizes Glycosylrutin, which helps to prevent sun-induced 50ml (cream-fl uid) allergies such as PLE. Unperfumed, to minimise the Price risk of skin irritation, the non-greasy and non-sticky £20.00 cream-gel absorbs quickly and is water-resistant. Indications SunSense Daily Face For sun-allergic skin, including Ego Pharmaceuticals Polymorphous Light Eruption. Description Sizes SunSense Daily Face is an SPF 50+ 150ml (gel-cream) facial sunscreen ideal for all-year-round Price protection. It contains vitamin E and £20.00 vitamin B3, to help improve skin tone and texture . Th is light, soft cream has Eucerin Oil Control Sun an oil-free base and is tinted for a matte Beiersdorf UK Ltd fi nish. It helps protect against visable premature Description ageing from sun exposure. It is fragrance free, non- A n everyday facial sunscreen for oily and comedogenic, and dermatologically tested. acne-prone skin. It contains broadband and UVA/ Indications UVB fi lters for high UV protection with Use it every day on the face and neck.

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Sizes chemical absorbers. It is free of lanolin, fragrance 75ml (lotion) or colour, minimising the potential for irritation. It Price contains moisturising Vitamin B3 to help improve £11.42 the appearance of skin texture and tone, as well as help replenish dry skin. It is dermatologically tested, SunSense Kids and provides four hours of water Ego Pharmaceuticals resistance. Description Indications SunSense Kids is an easy-to-apply lotion specially Use for sensitive or young skin. formulated for the delicate skin of children from Sizes six months and above. It provides SPF 50+ broad 100ml spectrum protection. It contains moisturising Price Vitamin B3 to help improve the appearance of £9.40 skin texture and tone, as well as help replenish dry skin. It is fragrance free, dermatologically tested, SunSense Ultra and provides four hours of water Ego Pharmaceuticals resistance. Description Indications SunSense Ultra is a light, smooth, easy-to-apply For use on the delicate skin of lotion for the whole family, providing SPF 50+ children aged six months and above. protection with four hours of water resistance. It Sizes contains moisturising Vitamin B3 to help improve 50ml, 125ml the appearance of skin texture and tone, as well Price as help replenish dry skin. It is fragrance free and £5.01, £8.14 dermatologically tested. Indications SunSense Lip Balm Shake well. Apply liberally to clean, dry skin at least Ego Pharmaceuticals 15 minutes prior to sun exposure. Reapply every 2 Description hours and aft er swimming, exercise and towel dry. SunSense Lip Balm soothes, moisturises and helps Be careful to avoid contact with eyes. Always read protect lips in all seasons . It provides SPF 50+, the label and use only as directed. UVA and UVB broad spectrum protection, and Sizes helps relieve chapped lips due to exposure to the Roll on: 50ml. Bottle: 125ml. Pump dispenser: sun. It contains Vitamin E to help improve the skin 500ml elasticity, is fragrance and preservative free, and has Price been dermatologically tested. £5.09 (50ml), £8.26 (125ml), £18.43 (500ml) Indications Glide-on applicator for soft , gentle and easy Uvistat application. Boston Healthcare Ltd Sizes Description 15g Uvistat Sun Creams are 100% fragrance-free and Price specially formulated for sensitive skin. Uvistat £3.36 provides high UVA/UVB protection. Uvistat SPF50 SunSense Sensitive Lipscreen contains Vitamin E Ego Pharmaceuticals and Oil to help protect against Description cold sores and dry chapped lips . SunSense Sensitive is suitable for very sensitive skin Indications because it contains physical blockers, rather than Sun protection for those

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with sensitive skin.Protection of the skin from UV colour: radiation in abnormal cutaneous photosensitivity Long sleeve vest: small; medium; large dueto genetic disorders or photodermatosis Short sleeve vest: small; medium; large (including those resulting from radiotherapy). Leggings: small; medium; large Sizes Cycle shorts: small; medium; large Sun cream (SPF30, SPF50)—125ml. Lipscreen Gloves: large child/small adult; medium adult; large (SPF50)—5g adult Price Price Sun cream—£7.66, £8.68. Lipscreen—£3.20 CliniFast Garments for babies and children: Clava: £5.85; £6.75 Long sleeve vest: £7.13; £9.50; £10.69; £11.88; £11.88 Therapeutic clothing Mittens: £2.97; £2.97; £2.97 Tights: £7.13 CliniFast Leggings: £9.50; £10.69; £11.88; £11.88 Clinisupplies Socks: £2.97; £2.99 Description Gloves: £5.03; £5.03; £5.03 Elasticated viscose stockinette. CliniFast Garments adults: Indications Long sleeve vest: £12.75; £14.54; £16.58 Dressing retention, wet and dry wrapping. Short sleeve vest: £12.59; £14.35; £16.37 Sizes Leggings: £12.75; £14.54; £16.58 Red line: 3.5cmx1m. Green line: 5cmx1m; 5cmx3m; Cycle shorts: £12.59; £14.35; £16.37 5cmx5m. Blue line: 7.5cmx1m; 7.5cmx3m; Gloves: £5.03; £5.03; £5.03 7.5cmx5m. Yellow line: 10.75cmx1m; 10.75cmx3m; 10.5cmx5m. Beige line: 17.5cmx1m ComfiFAST Easywrap Price Garments Red line: £0.56. Green line: £0.58; £1.62; £2.81. Blue Vernacare Ltd line: £0.77; £2.13; £3.74. Yellow line: £1.20; £3.49; Description £6.04. Beige line: £1.83 A range of easy-to-apply, washable garments used in wet and dry wrapping for the treatment of CliniFast Garments atopic eczema. Easywrap garments are available for Clinisupplies children, teenagers and adults. Description Indications Elasticated viscose stockinette garments. Wet and dry wrapping for the treatment of atopic Indications eczema. Wet and dry wrapping, dressing retention. Sizes Sizes 6–24 months, 2–5 years, 5–8 years, 8–11 years, 11– CliniFast Garments for babies and children. 14 years, adult S–L. Available sizes vary depending Available in pink or blue colour: on selected garment(s) Clava: 6 months to 5 years; 5–14 years Price Long sleeve vest: 6–24 months; 2–5 years; 5–8 years; Leggings: 8–11 years; 11–14 years £9.50 (2-5 years), £10.69 (5-8 years), £11.88 (8-11 Mittens: up to 2 years; 2–8 years; 8-14 years years), £11.88 (11-14 years), £12.75 (Small Adult), Tights: 6–24 months £14.54 (Medium Adult), £16.58 (Large Adult) Leggings: 2–5 years; 5–8 years; 8–11 years; 11–14 Mittens: years £2.97 (up to 24 months), £2.97 (2-8 years), £2.97 Socks: up to 8 years; 8–14yrs (8-14 years) Gloves: small child; medium child; large child Socks: CliniFast Garments for adults. Available in white £2.97 (up to 8 years), £2.97 (8-14 years)

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Tights: Sizes £7.13 (6-24 months) Infant hat: 0–3 months; 3–12 months; 2–24 month Clava: Eye mask: one size £5.85 (6 months-5 years) Facial mask: 6–12 months (infant); 1–6 years £6.75 (5-14 years) (child); teen; adult Vest Long Sleeve: Adult ladies soft cup bra: XS/S, M/L, XL/XXL £7.13 (6-24 months) Body suit: 0–3 months (height 62cm); 3–6 months £9.50 (2-5 years) (height 68cm); 6–9 months (height 74cm); 9–12 £10.69 (5-8 years) months (height 80cm); 12–18 months (height £11.88 (8-11 years) 86cm); 18–24 months (92cm); 24–36 months £11.88 (11-14 years) (height 98cm); 3–4 years (height 110cm) £12.75 (Small Adult) Adult men’s boxers: XS/S, M/L, XL/XXL £14.54 (Medium Adult) Boy’s briefs: 3–6 years; 7–10 years £16.58 (Large Adult) Girl’s briefs: 3–6 years; 7–10 years Alternative Supply Chain prices are also available Adult ladies briefs: XS/S, M/L and XL/XXL Adult ladies minishorts: XS/S, M/L, XL/XXL DermaSilk Therapeutic Unisex child’s roll neck shirt: 3–4 years; 5–6 years; Clothing 7–8 years; 10–12 years Espère Healthcare Unisex adult roll neck shirt: S, M, L, XL, XXL Description Adult round neck shirt (female): S, M, L, XL, XXL DermaSilk are itch-reducing garments and tubular Adult round neck shirt (male): S, M, L, XL, XXL sleeve that are designed to treat pruritusand Tubular sleeves: 2 x 33cm; 2 x 50cm; 2 x graduated irritation caused byeczema, dry skin and dermatitis 70cm in adults and children, plus chemo and radiotherapy Leggings: 0–3 months (height 62cm); 3–6 months induced conditions and certain gynaecological (height 68cm); 6–9 months (74cm); 9–12 months conditions such as lichen sclerosus, lichen (80cm); 12–18 months (height 86cm); 18–24 simplex chronicus and recurrent thrush. They months (92cm); 24–36 months (height 98cm); 3–4 are made from a unique combination of medical years (height 110cm); Adult Male (S-XXL); Adult grade, fibroin silk, protected by a non-migrating Female (S-XXL) antimicrobial that cannot be removed from the Child’s gloves: small 3–4 years, medium 5–9 years fabric. DermaSilk is designed to be worn as a long- Adult gloves: S, M, L, XL and XL term prophylactic and is not intended for wet or Child’s fingerless gloves: small 3–4 years, medium dry wrapping. Only a light amount of non-greasy 5–9 years emollient is required under it. The garments can Adult fingerless gloves: S, M, L, XL and XXL be used in the presence of infection as they are not Pyjamas: 3–4 years (height 110cm); 5–6 years occlusive and have been tailored to ensure that they (height 120cm); 7–8 years (height 135cm); 10–12 will last for as long as they fit the patient. years (height 150cm) Indications Comfort socks: size 5–6.5; 7–8.5; 9–10.5; 11–13 To be worn continuously for the management of: Knee-length undersocks: standard length, size irritated skin caused by mild to moderate atopic 3.5–6.5 (2 pairs); longer length, size 7–11 (2 eczema; gravitational eczema; epidermolysis; bullsoa; pairs) intertrigo; radiotherapy; lymphoedema; lichen Thigh-Length undersocks: standard Length size sclerosus; and recurrent vulval candidosis. Also used 3.5-6.5 (2 pairs); longer length size 7–11 (2 pairs) as a non-irritant dressing retention. Controls itch by Child’s undersocks: size 3–8 (2 pairs); size 9–1 (2 regulating body temperature and humidity and can pairs); size 2–5 (2 pairs) reduce the frequency and severity of eczema flares Adult undersocks: size 5.5–6.5 (2 pairs); 7–8.5 (2 and thrush outbreaks. pairs); 9–10.5 (2 pairs); 11–13 (2 pairs)

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Price away unwanted moisture from weeping wounds Infant hat: £17.25 or perspiration. In addition, the polymer helps Eye mask: £10.24 restore the skin’s own ability to regulate moisture Facial mask: £16.69, £16.69, £21.29, £21.29 and temperature. The polymer has been applied Adult ladies soft cup bra: £38.63 to a range of medical grade silk garments for Body suit: £38.81, £38.90 £40.01, £41.04, £41.12, comfort, delivery and easy patient concordance. £42.16, £42.24, £43.35 The garments are manufactured to the highest Adult men’s boxers: £42.37 standards, featuring advanced fabrication Boy’s briefs: £22.09 techniques, such as flat seams for minimal irritation. Girl’s briefs: £22.09 The garments are machine washable at 40 degrees Adult ladies briefs: £31.53 and designed to be worn during the day or night Adult ladies minishorts: £33.54 underneath normal clothing, for sufferers of eczema Unisex child’s roll neck shirt: £47.94, £51.13, £53.26, and contact dermatitis.They can also be used in £55.40 conjunction with other medications and emollients. Unisex adult roll neck shirt: £78.78 Indications Adult round neck shirt (female): £78.78 For eczema and contact dermatitis. Adult round neck shirt (male): £78.78 Sizes Tubular sleeves: £27.77, £34.27, £42.31 Premature 0–14 years; child S–M; adult S–XXL. Leggings: £27.71, £27.77, £28.88, £29.93, £29.99, Available sizes vary depending on selected £31.05, £31.11, £32.22, £79.71, £79.71 garment(s) Child’s gloves: £15.02 Price Adult gloves: £21.09, £21.09, £21.09, £21.05 Eye mask: £10.35 Child’s fingerless gloves: £14.86 Head mask: £20.76 (50–54cm teenager, and 54+ adult) Adult fingerless gloves: £20.85 Body suit: £36.15 (0–3 months), £36.66 (3–6 months), Pyjamas: £72.28, £76.74, £80.07, £83.41 £38.14 (6–9 months), £38.70 (9–12 months), £39.20 Comfort socks: £18.63 (12–18 months), £39.74 (18–24 months), £40.27 Knee-length undersocks: £24.66 (24–36 months), £41.33 (3–4 years) Thigh-Length undersocks: £35.12 Shirt round neck: £46.76 (3–4 years), £48.84 (5–6 Child’s undersocks: £18.75 years), £50.92 (7–8 years), £51.96 (9–10 years), £53.00 Adult undersocks: £18.75 (11–12 years), £76.84 (adult male, S–XXL), £76.84 (adult female, S–XXL) DreamSkin Briefs and fitted boxers: £21.79 (boys and girls, 3–4 DreamSkin Health years and 11–12 years), £34.27 (adult male, S–XXL), Description £32.19 (adult female, S–XXL) DreamSkin is a unique polymer technology that Tubular sleeves: £26.87 (33cm long), £33.42 (50cm simultaneously protects and moisturises skin, while long) also supporting the skin’s natural repair function Baby leggings with foldaway feet: £25.66 (0–3 months), and reducing the effects of external irritants. In £26.17 (3–6 months), £27.53 (6–9 months), £28.06 eczematous skin, the skin barrier is defective and (9–12 months), £28.59 (12–18 months), £29.13 (18–24 lacks the ability to retain and produce sufficient months), £29.66 (24–36 months), £30.72 (3–4 years) amounts of natural moisture like normal skin, Leggings (footless): £30.72 (3–4 years), £32.24 (5–6 leaving it dry, cracked and unable to properly years), £32.76 (7–8 years), £33.28 (9–10 years), £33.80 defend against external irritants. The DreamSkin (11–12 years), £77.74 (adult male, S–XXL), £77.74 polymer imitates the ability of healthy skin to (adult female, S–XXL) protect against these irritants and has the ability to Gloves: £14.54 (child, S–M), £20.41 (adult, S–XL) both add and take away moisture simultaneously. Pyjamas: £68.91 (3–4 years), £73.16 (5–6 years), £76.34 In this way, it helps retain the beneficial moisture (7–8 years), £77.96 (9–10 years), £79.52 (11–12 years) that the skin produces naturally, while also drawing Liner socks (2 pairs): £18.29 (child), £18.29 (adult male

42 Dermatology Handbook 2021–2022 Adjuvant treatments

and female) Socks: 6 months–14 years (regular); child S–L (knee Heel-less undersocks (2 pairs): £24.05 length); adult S–XL. Gloves: child S–L; adult S–L. Knee-length sock: child S–L; adult S–XL Microair Barrier Socks and Price Gloves Clavas: £14.80 (6 months–5 years); £14.80 (5–14 Espère Healthcare years). Leggings: £25.28 (6–24 months); £28.39 Description (2–5 years); £29.90 (5–8 years); £32.70 (8–11 years); Microair barrier fabric prevents allergens/irritants £35.90 (11–14 years); £69.99 (adult small); £71.99 from getting into contact with the skin but still lets it (adult medium); £73.72 (adult large). Vest long- breathe. This is a tri-layered fabric, made of a knitted sleeved: £44.46 (6–24 months); £47.49 (2–5 years); polyester microfibre in layers 1 & 3. The internal layer £49.51 (5–8 years); £51.54 (8–11 years); £52.54 is a micro porous membrane (2) which allows the (11–14 years); £69.99 (adult small); £71.99 (adult passage of water vapour and sweat whilst remaining medium); £73.72 (adult large). Baby grow: £35.81 waterproof, blocking the passage of allergens. (premature); £35.81 (0–3 months); £35.81(3–6 Indications months); £37.87 (6–12 months). Shorts: £19.99 (6– For people suffering from contact dermatitis of the 24 months); £19.99 (2–5 years); £19.99 (5–8 years); hands or feet, or for those working in industries £19.99 (8–11 years); £21.99 (11–14 years); £37.99 with the risk of potentially harmful chemicals (adult small); £38.49 (adult medium); £38.99 (adult coming in contact with the skin. large). Vests sleeveless: £42.29 (child 6–24 months); Sizes £42.79 (child 2–5 years); £43.29 (child 5–8 years); Gloves: S, M, L, XL, XXL. Socks: shoe size 4–5, £43.79 (child 8–11 years); £44.11 (child 11–14 6–6.5, 7–7.5, 8–9.5, 10–12.5 years); £67.49 (adult small); £68.99 (adult medium); Price £69.99 (adult large). Short sleeve vests: £43.39 (6–24 Gloves: £33.89 per pair. Socks: £33.89 per pair months); £44.49 (2–5 years); £44.99 (5–8 years); £45.11 (8–11 years); £45.49 (11–14 years); £68.99 Skinnies Silk (adult small); £70.99 (adult medium); £72.99 (adult Skinnies large). Mittens: £13.49 (0–24 months); £13.49 (2–8 Description years); £13.49 (8–14 years). Gloves: £13.22 (child A clinically proven range of seamless and coloured small); £13.49 (child medium); £13.99 (child large); medical garments designed to be worn continuously £17.98 (adult small); £18.19 (adult medium); £18.96 for the management of irritated skin caused by mild (adult large). Tubular sleeves: £24.90 (33cm long); to moderate atopic eczema, epidermolysis bullosa, £29.90 (50cm long). Socks: £16.75 (6 months–8 palliative care, radiotherapy and as a non-irritant years); £16.75 (8–14 years). Knee-length sock: dressing retention. The itch is controlled by using £22.39 (child small); £22.39 (child medium); £22.39 the properties of stretch and seamlessness enabling (child large); £22.39 (adult small); £22.39 (adult body temperature regulation and can reduce the medium); £22.39 (adult large); £22.39 (adult XL) frequency and severity of eczema flare-ups. Indications Skinnies Viscose Garments Dressing retention, wet and dry wrapping for the Skinnies treatment of atopic eczema. Description Sizes A range of easy-to-apply, washable garments used Clavas: 6 months–14 years. Leggings: 6 months–14 in wet and dry wrapping for the treatment of atopic years; adult S–L. Vest long-sleeved: 6 months–14 eczema. years; adult S–L. Baby grow: premature–12 months. Indications Shorts: 6 months–14 years; adult S–L. Sleeveless Wet and dry wrapping for the treatment of atopic vests: 6 months–14 years; adult S–L. Short sleeve eczema. vests: 6 months–14 years; adult S–L. Mittens: 0–14 Sizes years. Tubular sleeves: 33cm long; 50cm long. Premature: 6–24 months; 2–5 years; 5–8 years; 8–11;

Dermatology Handbook 2021–2022 43 Dermatology Handbook

11–14 years; child S–L and adult S–L Price Price Skull Cap –£35.00 (0-5 years), £35.00 (5-11 Body suit: £16.18 (premature); £16.18 (up to years), £35.00 (11-14 years), £40.50 (S, M, L) 3 months); £16.18 (3–6 months); £18.21(6-12 Clava – £35.00 (0-5 years), £35.00 (5-11 years), months). Clava: £6.74 (6 months–5 years); £7.73 (5– £35.00 (11-14 years), £40.50 (S, M, L) 14 years). Vest long sleeve: £10.48 (6–24 months); Round Top Long Sleeve – £85.00 (0-24 months), £13.74 (2–5 years); £15.52 (5–8 years); £17.20 (8–11 £85.00 (2-7 years), £85.00 (7-11 years), £85.00 years); £17.20 (11–14 years); £21.27 (small adult); (11-14 years), £99.00 (XS, S, M, L, XL) £23.20 (medium adult); £25.13 (large adult). Vest Round Top Short Sleeve – £75.00 (0-24 months), short sleeve: £10.38 (6–24 months); £13.63 (2–5 £7500 (2-7 years), £75.00 (7-11 years),£75.00 (11- years); £15.36 (5–8 years); £17.09 (8–11 years); 14 years), £90.00 (XS, S, M, L, XL) £17.09 (11–14 years); £21.16 (small adult); £23.10 High Top Long Sleeve –£90.00 (0-24 months), (medium adult); £25.03 (large adult). Vest sleeveless: £90.00 (2-7 years), £90.00 (7-11 years), £90.00 £10.38 (6–24 months); £13.63 (2–5 years); £15.42 (11-14 years), £105.75 (XS, S, M, L, XL) (5–8 years); £17.09 (8–11 years); £17.09 (11–14 High Top Short Sleeve– £80.00 (0-24 months), years); £21.16 (small adult); £23.10 (medium adult); £80.00 (2-7 years), £80.00 (7-11 years), £80.00 £25.03 (large adult). Gloves: £5.29 (small child); (11-14 years), £96.75 (XS, S, M, L, XL) £5.34 (medium child); £5.34 (large child); £5.29 Wrap Top Long Sleeve – £148.50 (XS, S, M, L, XL) (small adult); £5.34 (medium adult); £5.34 (large Wrap Top Short Sleeve – £135.00 (XS, S, M, L, adult). Knee-length shorts: £10.38 (6–24 months); XL) £13.63 (2–5 years); £15.42 (5–8 years); £17.09 (8–11 Wrap Top Sleeveless – £121.50 (XS, S, M, L, XL) years); £17.09 (11–14 years); £21.16 (small adult); Single Arm Top – £72.00 (XS, S, M, L, XL) £23.10 (medium adult); £25.03 (large adult). Knee Arm Tube – £45.00 (0-5 years), £45.00 (5-11 sock: £13.94 (small child 0–1); (medium child 1–2) years), £45.00 (11-14 years), £51.75 (S, M, L) £13.94; £13.94 (large child 2–4); £13.94 (small adult Lower Leg Tube – £45.00 (0-5 years), £45.00 (5-11 4–6); £13.94 (medium adult 6–8); £13.94 (large years), £45.00 (11-14 years), £51.75 (S, M, L) adult 8–11); £13.94 (X large adult 11+). Leggings: Upper Leg Tube –£45.00 (0-5 years), £45.00 (5-11 £10.48 (6–24 months); £13.74 (2–5 years); £15.52 years), £45.00 (11-14 years), £51.75 (S, M, L) (5–8 years); £17.20 (8–11 years); £17.20 (11–14 Waist Tube– £45.00 (0-5 years), £45.00 (5-11 years); £21.27 (small adult); £23.20 (medium years), £45.00 (11-14 years), £51.75 (S, M, L) adult); £25.13 (large adult). Mittens: £3.87 (up to Leggings – £75.00( 0-24 months), £75.00 (2-7 24 months); £3.87 (2–8 years); £3.87 (8–14 years). years), £75.00 (7-11 years), £75.00 (11-14 years), Socks: £4.27 (up to 8 years); £4.27 (8–14 years) £83.25 (XS, S, M, L, XL) Crotchless Leggings – £83.25 (XS, S, M, L, XL) Skinnies WEB Garments Single Leg Leggings – £72.00 (XS, S, M, L, XL) Skinnies Shorts – £50.00 (0-24 months), £50.00 (2-7 years), Description £50.00 (7-11 years), £50.00 (11-14 years), £58.50 A range of easy-to-apply, modular garments for the (XS, S, M, L, XL) purpose of dressing retention, where it is necessary Crotchless Shorts – £58.50 (XS, S, M, L, XL) for dressing stability and conformity reducing Single Leg Shorts – £58.50 (XS, S, M, L, XL) impact damage, enabling improved healing and Socks – £35.00 (0-5 years), £35.00 (5-11 years), quality of life. £35.00 (11-14 years), £40.50 (S, M, L) Indications Gloves Full 5 Digit – £45.00 (0-5 years), £45.00 Epidermolysis bullosa, palliative care, (5-11 years), £45.00 (11-14 years), £51.75 (S, M, chemotherapy, burns and general wound care. L) Sizes Gloves Half 5 Digit – £40.00 (0-5 years), £40.00 0-5 years, 5-11 years, 11-14 years, XS–XL. Available (5-11 years), £40.00 (11-14 years), £45.00 (S, M, sizes vary depending on selected garment(s) L)

44 Dermatology Handbook 2021–2022 Adjuvant treatments

Gloves 2 Digit –£40.50 (S, M, L) Mitten –£40.50 (S, M, L) Tubifast Garments with 2-Way Stretch Technology Mölnlycke Health Care Description Elasticated tubular garments with SoftSeam technology. Indications For wet or dry wrapping and dressing retention. Sizes Vest Long Sleeve (6-24 months; 2-5 years; 5-8 years; 8-11 years; 11-14 years) Leggings: 2-5 years; 5-8 years; 8-11 years; 11-14 years Socks: one size Tights: 6-24 months Gloves: extra small child; small child; small/medium adult; medium/large adult Price Vest Long Sleeve: £11.72; £15.63; £17.58; £19.53; £19.53 Leggings: £15.63; £17.58; £19.53; £19.53 Socks: £4.95 Tights: £11.72 Gloves: £5.88 per pair

Dermatology Handbook 2021–2022 45 Dermatology Handbook Dermocosmetics

These are skin solutions for mild skin conditions and may be used alongside topical or oral treatments for more moderate or severe skin conditions

esthetics is a growing area of practice. It and itch. These symptoms, especially in visible areas represents that aspect of diagnosing, treating, of the body, like the facial zone, can have a negative and preventing the changes to the skin that impact on their self-esteem and quality of life. People Aare aesthetically not pleasing to the patient. Whether with milder skin conditions are often looking for it is aging lines, acne scarring or photodamaged skin, solutions, which will enable them to self-manage these skin changes can cause psychological distress.1 their skin condition. Healthcare professionals can Dermocosmetics describe a range of topical products help recommend dermocosmetics, which can be rather than beauty products. They are generally not used alone or alongside prescription topical or oral available on prescription and may be suitable for treatments patients with mild skin conditions, giving a wider Aesthetic practioners recommend products and range of choice for self-management. reputable practioners should work to the Cosmetic Patients may seek treatments to improve their Practice Standards Authority (CPSA) Clinical and appearance, so these are cosmetic patients.1 Other Practice Standards. The CPSA standards are for non- patients who have medical skin problems may also surgical cosmetic treatments, which could include have cosmetic concerns.1 These may be caused by dermocosmetics, in certain instances. Practioners the condition itself, acne, facial redness and flushing are expected to provide effective treatments based on due to rosacea, hyperpigmentation caused by active best evidence and be open and honest about efficacy melanin, or hypopigmentation due to underactive of treatments. melanin. Many patients with mild skin conditions may find it difficult to access skin solutions to help References 1 British Cosmetic Dermatology Group, 2016. What their skin symptoms. The products featured in this is cosmetic dermatology? http://www.bad.org.uk/ chapter are for facial skin conditions, including acne, healthcare-professionals/specialist-groups/british-cosmetic- rosacea and pigmentation disorders. dermatology-group (accessed March 2020) Skin conditions are very common, especially at 2 Schofield JK, Grindlay D, Williams HC. Skin conditions in the UK: a health care needs assessment. Metro Commercial the mild-moderate spectrum. An epidemiology Publishing, Hertfordshire, 2009 report based on UK data stated that 23–33% of the 3 CPSA. Improving safety in cosmetic practice. 2021. https:// population have a skin problem that can benefit bit.ly/3vckhpU (accessed March 2021) from medical care at any time with some 54% of the UK population experiencing a skin condition in a given 12-month period. Most of these patients (69%) manage the condition themselves, with only around 14% seeking further medical advice, usually from the doctor or community nurse.2 There are numerous prescribed and over the counter (OTC) treatment options available to patients who have skin conditions—prescription only topical treatments, OTC treatments and dermocosmetics. Patients with mild skin conditions will be affected by physical symptoms such as soreness, inflammation

46 Dermatology Handbook 2021–2022 Dermocosmetics

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Acne Sizes Four items in the kit: active cleanser (6 floz), Anti-Blemish Solutions 3-step Clearing hydrator (2.5 floz), night- time treatment System (2.5 floz), spot therapy 0.5 floz) Clinique Laboratories Price Description £69.50 (consumer price) This set contains a 4-week supply of all three steps: cleanse, exfoliate and moisturise. DCL Spot Therapy Indications Medical Aesthetic Group For acne-prone skin in all skin types. Description Sizes An ultra-concentrated, clinically proven anti-acne 30ml (clearing treatment)—50ml (cleansing foam); treatment powered by 2% salicylic acid that helps 100ml (clarifying lotion) clear breakouts instantly, while helping to prevent Price future blemishes from forming. Natural antiseptics, Kit: £25.00 (consumer price) astringents and exfoliants help eliminate excess oils, keep pores clean and battle acne-causing bacteria. Antiac Activ Skin-calming botanicals help relieve redness and Salcura irritation, while helping to correct post-pimple Description dark spots. Precise and potent, this targeted therapy An intensive natural acne spray formulated to leaves skin perfected, purified and completely at deal with moderate to severe acne on the face and peace. body. It is 97% natural with sea buckthorn for Indications skin rejuvenation and healing, rosemary for skin Intensive treatment for blemish prone skin. toning and cell regeneration, and lavender for its Sizes antibacterial and balancing properties. 15ml Indications Price Acne, spots, papules, whiteheads and blackheads. £24.17 (ex. VAT) Sizes 50ml, 100ml Effaclar H Price La Roche Posay Contact supplier Description A soothing moisturiser with clinically proven DCL Acne Healing System efficacy on acne-prone skin made fragile by Medical Aesthetic Group over drying treatments. Restoring comfort and Description suppleness, with a minimalist formula that is The system includes: Active Cleanser, which deeply tolerance tested under dermatological control cleanses, exfoliates and purifies with lactic and salicylic containing no parabens. acids; Clearing Hydrator, which hydrates the skin Indications without greasiness; Nighttime Treatment, which clarifies Specifically formulated to compensate for the drying and balances with salicylic acids and botanicals; Spot side effects of systemic skin treatments used for Therapy, which targets existing blemishes to lessen oily skin susceptible to acne. To be applied to the healing time and prevent recurrence. entire face and neck once or twice daily after gentle Indications cleansing and also suitable for skin sensitised with Suitable for oily and acne-prone skin types. visible signs of redness and chapped skin.

48 Dermatology Handbook 2021–2022 Dermocosmetics

Sizes Price 40ml Contact supplier Price £17.00 Eucerin DermoPurifyer Oil Control Adjunctive Soothing Effaclar K+ Cream La Roche Posay Beiersdorf UK Ltd Description Description Specifically formulated for sensitive skin, this gel A moisturising, non-greasy cream that alleviates the refines the skin texture of combination to oily, side effects often associtaed with acne medication imperfection prone skin and reduces the appearance and improves compliance. Ceramides support the of blackheads whilst mattifying the skin for 8 hours skin’s protective barrier and reduce moisture loss. from the very first application. The ultra-fresh SymSitive helps to calm irritations, such as stinging aquagel texture is refreshing on application and and burning directly at source, and Licochalcone A is ultra-light with quick absorption, providing a helps to soothe irritations. The formula helps to smoother looking skin texture with pores looking bring demanding, blemish- and acne-prone skin unclogged and controlled shine. The gel provides under control. all-day comfort and gives a moisturised/hydrated Indications feel. Suitable for acne-prone skin, Indications formulated for people undergoing Daily renewal fluid for oily skin susceptible to medical acne treatment. acne formulated to prevent relapse. To be applied Sizes morning and/or evening to the whole face, avoiding 50ml (cream) eye area. Price Sizes £10.00 30ml Price iS Clinical Tri Active Exfoliant £17.00 Harpar Grace International Description Emergency Gel Lotion iSClinical Tri Active Exfoliantis an invigorating Clinique Laboratories facial exfoliant, which transforms the appearance Description of dull, congested skin. The powerful blend of Targets persistent, resistant acne with benzoyl Salicylic Acid, botanical enzymes and natural peroxide and other anti-blemish ingredients to microbeads work to effectively unclog blocked help control the spread of the acne-causing agents. pores and remove excess oils and dead skin Oil-controlling and oil-absorbing ingredients help cells. Copper PCA controls sebum production, prevent oil build-up on skin’s surface that can lead reducing the formation of breakouts and keeping to clogged pores so that skin looks fresh, not oily or skin clear. shiny. Anti-irritants such as green tea extract, sea Indications whip extract, kola nut extract, caffeine and sucrose For acne-prone skin. help soothe irritation associated with breakout. Sizes Exfoliates dead skin cells that can contribute to 50ml clogged pores with acetyl glucosamine leaving skin Price looking cleaner and clear. £64.99 Indications For all skin types with persistent resistant acne. Subscribe to BJCN visit Sizes www.magsubscriptions.com Contact supplier

Dermatology Handbook 2021–2022 49 Dermatology Handbook

M&M Systems PCA Skin Acne Gel Medical Aesthetic Group PCA Skin Description Description This is an optimal combination of ingredients using PCA Skin Acne Gel contains 2% Salicylic Acid. the glycolic acid base and benzalkonium chloride Blemishes are dried up and pores cleared to prevent to remove excess oils and pore clogging debris from build ups of spot causing bacteria. Azelaic Acid oily and acne-prone skin. and a blend of botanical extracts work to clear the Indications complexion and improve the appearance of any For acne-prone skin. post-acne pigmentation. Sizes Indications 50ml For acne-prone skin. Price Sizes £21.67 (ex. VAT) 1oz Price Mene and Moy acne gel £37.00 Medical Aesthetic Group Description Contains 8% glycolic acid to loosen and remove Eczema treatments dead skin cells and excess oil from within the pores, plus benzalkonium chloride, which kills acne Eucerin AtoControl Acute Care causing bacteria to prevent and reduce the severity Cream of breakouts. Beiersdorf UK Ltd Indications Description For acne-prone skin. The formula of Eucerin AtoControl Acute Care Sizes Cream is a skin-calming complex based on four 50ml key ingredients: Omega-6 Fatty Acids, Decandiol, Price Licochalcone A and Menthoxypropanediol. Irritated £24.00 (consumer price) and reddened skin is calmed and soothed, helping to improve mild to moderate flare-ups significantly. NeoCeuticals Acne Spot Indications Treatment Gel Effective relief of dry, itchy, irritated and Neostrata atopic skin. Description Sizes NeoCeuticals Acne Spot Treatment Gel penetrates 40ml pores to quickly eliminate most acne blemishes and Price allow skin to heal. Patented NeoHydroxy Complex £12 combined with 2% salicylic acid, and pro-vitamin A. Indications Toleriane Ultra For acne-prone skin. La Roche Posay Sizes Description 15g Specifically designed for sensitive, intolerant and Price reactive skin, containing a range of high tolerance £17.49 products and formulated with minimum ingredients to limit the risks of allergies. Clinically proven to make your skin less sensitive, while providing long- Subscribe to NRC visit last hydration. www.magsubscriptions.com Indications Sensitive reactive allergy prone skin.

50 Dermatology Handbook 2021–2022 Dermocosmetics

Sizes range is clinically proven to reduce the appearance 20ml; 40ml of hyperpigmentation with first visible results after Price two weeks. £18.50 (Ultra fluid), £16 (Ultra Eye Cream) Indications For pigmentation, dark spots and uneven skin tone. Sizes Hyperpigmentation 30ml (serum) 50ml (creams) Price Advanced Pigment Corrector £38.00; £25.00 SkinCeuticals Description DCL Skincare Advanced pigment controller is a lightweight lotion Medical Aesthetic Group which evens skin tone and reduces the appearance Description of skin discolouration. A super-smart, clinically-proven, multi-faceted Indications moisturiser formulated with 2% salicylic acid and For hyperpigmentation/uneven skin tone. lactic acid to help clear existing blemishes and Sizes prevent future breakouts, as state-of-the- art soothers 30ml comfort the irritation that often accompanies acne- Price prone skin. Vitamin C works overtime to even out £95.00 skintone, diminish the appearance of dark spots and make acne scars far less visible. Proven hydrators Azelac RU soften and condition to keep skin completely Sesderma comfortable and healthy looking. Description Indications A liposomal depigmenting serum containing Soothes, brightens and treats blemish prone skin. liposomes active ingredients that act directly on the Sizes origin of skin spots homogenizing the skin tone. 50ml It has a depigmenting effect, and works as an anti- Price inflammatory and antioxidant. £30.83 (ex. VAT) Indications For post inflammatory hyperpigmentation and Enlighten Pigment Controller melasma. Can be used on all skin types. Neostrata Sizes Description 30ml A topical lightening product that has been Price developed to reduce the production of tyrosinase £40.00 and melanin to even the skin tone and prevent fewer pigmented areas on skin forming in the future. Eucerin Anti-Pigment Indications Beiersdorf UK Ltd For uneven skin tone. Description Sizes Effectively reduces dark spots and prevents their 30ml reappearance. The Eucerin Anti- Price Pigment range contains Thiamidol, £58.00 that acts at the root cause of hyperpigmentation by inhibiting Clinical and practical titles melanin producing enzyme and for healthcare professionals reducing hyperpigmenattion rleated www.quaybooks.co.uk inflammation. The Anti-Pigment

Dermatology Handbook 2021–2022 51 Dermatology Handbook

Even Better Sizes Clinique Laboratories 30ml Description Price The Even Better spot concealer contains £96.99 discolourations 1–2 shades in 4 weeks with patented CL-302 Complex, that includes: vitamin C to help Lumixyl Active Preparation reduce the appearance of discolouration; advanced SilDerm brightening yeast blend to break up the appearance Description of large visible dark spots into smaller, less visible This product gently cleanses the skin and prepares particles, similar to ‘dust’; encapsulated salicylic acid it for optimal application of skin brightening and acetyl glucosamine to exfoliate skin to speed agents. departure of surface discolourations. Indications Indications Antioxidants such as Rosmarinus officinalis To visibly reduce dark spots, discolouration, and (rosemary) leaf extract, Salvia officinalis (sage) leaf even skin tone. extract and Hordeum distichon (barley) extract help Sizes inhibit oxidative steps necessary for the production Contact supplier of melanin. Price Sizes Contact supplier 180ml Price Even Better Dark Spot Contact supplier Defense SPF 50 Clinique Laboratories Lumixyl Glycopeel Description SilDerm Sheer, non-chemical, shake-well sunscreen Description that helps prevent the formation of dark spots. This is a safe leave-on lotion and contains a high Contains 100% non-chemical UVA/UVB concentration of glycolic acid (20%), which protection from Zinc Oxide and Titanium Dioxide. enhances the turnover of cells for improved natural For all skin types. exfoliation. Unlike other GlycoPeels currently Indications available on the market only Lumixyl has a pH For preventing the formation of dark spots. of 3+, which allows enhanced tolerability while Sizes maintaining exfoliating efficacy. Contact supplier Indications Price This product helps to balance epidermal and dermal Contact supplier moisture while creating a more even skin surface and tone. iS Clinical White Lightening Sizes Complex 60ml Harpar Grace International Price Description Contact supplier iS Clinical White Lightening Complex features an innovative blend of proprietary lightening Lumixyl Kit ingredients and pharmaceutical grade botanicals. SilDerm It brightens and lightens the skin, targeting Description five mechanisms that are proven to cause Lumixyl is a clinically proven skin lightening and hyperpigmentation. hyperpigmentation treatment specially designed for Indications the face. It lightens the appearance of uneven skin For hyperpigmentation. tones and dark spots.

52 Dermatology Handbook 2021–2022 Dermocosmetics

Indications Vichy Normaderm Double Lumixyl contains a unique and safe active Correction Daily Care ingredient Ôdecapeptide-12Õ, which helps regulate Moisturiser overproduction of melanin and gradually improves Vichy hyperpigmentation. Description Sizes A daily care for blemish-prone skin enriched Kit contains active prep, brightener, glycopeel and with dermatological ingredients from natural moisturiser origins. Visible efficacy on blemishes, blackheads Price and scarring. In addition to protecting the skin Contact supplier barrier and controlling the appearance of excess oil, Normaderm Phytosolution Double-Correction Pigmentclar Daily Care leaves skin looking smoother and more La Roche Posay radiant whilst providing up to 24 hours hydration. Description Indications Targeted treatment for dark spots and dull Targets imperfections, including hormonal complexion. The range of pigmentation creams imperfections. Apply morning and evening. After and serums target the appearance of an uneven and washing face with Normaderm Phytosolution non-uniform skin tone. Containing no parabens or Purifying Cleansing Gel, apply to face. perfume, the creams and serums target dullness and Sizes dark spots for optimum results, even on sensitive 50ml skin. Containing PhE-Resorcinol is an inhibitor Price of the enzyme responsible for the production of £18 (Retail price) melanin, thereby reducing melanin synthesis and Ferulic Acid and Niacinamide to reduce melanin White Balance Click oxidation and inflammation that affects pigment Medik8 production. Description Indications A formula containing seven active ingredients For pigmentation, dark spots and uneven skin tone. for skin brightening. It helps to balance skin tone Sizes and fades dark spots and freckles caused by sun 30ml (serum); 15ml (eye cream); 40ml (moisturiser) exposure and ageing. It also promotes lightening Price and an even skin tone on all skin types, moisturises £30.00; £26.00; £27.00 the skin, acts as an antioxidant, and boosts the exfoliation process. It also helps increase epidermal Thiospot Intensive Cream cell turnover and prevents the overall appearance of Synchroline pigmentation. Description Indications Based on natural ingredients, this slows down Indicated for reducing pigmentation caused by dark melanin production. It normalises excessive spots, age spots, freckles, blotchiness, sun damage, production, causing new lighter skin cells to migrate uneven skin tone and melasma. to the skin surface and replace older darker ones. It Sizes contains a mild exfoliant (lactic acid). 2 x 10ml Indications Price For reducing pigment marks caused by sun damage, £45.00 pregnancy, scarring, liver spots and age spots. Sizes 30ml To advertise call Price Ed Croome 020 7333 1741 Contact supplier

Dermatology Handbook 2021–2022 53 Dermatology Handbook

White Balance Click Oxy-R trigger in the appearance of rosacea and couperose Medik8 symptoms. It restores the skin barrier, treating the Description rosacea symptoms, and fortifies the skin barrier, Helps reduce the visible signs of skin pigmentation, protecting from new flare-ups. blotchiness, uneven skin tone, dark spots, age spots Indications and freckles. Contains 10 carefully chosen active For the treatment of rosacea and couperose skin ingredients in a patent-pending solution to help symptoms such as redness, flushing, visible spider reduce the appearance of skin pigmentation as well veins, tightened and hardened skin and dryness. as providing the feeling of immediate hydration. Sizes Suitable for sensitive skin, it is free from kojic acid, 30g reinoids and Hydroquinone. Contains a hint of Price Ylang Ylang for a natural and comforting fragrance. £18.99 (consumer price) Indications Indicated for reducing the visible signs of skin Eucerin Anti Redness pigmentation, blotchiness, uneven skin tone, dark Concealing Day Cream SPF 25 spots, age spots and freckles. + UVA Sizes Beiersdorf UK Ltd 2 x 10ml Description Price Applied after cleansing, it instantly hydrates, calms £59.00 (RRP) irritation and helps cover visible redness. This innovative formula combines two active ingredients: SymSitive and Licorice Extract. Alongside its two Rosacea treatments active ingredients, the cream also contains green pigments that cover and neutralise reddened skin AesthetiCare Control Tactics resulting in an instant even-toned complexion. To Redness-Control Gel minimise the chance of intolerance or skin reactions AesthetiCare the formula is pure, while the packaging has been Description designed to protect it from contamination thanks to Reduces inflammation by combining anti- a dual valve system. inflammatory, antioxidant and hydrating medi- Indications grade ingredients to boost skin’s recovery. Helps For reddened, hypersensitive and rosacea/ minimise swelling and irritation in the skin. couperose-prone skin. Contains beta-glucan and arnica, and is gentle to Sizes delicate and sensitive skin. 50ml Indications Price Suitable for sensitive and rosacea-prone skin. £20.50 Sizes 60ml Eucerin Anti Redness Soothing Price Care £26.00 Beiersdorf UK Ltd Description Dermalex Repair Consists of two main ingredients: SymSitive and Dermalex licorice extract. SymSitive acts as a sensitivity Description regulator directly at the source of the hyper- Dermalex Repair reduces the typical symptoms reactivity. It calms the unpleasant sensation and of rosacea by promoting the full restoration of the increases the tolerance of hypersensitive skin. skin’s barrier function. It also protects the skin Licorice extractis a natural ingredient derived from through special UV filters neutralising an important glycyrrhiza inflata root extract. It is both an anti-

54 Dermatology Handbook 2021–2022 Dermocosmetics

inflammatory and an anti-oxidant, and so reduces Sizes redness and soothes irritation. 150ml Indications Price Developed for reddened, hypersensitive and £25 (RRP) rosacea/couperose-prone skin. Sizes Redness Corrector 50ml Medik8 Price Description £20.50 A complete ‘anti-redness’ product with six targeted actions to reduce visible redness and minimise the PCA Skin Anti-Redness Serum appearance of future breakouts. Key ingredients PCA Skin are: alpha-bisabolol, aloe vera, and white tea, which Description soothes and calms; caffeine and potassium chloride, Contains Aldavine (an advanced blend of brown which helps to reduce the appearance of capillaries and red algae), Capparenols (found in caper and thread veins; perfluorodecalin and caffeine, buds) and Bisabolol (one of the principal acive which minimise the appearance of future redness compounds found in chamomile). Together, these outbreaks; vitamin E, a strong antioxidant to protect skin-soothing ingredients work to calm irritation the skin from environmental damage; and bakuchiol and reduce redness caused by sensitive skin or and aloe vera, which helps to minimise the skin’s environmental triggers. This serum can be used response to irritants. Benefits include: instantly following an aesthetic procedure or for treating conceals redness with green mineral pigments; rosacea. provides anti-inflammatory effects; protects the skin Indications from environmental damage; helps to reduce the For rosacea-prone skin or sensitive skin post skin’s reactivity to external irritants procedure. Indications Sizes Indicated to help redness associated with: sensitivity 1oz or reactivity, hormonal change, broken capillaries Price and thread veins. It also helps to reduce the burning £52.00 sensation and skin discomfort associated with redness Red Alert Cleanse Sizes Medik8 50ml Description Price Helps prevent the appearance of skin redness £63 (RRP) by gently cleansing the skin without stripping the natural protective oils. Helps relieve and Redness Solutions Daily calm irritated skin and provides environmental Protective Base SPF 15 protection.Contains Teprenone, a patented Clinique Laboratories anti-redness active ingredient that aids the Description reduction of skin hypersensitivity; vitamin K, This comforting, oil-free, make-up primer protects which helps strengthen the capillary wall at the skin from UVA/UVB exposure, which can aggravate site of damage, reducing the appearance of skin skins withpersistent or reactive redness. Does not redness; sweet orange oil, which has soothing and contain chemical sunscreens. Its green tint helps anti- inflammatory properties. Helps relieve and correct redness and even out skin tone. calm irritated skin and provides environmental Indications protection. For redness-prone skin. Indications Sizes Suitable for skin prone to any form of facial redness. 40ml

Dermatology Handbook 2021–2022 55 Dermatology Handbook

Price £21.00 Redness Solutions Daily Relief Cream Clinique Laboratories Description An extra-gentle, oil-free moisturising cream that calms skin prone to persistent redness. It relieves visible redness and blotchiness, and soothes to cool discomfort. Over time, it also helps improve the comfort of the skin and lessens the look of broken capillaries. Indications For redness-prone skin. Sizes 50ml Price £40.00 Redness Solutions Soothing Cleanser Clinique Laboratories Description An extra-gentle, non-drying cream-gel that melts away makeup and impurities. It helps calm the appearance of visible redness and irritation while preserving the skin’s moisture balance. It soothes with mild exfoliation. Indications For redness-prone skin. Sizes 150ml Price £18.00

56 Dermatology Handbook 2021–2022 Dermocosmetics

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Medical devices and equipment specifically designed for investigating and diagnosing skin conditions, including patch testing and dermoscopy

chapter includes medical devices and skin lesion recognition skills.3 The examination by diagnostic equipment specifically used dermosocpy should be accompanied with an optimal todiagnose patients with dermatology clinical image, which is used for clinical decision Tconditions, both in primary and secondary care. making and transferred to the dermatologist.3 Allergic contact dermatitis is when a person Adherence to policies for transferring images to becomes sensitised to something in the environment dermatology, tele-dermatology services, and advice that comes into contact with the skin. Sometimes, and guidance should be sought locally. However, the unresolved contact dermatitis can cause suffering for RCGP Spotlight toolkit for dermatology is a good years with a diminished quality of life and increased starting point.4 The Primary Care Dermatology medical treatment costs. However, the condition Society (PCDS) runs several dermoscopy courses, can be effectively treated once an accurate diagnosis from absolute beginners to advanced level (http:// is obtained. This diagnosis needs to be made with www.pcds.org.uk/events/dermoscopy/4). patch testing, usually in a dermatology department. Melanoma kills twice as many Britons as cancer Potential allergens are placed in small chambers (in of the cervix, well over 2000 a year and rising.5 Skin groups of 10), placed on the back and left in place for lesion recognition skills are essential and should be 2 days. They are then removed and a first reading is a core skill for primary healthcare professionals, taken; 48 hours later, a second reading is taken and a and not necessarily the domain of dermatologists. diagnosis based on positive reactions.1 With the correct training in dermoscopy, very Dermoscopy is a diagnostic technique using common benign lesions can be easily diagnosed an illuminated light source. There are three types (haemangiomas, solar lentigos and seborrheic of dermoscopy devices: contact oil immersion keratosis), and recognition of lesions that do need (non-polarised) devices; cross-polarised devices; referral on the 2-week wait can be identified, as and hybrid devices combining both polarised and dermoscopy is the tool for early diagnosis.6 non-polarised modes. Dermoscopy is a fusion of the two major principles that facilitate good References 1 British Society of Cutaneous Allergy (BCSA). skin examination, namely magnification and Recommended series. https://tinyurl.com/ydgxzzac illumination. This provides skin morphology and (accessed March 2021) enables the HCP to recognise features of lesions by 2 Rosendahl C, Marozava A. Dermatoscopy and skin pattern analysis, and use of decision algorithms.1 cancer–A handbook for Hunters. 2019. Scion Publishing 3 Bowling J. Diagnostic Dermoscopy: The Illustrated Guide. By using dermoscopy, dermatologists will be Wiley Blackwell, Oxford, 2011 forced to examine individual lesions more closely. 4 Royal College of General Practitioners (RCGP) Their diagnostic accuracy for diagnosing not only Dermatology Toolkit. Available at: https://tinyurl.com/ u5x69jp (accessed March 2021) pigmented skin lesions and melanoma, but also a 5 Cancer Research UK (2019) Melanoma skin cancer whole variety of dermatoses, including infections and mortality statistics. https://bit.ly/2uRnvkO (accessed March inflammatory conditions, will increase with time and 2021) training.2 In the same way that GPs use stethoscopes, 6 Hayes S (2018) Nine things you need to know about dermoscopy. Pulse Online. https://bit.ly/2GdbnQv auroscopes and ophthalmoscopes to aid diagnosis, (accessed March 2021) dermatoscopes and dermoscopy training can become uniform practice in primary care to improve

58 Dermatology Handbook 2021–2022 Diagnostics EXPLORE THE COMPLETE ARCHIVE www.magonlinelibrary.com/ journal/jprp

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Journal of Prescribing Practice is the peer-reviewed, multidisciplinary journal for all non-medical prescribers. Every month it shares the latest clinical updates, pharmacology information and practical guidance, with more than 6,000 pages of content in our online archive. Providing the knowledge to prescribe ef ciently and effectively Dermatology Handbook 2021–2022 59 Dermatology Handbook Diagnostics

Dermoscopy super-quick, retractable spacer mechanism with precise focusing. It also offers IceCap (infection DermLite Basic control caps) compatibility, an increased battery Schuco International (London) life and integrated MagnetiConnect smartphone Description connectivity. The HR model benefits from ultra- The DermLite Basic is the original choice for oil-free bright, all-polarised illumination. dermoscopy. By incorporating 8 bright-white LEDs, Indications 10x magnification and advanced cross-polarisation, For the advanced practitioner, to assess and the DermLite Basic aids the early detection of diagnose a variety of skin lesions. melanoma by enhancing visualisation of pigmented Price skin lesions. £825.00 (exc. VAT) Indications For the new user to assess and diagnose a variety of DermLite DL200 Hybrid skin lesions. Schuco International (London) Sizes Description One size With an ergonomic, easy-to-clean stainless steel Price body, the DL200 Hybrid adopts the optical system £299 (exc. VAT) from the DL2 Hybrid and integrates an innovative, super-quick, retractable spacer mechanism with DermLite Carbon precise focusing. It also offers IceCap (infection Schuco International (London) control caps) compatibility, an increased battery Description life and integrated MagnetiConnect smartphone The DermLite Carbon provides instant toggle connectivity. The DL200 Hybrid also combines control over lesion visualisation, from the superficial polarised and non-polarised lighting to allow structures to deeper pigmentation, by activating two visualisation of pigment and vascular structures groups of LEDs, each with distinct polarisation. The with or without immersion fluids. first group of 8 LEDs produces cross-polarised light Indications ideal for visualising deep structures, whereas the For the advanced practitioner, to assess and second set of 8 LEDs is linearly polarised, creating a diagnose a variety of skin lesions. clear rendition of the skin surface. Price Indications £900.00 (excluding VAT) For the infrequent user, to assess and diagnose a variety of skin lesions. DermLite DL3N Sizes Schuco International (London) One size Description Price The DermLite DL3N contains refined optics and £429 (exc. VAT) improved visualization of both pigmented and vascular structures. Precision-engineered and DermLite DL200 HR crafted from recyclable aluminum, it features a Schuco International (London) 25 mm four-element lens, 28 high-powered LEDs Description and PigmentBoost illumination. For optimum With an ergonomic, easy-to-clean stainless steel ease of use, a quick tap on its power button body, the DL200 HR adopts the optical system instantly toggles between polarization modes, from the DL2 Pro HR and integrates an innovative, while the optional PigmentBoost mode produces a

60 Dermatology Handbook 2021–2022 Diagnostics

warmer illumination reminiscent of conventional Indications dermatoscopes. To aid in the visualisation of your surgical Indications procedures. When choosing a magnification system, To assess and diagnose a variety of skin lesions. it is important to consider several factors. The two Price most important points to remember are optical £925.00 (exc. VAT) performance and ergonomics. Sizes DermLite DL4 Heine Loupes are available in varying Schuco International (London) magnifications and working distances, as well as Description mounting options The 4th-generation DermLite Dermatoscope has Price been designed from the ground up to be more refined Headlights: from £675.16. Loupes: from £772.81 in every detail. A smooth, ergonomically optimised all-aluminium design, DermLite DL4 provides Heine Delta 20T versatility, large optics and instant on/off control. Brymill Cryogenic Systems (UK) Ltd Price Description £1125.00 (exc. VAT) The new Delta 20T offers unrivalled precision optics and the functionality to toggle between DermLite DL4W polarised and non-polarised illumination. No Schuco International (London) time consuming exchange of contact plates is Description necessary, at the same time contact dermatoscopy The newest fourth generation DermLite achieves with immersion liquids is possible at any point, brighter white illumination in both the polarised allowing the examination method to be matched and non-polarised modes. With its smooth, with the respective pigmented skin lesion to obtain ergonomically optimised all-aluminum design that the best diagnosis. The Heine dermatoscope is comfortably molds to your hand, DermLite DL4W a vital screening tool for use in general practice provides phenomenal versatility, the largest optics and dermatology departments alike. Allowing of any pocket-size DermLite, and instant on/off different diagnosis of pigmented skin lesions, the control. contact dermatoscope principle gives an invaluable Indications insight into the structure and nature of skin lesions To assess and diagnose a variety of skin lesions. and melanoma. When used in conjunction with Price the Heine Compendium of Dermatology, the £1045.00 (exc. VAT) dermatoscope allows the practitioner to accurately determine and detect potential malignancies using Heine Headlight & Loupes LED illumination. Brymill Cryogenic Systems (UK) Ltd Indications Description To aid the diagnosis of pigmented skin lesions or The Heine headlights meet high quality standards, other skin conditions such as scabies. providing a bright and homogeneous, illuminated Sizes field. The most common options are either the Available as either a battery handle, mobile charging Heine ML4 LED HeadLight or LED LoupeLight handle or desktop rechargeable device that can with state-of-the art LED technology. High-quality be attached to a compact digital, DSLR camera or optical magnification offers many advantages smartphone during treatment, such as improved sharpness of the Price image, and the experience of a healthier, ergonomic From £738.59 body posture. Heine high-tech optics, fitted with achromatic lenses, give clear and brilliant images www.dermatologyhandbook.co.uk with no colour distortion.

Dermatology Handbook 2021–2022 61 Dermatology Handbook

Opticlar D-Scope is easy to use and there is no wastage caused by Brymill Cryogenic Systems (UK) Ltd patient non-attendance. Description Indications Opticlar D-Scope with combi immersion and For the diagnosis of contact dermatitis. polarisation plate with X/Y measuring graticule and Price power handle. Single-use contact plate system and £390 (exc. VAT) for 10 patients zip carry case. Available as either a battery handle, mobile charging handle or desktop rechargeable device that can be attached to a compact digital, a DSLR camera or smart phone. Indications Aids diagnosis of pigmented skin lesions or other skin conditions such as scabies. Sizes Available as either a battery handle, mobile charging handle or desktop rechargeable device that can be attached to a compact digital, a DSLR camera or smart phone Price From £599.00

Patch testing Allergopharma Skin Prick Test Solutions Diagenics Description Diagenics offers a wide range of solutions for the diagnosis of Immediate Hypersensitivity (Type 1 allergy). Sizes Solutions of grass, tree and weed pollens, animal epithelia, moulds, mites and foods are supplied in 3ml vials. Patient leaflets and other support material is available. Training in skin prick testing techniques is given to customers. One size Price £25 (exc. VAT) per vial (sufficient for at least 100 tests) True Test Diagenics Description Each allergen in True Test is incorporated into a hydrophilic gel that is dried into a thin film. When applied to the skin, this film becomes hydrated by skin moisture and the allergen is released. True Test

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Accessible | Relevant | Mobile and Desktop www.internurse.comDermatology Handbook 2021–2022 63 Dermatology Handbook Emollients

Complete emollient therapy is essential to prevent dry skin and first-line therapy, and also to restore the skin barrier and reduce the likelihood of skin damage to improve skin health and quality of life

ry skin is a clinical symptom of many skin bath and shower products.1 Emollients (referred to as conditions, which manifests as flaking, medical moisturisers) are available as lotions, creams, scaling, crusting and painful fissures. Dry gels or ointments, and nearly all emollients can also skinD is generally always itchy, invariably leading to be used for washing as soap subsistutes. Individual inflammation caused by the vicious itch-scratch cycle. choice is the most important aspect when selecting It is caused by the loss of integrity of the stratum suitable emollients; for example, one formulation corneum, which leads to the breakdown of the skin may be preferred for both washing and moisturising, barrier. Dry skin can also cause psychological distress, or a selection of different products for washing and as symptoms and appearance can be difficult to cope moisturising may be required (eg, lotion or cream with. Dry skin caused by skin barrier breakdown is for the day and an ointment overnight). The BATHE the first event in the development of atopic eczema, study found that emollient bath additives do not add together with the interaction of environmental agents any benefit over standard management.3 However, it is and genetic changes in structural proteins, such as important to wash with soap substitutes, so depending filaggrin and excessive protease activity. on patient preference, bath additives can still be These changes in the skin barrier lead to decreased prescribed or recommended as a wash emollient of levels of natural moisturising factors (NMFs) and choice for some patients. the breakdown of lipid lamellae from around the Emollients should be non-perfumed and not contain corneocytes.1 These skin barrier changes are present in anionic surfactants, such as sodium lauryl sulfate (SLS), all types of eczema and dermatitis, as well as psoriasis which are known skin irritants and adversely affect the and ichthyosis. Infants and older people are particularly skin barrier (for example Aqueous cream, which should vulnerable to physiological dry skin, due to reduced be avoided as a washing and left-on emollient).4 They levels of NMFs and alterations in lipid composition in should be applied liberally and frequently in downward the developing and ageing skin.2 strokes and reapplied throughout the day, when Emollients are first-line therapy for dry skin necessary. The majority of moisturisers are paraffin- conditions, as they restore the skin barrier and soothe based and work by preventing water from being lost dry skin by creating a partially occlusive barrier through the skin by acting as an occlusive barrier on preventing transepidermal water loss (TEWL), the stratum corneum. Lighter creams and lotions are protecting the skin from entry of irritants and allergens quickly absorbed because of a high water content, from the external environment and restoring NMFs to which means they are unable to prevent TEWL as well rehydrate.2 Complete emollient therapy is essential and as greasy ointments, but these may be inconvenient to recommended to prevent dry skin, helping to reduce use and messy.1 Humectant creams act by replacing scaling and painful fissuring. Daily use of emollients NMFs found naturally in skin, such as urea and may also help prevent acute flares and will improve skin glycerol, thereby attracting and retaining water in the health and quality of life. skin cells (called corneocytes). Complete emollient therapy (CET) is the most A patient with a dry skin condition should be offered important treatment for all dry skin diseases. The a choice of emollient products and principle of CET is that everything that goes on the prescribed complete emollient therapy. Informed skin should be emollient-based, and all soaps and patient choice is a crucial factor when selecting and detergents should be replaced with emollient wash, prescribing emollients for patients, as emollient efficacy

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is dependent on usage and patient adherence.2 There is emollient or emollient-treated skin can rapidly ignite.10 a wide range of emollients on prescription and they are Emollient regimens should be tailored to the patient’s also available to buy in pharmacies. Local formularies needs and lifestyle. They need to be combined with may dictate which emollients are prescribed, and these topical treatments in acute episodes of skin disease. should have a range of choice between simple, greasy It is essential that all topical treatments, including and humectant emollients. Emollients should not be emollients, are demonstrated and explained in detail prescribed on cost alone. If an emollient does not suit to patients. All health professionals involved in the care a patient, this is where cost is significant due to waste of patients with dry skin conditions should understand and flaring of skin conditions, which will then require the basic principles of complete emollient therapy. management and additional treatments dramatically Non-proprietary emollient preparations include: increasing NHS resources. • Emulsifying ointment BP A paper looking at emollient formularies in England • Hydrous ointment BP and Wales concluded that formularies vary widely • Liquid and white soft paraffin ointment NPF in their structure, recommendations and rationale. • Paraffin white soft BP The reasons for such inconsistencies are unclear, risk • Paraffin, yellow soft BP. confusion and make for inequitable regional variation.5 The paper states there is poor justification for multiple References 1 Cork MJ, Danby S. Skin barrier breakdown: A renaissance different, conflicting formularies. Therefore, there is no in emollient therapy. Br J Nurs 2009; 18: 14, 872–877 evidence or justification for restricting emollient choice 2 Moncrieff G, Cork M, Lawton S et al. Use of emollients for patients. A BAD position statement discusses that in dry skin conditions: consensus statement. Clinical and Experimental Dermatology 2014; 38, 231–238 patients should be given a choice of products. To avoid 3 Santer M, Rumsby K, Ridd MJ et al. Bath additives for the wasting resources, it is reasonable to offer low cost treatment of childhood eczema (BATHE): protocol for choices, SLS-free, paraffin-based emollients which can multicentre parallel group randomised trial. BMJ Open 2015; 5:e009575 be prescribed in 500g containers. However, if a patient 4 Medicines and Healthcare products Regulatory Agency requires more expensive emollients due to irritation (MHRA). Drug Safety Update: Aqueous cream: may cause or allergy, these needs should be reflected in any local skin irritation. MHRA, 2013. https://tinyurl.com/prkanxo (accessed March 2021) 6 prescribing policy. 5 Chan JP, Boyd G, Quinn PA et al. Emollient prescribing Emollients should be used liberally and prescribed formularies in England and Wales: a cross-sectional study. in large quantities. The Primary Care Dermatology BMJ Open 2018; 8:e022009 6 British Association of Dermatologists (BAS). NHSE 6 Society (PCDS) recommends 500g per week for adults. consultation statement on bath emollients. https://bit. The National Institute for Health and Care Excellence ly/2I9KVua (accessed March 2020) (NICE) childhood atopic eczema Quality Standard 7 Primary Care Dermatology Society (PCDS). Eczema— atopic eczema. https://tinyurl.com/krdcb9e (accessed March recommends that children should be prescribed at least 2021) 250g per week of emollient.8 The NICE atopic eczema 8 National Institute for Health and Care Excellence (NICE). Atopic eczema in children. Quality Standard 44. NICE guidance for children under 12 years was updated in 2013. http://tinyurl.com/m7z6ewj (accessed March 2021) 2021 and recommends that parents should be given 9 National Institute for Health and Care Excellence (NICE). a choice of emollients, which should be used in larger Atopic eczema in under 12s: diagnosis and management. NICE 2007. https://bit.ly/2FZ9maq (accessed March 2021) amounts than other treatments, and on the whole body, 10 Medicines and Healthcare products Regulatory Agency even when it is clear of skin disease.9 (2018). Emollients: new information about risk of severe There are some safety issues: emollients used for and fatal burns with paraffin-containing and paraffin-free washing may cause the bath or shower to become emollients. https://bit.ly/2CVkGT9 (accessed March 2021) slippery, so a bath mat should always be used. There is a fire risk with all paraffin-containing emollients, regardless of paraffin concentration, and it also cannot be excluded with paraffin-free emollients. It is important to instruct them not to smoke or go near naked flames, because clothing or fabric such as bedding or bandages that have been in contact with an

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Bath additives with the risk of eczema becoming infected, while also antimicrobials restoring moisture back into the skin. Indications Dermol 600 Bath Emollient For treating eczema that is at risk of becoming Dermal Laboratories Ltd infected. Description Sizes Dermol 600 is an antimicrobial bath emollient that 500ml rehydrates the keratin by replacing lost lipids. It Price contains 50% oils emulsified in water and a well- £7.94 known antiseptic, benzalkonium chloride, which helps prevent secondary infection. Indications Bath oils and additives For use as an aid in the treatment of dry and pruritic skin conditions, Balneum Bath Oil especially eczema and dermatitis, Almirall Ltd ichthyosis or xeroderma. Description Sizes Emollient bath oil containing 84.7% soya oil. 600ml Indications Price Dry skin conditions including those associated with £7.55 dermatitis and eczema. Sizes Emulsiderm Bath Additive 200ml, 500ml, 1l Dermal Laboratories Ltd Price Description £2.48, £5.38, £10.39 Emulsiderm is a liquid emulsion that can be used as a bath additive or applied directly to the skin. It Cetraben Bath Additive is an antimicrobial bath emollient that permits the Thornton & Ross rehydration of the keratin by replacing lost lipids. Description It contains 50% oils emulsified in water and a well- An emollient, moisturising and protective oil. Free known antiseptic, benzalkonium chloride, which from fragrance, colouring, SLS, lanolin and parabens. assists in preventing secondary infection. Indications Indications Symptomatic relief of red, inflamed, dry, damaged or For use as an aid in the treatment of dry and pruritic chapped skin, especially when associated with eczema. skin conditions, especially eczema and dermatitis, Sizes ichthyosis and xeroderma. 500ml Sizes Price 300ml, 1L £5.75 Price £3.85—300ml, £12.00—1L Dermalo Bath Emollient Dermal Laboratories Ltd Oilatum Plus Antiseptic Description Thornton & Ross Dermalo Bath Emollient contains 65% liquid Description paraffin and 5% acetylated wool alcohols, which A rehydrating bath emollient that works to reduce have moisturising and skin-softening properties.

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It is specially formulated to facilitate dispersion in Sizes bath water and for ease of application after a shower. 500ml Indications Price For symptomatic relief of contact dermatitis, atopic £5.45 dermatitis, senile pruritus, ichthyosis and related dry skin disorders. E45 Bath Oil Sizes Reckitt Benckiser Healthcare UK 500ml Description Price An effective yet gentle bath oil that is clinically £3.44 proven to soothe and moisturise dry skin. It creates a lasting barrier that protects against Dermipar Ointment moisture loss. Galen Limited Indications Description For moisturising dry and itchy skin conditions. Dermipar Ointment is formulated for long-lasting Sizes intensive relief of very dry or cracked skin, or for 250ml, 500ml use at night for long term-moisturisation. It feels Price soft to the touch and easily rubs into the skin, Contact supplier providing a protective barrier to prevent water loss. It is suitable as a bath additive or as a skin cleanser Hydromol Bath & Shower in the shower or bath. It contains liquid paraffin Emollient 40%, white soft paraffin 30% and is free from Alliance Pharmaceuticals Ltd sodium lauryl sulphate (SLS), lanolin, parabens, Description preservatives, colourings and fragrances. Light liquid paraffin 37.8%; Isopropyl Myristate 13% Indications Indications For the relief of moderate to severe dry skin. Used topically for the management of dry skin, a Suitable for treating a wide range of skin conditions, feature present in all forms of dermatitis/eczema including sensitive dry skin and all degrees of ichthyosis and senile pruritus. complaints such as eczema and Sizes psoriasis. 350ml, 500ml, 1L Sizes Price 500g £3.91; £4.46; £8.87 (DT) Price £4.92 LPL 63.4 Fragrance Free Bath Emollient Doublebase Emollient Bath Huxley Europe Additive Description Dermal Laboratories Ltd Fragrance-free emollient bath additive. Description Indications Doublebase Emollient Bath Additive An emollient is suitable for use as part of complete contains 65% liquid paraffin, which emollient therapy. has moisturising and skin-softening Sizes and the elderly. properties, and is specially formulated 500ml to disperse in bath water. Price Indications £3.10 For the symptomatic relief of contact dermatitis, atopic dermatitis, senile pruritus, ichthyosis and www.dermatologyhandbook.co.uk related dry skin disorders.

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For the relief of dry skin conditions

Suitable for use with eczema, psoriasis, dermatitis and a range of dry skin conditions. For the relief of dry skin conditions

MOISTURISE QV Cream MOISTURISE QV Intensive Ointment MOISTURISE QV Bath Oil CLEANSE

• A highly concentrated, rich, • Highly emollient intensive balm. • Clear, non-greasy formula. • moisturising cream. • Protects and soothes sore skin to • Non-slip, disperses easily in water. • Use as often as required to moisturise promote healing. • Simply add to the bath as directed. areas such as elbows and knees. • Won’t sting when applied to inflamed • Now available in a convenient pump or cracked skin. soap can. pack to help reduce the risk of • Apply as often as required, particularly contamination and cross-infection. after bathing or showering, is www.qvskincare.co.ukrecommended for most skin types

Available 100g, 500g &1050g Available 450g Available 250ml & 500ml To request samples or find out more about how QV can help your WWW.QVSKINCARE.CO.UKpatients contact: [email protected] SOAP, COLOUR, NOT TESTED PH BALANCED LOW IRRITANT FORMULA FRAGRANCE FREE ON ANIMALS Dermatology Handbook 2021–2022 69 Dermatology Handbook

Oilatum Emollient Zerolatum Bath Additive Thornton & Ross Thornton & Ross Description Description A bath emollient that forms a protective film on the A fragrance-free, soothing bath treatment with skin surface to reduce moisture loss, leaving the skin 60% liquid paraffin for the symptomatic relief of soft, hydrated and soothed. contact dermatitis, atopic dermatitis, senile pruritus, Indications ichthyosis and related dry skin conditions. Formulated to treat dry and itchy skin conditions, Indications including eczema and dermatitis. Bath oil for the management of contact dermatitis, Sizes eczema, senile pruritus, ichthyosis & related dry 500ml skin disorders. Price This product is suitable of use in infants and £5.80 children. Sizes Oilatum Junior Bath Additive 500ml Thornton & Ross Price Description £4.79 A soothing bath additive that forms an emollient film on the surface to hydrate, protect and soften the Zeroneum skin by reducing moisture loss. It also cleanses the Thornton & Ross skin, so soaps are not needed. Description Indications A gently fragranced bath treatment that combines To treat eczema and dry skin in children and babies. cleansing and moisturising in one, containing 80% Sizes soya bean oil for soothing eczema and other dry 150ml; 300ml; 600ml skin conditions. Price Indications £2.95; £5.02; £7.34 Bath additive for the management of dry skin conditions such as eczema and dermatitis. This QV Bath Oil product is suitable for infants and chidlren. Ego Pharmaceuticals Sizes Description 500ml A non-greasy, soap-free bath oil suitable for Price large areas of dry or sensitive skin. It is fragrance £4.48 free, lanolin free, colour free, preservative free, dermatologically tested, and hypoallergenic. Indications Bath oils with antipruritics For the relief and treatment of dry skin conditions, such as dermatitis, eczema, psoriasis, xerosis or Balneum Plus Bath Oil ichthyosis. Relieves the symptoms of dry, itchy skin Almirall Ltd by helping to prevent moisture loss. Description Sizes Bath oils with antipruriticsEmollientsBath oil with 250ml, 500ml active ingredients that have emollient and local Price anesthetic properties (lauromacrogols 15%) and £2.93, £4.79 provide relief of pruritus. Indications Subscribe to BJN visit It is recommended for the treatment of dry skin www.magsubscriptions.com conditions, including those associated with dermatitis and eczema where severe pruritus is also experienced

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Sizes Indications 500ml For all skin types including sensitive skin, for use on Price the face, hands and whole body, dryness caused by £6.66 prescription skincare products. Sizes 236ml, 473ml Emollient washes (including Price shower preparations) £5.06, £8.24 Aquamax Wash Cetaphil Restoraderm Skin Intrapharm Laboratories Restoring Body Wash Description Galderma (UK) An emollient wash that is free from sodium lauryl Description sulphate (SLS), lanolin and parabens. The body wash includes skin-nourishing oils in a Indications soap-free foaming wash that gently cleanses without A non-foaming soap substitute. irritation or drying of skin. The wash contains Sizes innovative ingredients to preserve moisture content, 250g enhance the skin’s integrity and rebuild the natural Price barrier function. It is ideal as part of the daily £2.99 management of dry skin for the whole family. Indications Care Aqueous Emollient Cream For all skin types including sensitive, dry and (SLS Free) eczema-prone skin. Thornton & Ross Sizes Description 295ml This gentle yet effective two-in-one emollient and Price soap substitute is perfect for keeping dry and flaky Contact supplier skin in tip-top condition. Fragrance and colour free, it can be used as an emollient to put valuable Doublebase Emollient Shower moisture back into dry skin, or in the bathroom as a Gel and Doublebase Emollient non-drying alternative to soap or shower gel. Wash Gel Indications Dermal Laboratories Ltd Two-in-oneemollient and soap substitute for the Description treatment of dry skin conditions. Doublebase Emollient Shower Gel and Doublebase Sizes Emollient Wash Gel are designed to deliver 100g emollient ingredients into the stratum corneum Price when gently applied to areas of dry skin. They are £1.71 relatively non-greasy, despite their high oil content. The oily ingredients, isopropyl myristate and liquid Cetaphil Gentle Skin Cleanser paraffin, encourage rehydration and softening of Galderma (UK) dry skin by forming an occlusive barrier within the Description skin surface, which reduces drying A mild formulation that gently moisturises and resulting from evaporation removes unwanted impurities, without stripping of water diffusing from the the skin’s natural protective oils and emollients, or underlying layers. Both upsetting the pH balance. Soothing and fragrance products are suitable for use free, daily use relieves the dryness often caused by as a soap substitute owing to medicated skin products without itching or irritation. the presence of a non-ionic

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emulsifi er (cetomacrogol) . to-reach areas. Indications Indications Regular fi rst-line treatment and prophylaxis of dry For removal of urine and faeces following episodes or chapped skin conditions that may also be pruritic of incontinence. For breakdown and removal of (itchy) or infl amed. May also be used as an adjunct stubborn dried bodily fl uids, such as faeces and to other topical treatments . blood, postoperative antiseptic cleansing solutions Sizes and skin barrier protectants. 200g Sizes Price 250ml spray £5.21 Price £5.95 E45 Wash Cream Reckitt Benckiser Healthcare UK Myribase Emollient Shower Gel Description Galen Limited E45 Wash Cream is an emollient soap substitute Description that is clinically proven to wash dry and itchy skin Myribase Emollient Shower Gel is designed for conditions. daily use in the relief of low-to-moderate dry skin Indications and as an alternative to normal soaps and For washing dry and itchy skin conditions . shampoos, which typically cause the skin to dry Sizes out. It contains the non-ionic soap substitute 250ml cetomacrogol, which gently cleans; the humectant Price glycerol, which attracts water to moisturise; and Contact supplier isopropyl myristate and liquid paraffi n, to prevent water loss and soft en the skin by forming an Eucerin Urea Repair Plus 5% occlusive barrier within its surface, reducing Urea Replenishing Body Wash drying resulting from evaporation of moisture Beiersdorf UK Ltd diff using from the underlying layers. It is Description non-greasy, despite its high oil content, and A gentle cleanser that will not wash away the suitable for use as a soap substitute due to the skin’s natural protective barrier. It is enriched with presence of non-ionic emulsifi ers. moisturising Urea and Lactate to soothe dry to very Indications dry skin. For use as regular fi rst-line treatment and Indications prophylaxis of low-to-moderate dry or chapped skin Daily cleansing of dry or mature skin. Suitable for conditions that may also be pruritic or infl amed, use for skin aff ected by psoriasis or diabetes . including eczema, contact dermatitis, Sizes psoriasis, ichthyosis and pruritus. Can 400ml be used as an adjunct to other topical Price treatments. £15 Sizes 200ml Medi Derma-Pro Foam and Price Spray Incontinence Cleanser £4.17 Medicareplus International Description pH-balanced, skin-friendly, no-rinse, moisturising Subscribe to cleanser suitable for use on severely damaged skin Practice Nursing from moisture associated skin damage. Can be used in www.magsubscriptions.com a foam or spray mode for easy application to diffi cult-

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Oilatum Shower Gel conditions. Contains white soft paraffi n 15% and Th ornton & Ross liquid paraffi n 6% . Description Indications A moisturising shower gel that soothes and Suitable from birth for eczema, psoriasis, other dry skin conditions the skin, relieving it from itching and conditions as well as being an eff ective soap substitute . dryness. Sizes Indications 50g; 500g To use in the shower to treat eczema and dry skin Price conditions. £1.70; £4.95 Sizes 150g AproDerm Gel Price Fontus Health £5.27 Description A highly moisturising emollient gel without the QV Gentle Wash greasiness of an ointment, that actively draws and Ego Pharmaceuticals retains moisture within the skin and provides Description a protective barrier to help reduce dryness and A soap-free, foaming liquid cleanser. It contains irritation. Free from SLS, parabens, benzyl alcohol, 15% Glycerin. It is formulated for use on dry triethanolamine, fragrances and colours, AproDerm or sensitive skin, and is pH balanced, fragrance Gel contains isopropyl myristate 15% and liquid free, lanolin free, colour free, non-comedogenic, paraffi n 15% . dermatologically and Ophthalmologist tested, and Indications hypoallergenic. Suitable from birth for eczema, psoriasis and other Indications dry skin conditions . F or cleansing dry skin, as it contains a high Sizes moisturiser concentration. Helps manage the 100g; 500g (pump) symptoms of dry, itchy skin conditions such as Price dermatitis, eczema, psoriasis, xerosis and ichthyosis £1.99; £3.99 by aiding moisture retention in the skin. Mild enough for the face, and suitable for AproDerm Ointment the entire body. Fontus Health Sizes Description 250ml, 500ml AproDerm Ointment is an intensely moisturising, Price occlusive, leave-on emollient that is suitable from birth £3.19, £5.32 and free from sensitisers, irritants and preservatives. Providing long-lasting hydration as a result of its high oil content, AproDerm Ointment soothes, moisturises, Moisturisers protects and enhances the skin barrier. It can be used throughout the day, however if a patient fi nds the greasy AproDerm Emollient Cream formulation cosmetically unacceptable it can be applied Fontus Health at night time and complemented with another emollient Description during the day. Particularly great for overnight use and AproDerm Emollient Cream is a soap substitute and for hand eczema, AproDerm Ointment contains white an occlusive, leave-on emollient that is free from soft paraffi n 95% and liquid paraffi n 5%. SLS, parabens, chlorocresol, fragrances and colours. Indications Suitable from birth AproDerm Emollient Cream Suitable from birth for moderate to severe eczema, soothes, moisturises and protects the skin of those psoriasis and other very dry skin conditions, as well suff ering from eczema, psoriasis and other dry skin as being an eff ective pre-bathing emollient .

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Sizes Aquamax 50g, 500g Intrapharm Laboratories Price Description £1.45; £3.95 Aquamax has a higher lipid content, which creates a better barrier for hydration. It has a lack of skin Aquaderm Cetomacrogol sensitizers, which means there is less chance of Cream irritation. Impectron Ltd Indications Description Specially formulated as a leave-on emollient for Aquaderm Cetomacrogol Cream is a moisturusing softening, protecting and moisturising dry skin. cream and soap substitute containing cetomacrogrol Sizes 1000, white soft paraffin and liquid paraffin. 100g, 500g Indications Price Dry skin conditions. £1.89—100g, £3.99—500g Sizes 500g Aquasoothe Price Ennogen Pharma Ltd £3.91 Description An emollient containing 1–2% methol in aqueous Aquaderm Hydrous Cream cream. Impectron Ltd Indications Description For soothing skin which is irritated or itchy. Aquaderm hydrous cream is a moisturising Sizes ointment and soap substitute containing wool 100g, 500g (in 1% or 2%) alcohol, hard paraffin and white soft paraffin. Price Indications £3.70 (100g—1%), £15.43 (500g—1%), £1.86 Dry skin conditions. (100—2%), £15.43 (500—2%) Sizes 500g Bell’s Emollient Price Bell’s Healthcare £4.15 Description Bell’s Emollient is an ointment containing 50% w/w Aquaderm Liquid Paraffin and liquid paraffin BP and 50% w/w white soft paraffin. White Soft Paraffin Moisturising emollient for dry skin conditions. Impectron Ltd Indications Description For all dry-skin conditions. Aquaderm Liquid Paraffin and White Soft Paraffin Sizes is a moisturising ointment containing 50% white 250g, 500g soft paraffin and 50% liquid paraffin. Price Indications £2.06, £3.28 Dry skin conditions. Sizes Care Aqueous Calamine Cream 250g, 500g (SLS free) Price Thornton & Ross £1.75; £3.49 Description A soothing cream that works as a mild astringent www.dermatologyhandbook.co.uk to relieve mild sunburn and other minor skin conditions. Suitable for all adults, the elderly and

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children, and not considered likely to cause any Cetraben Cream undesirable effects during pregnancy. However, Thornton & Ross women who are pregnant or are breastfeeding Description should talk to their doctor or pharmacist before An emollient, moisturising and protective cream using this product. containing 13.2% white soft paraffin, 10.5% light Indications liquid paraffin and 4.5% glycerol. Free from Relieves mild sunburn and other minor skin fragrance, colouring, SLS, lanolin and parabens. conditions. Indications Sizes For the symptomatic relief of red, inflamed, dry or 100g chapped skin, especially when associated with eczema. Price Sizes £1.43 50g; 150g; 500g; 1050g Price Cetaphil Moisturising Cream £1.40; £3.98; £5.99; £11.62 Galderma (UK) Description Cetraben Lotion Designed to soften and soothe, this non-greasy, Thornton & Ross non-irritating and fragrance-free formulation is Description ideal for dry and sensitive skin. It does not block An emollient, moisturising and protective lotion pores and absorbs quickly, locking in the moisture containing 5% white soft paraffin, 4% light liquid and providing long-lasting hydration, leaving your paraffin and 3% glycerol. Free from fragrance, skin feeling soft, silky and revitalised. colouring, SLS, lanolin and parabens. Indications Indications For moisturising the whole body, particularly hands, For the relief of the symptoms of eczema, dermatitis feet, elbows and knees. and other dry skin conditions. Sizes Sizes 100g 200ml; 500ml Price Price Contact supplier £4.00; £5.64 Cetaphil Moisturising Lotion Cetraben Ointment Galderma (UK) Thornton & Ross Description Description The lotion enhances the skin’s moisture-protection An emollient, moisturising and protective ointment system and helps restore the natural protective containing 35% white soft paraffin and 45% light barrier. Its unique formula gives rapid, effective liquid paraffin. Free from fragrance, colouring, SLS, hydration and treats the dryness associated with lanolin and parabens. skin conditions and dermatological treatments. Indications Because the lotion is non-greasy, it absorbs quickly To moisturise and soften dry skin in eczema, dry into skin, leaving no discernable residue. cases of psoriasis and other dry skin conditions. Can Indications also be used as a skin cleanser or bath additive. For all skin types including dry, sensitive skin, Sizes and damaged skin following dermatological 125g; 450g treatments. Price Sizes £3.49; £5.39 236ml, 473ml Price To advertise call 020 7333 1741 £5.06, £8.24

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Dermacool Doublebase Gel Pern Consumer Products Ltd Dermal Laboratories Ltd Description Description Dermacool is a menthol in aqueous cream that Doublebase Gel is a highly soothes and cares for irritated skin. Available in three emollient and protective SLS-free strengths (0.5%, 1.0% and 2.0%) and one hydrating base. It may also non-SLS free strength (5.0%), its non-greasy formula be used as an adjunct to locks in moisture to hydrate and calm dry skin. other topical treatments. The Indications oily ingredients, isopropyl Suitable for skin discomfort caused by the sun, myristate and liquid paraffin, encourage rehydration certain medical treatments and prescribed drugs. and softening of dry skin by forming an occlusive Sizes barrier within the skin surface, thus reducing drying 0.5% (SLS free)–100g tube, 500g pump as a result of the evaporation of water diffusing from 1.0% (SLS free)–100g tube, 500g pump, 500g pot the underlying layers. 2.0% (SLS free)–100g tube, 500g pump Indications 5.0%–100g pot, 500g pump For regular first-line treatment and prophylaxis of Price dry or chapped skin conditions that may also be £3.85, £16.07 pruritic (itchy) or inflamed. £3.97, £16.59 Sizes £4.07, £16.97 100g (tube), 500g (pump pack), 1kg (pump pack) £4.69, £17.48 Price £2.65—100g, £5.83—500g, £10.98—1kg Diprobase E45 Cream Bayer PLC Reckitt Benckiser Healthcare UK Description Description Diprobase is a range of emollients with moisturising E45 Cream contains hypoallergenic lanolin, light and protective properties, recommended for the liquid paraffin and white soft paraffin, all of which management of eczema and other dry skin conditions. have emollient moisturising properties. Indications Indications Diprobase Cream is an emollient, moisturising For the symptomatic relief of dry skin conditions and protective cream for the follow-up treatment where the use of an emollient is indicated, such with topical steroids or in spacing such treatment. as flaking, chapped skin, ichthyosis, traumatic It may also be used as diluent for topical steroids. dermatitis, sunburn, the dry stage of eczema and Diprobase Cream is recommended for the certain dry types of psoriasis. symptomatic treatment of red inflamed, damaged, Sizes dry or chapped skin, the protection of raw skin 50g, 125g, 350g, 500g (pump pack) areas and as a pre-bathing emollient for dry/ Price eczematous skin to alleviate drying areas. The Contact supplier Diprobase Lotion relieves and soothes dry or eczematous skin. E45 Lotion Sizes Reckitt Benckiser Healthcare UK Cream; ointment; lotionCream: 50g (tube), 500g Description (pump). Ointment: 50g (tube), 500g (tub). Lotion: An emollient lotion containing light liquid 50ml (tube), 300ml (pump pack) paraffin 4%, cetomacrogol, white soft paraffin 10%, Price hypoallergenic anhydrous. Cream: £1.28 (50g), £6.32 (500g). Ointment: £1.28(50g), Indications £5.99 (500g). Lotion: £1.28 (50ml), £3.49 (300ml) For dry skin.

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Sizes Elave Sensitive Ointment 200ml, 500ml Ovelle Pharmaceuticals Price Description Contact supplier Elave Sensitive Ointment is formulated to protect the skins natural barrier and reduce flare-ups of Elave Sensitive Body Lotion eczema, dermatitis, psoriasis and other dry itchy Ovelle Pharmaceuticals sensitive skin conditions. The emollient rich Description formula contains 30% white soft paraffin and 50% Elave Sensistive Lotion is a light moisturising lotion liquid paraffin to moisturise and protect the skin. formula, which is quickly absorbed by the skin Elave Sensitive Ointment replaces skins oils and helping to relieve the itch of dry skin. It contains forms a water-proof barrier on the skin’s surface camomile to soothe irritated skin and is an ideal preventing water loss. Regular use can manage emollient for dry patches and eczema. It also contains dry, itchy skin in patients with eczema, dermatitis paraffinum liquidum and caprylic/capric triglyceride and psoriasis, reducing flare ups. Elave Sensitive to hydrate and help retain moisture in the skin. Ointment relieves and soothes red, inflamed, Indications damaged, dry, itchy or chapped skin. To soothe sensitive skin. Indications Sizes For the routine moisturisation and protection of 250ml dry, itchy and irritated skin. Price Sizes £7.49 250g Price Elave Sensitive Intensive £9.90 Cream Ovelle Pharmaceuticals Emcrem Description Glenmark Pharmaceuticals Europe Elave Sensitive Intensive Cream is an emollient Description treatment cream formulated to protect the skin’s A moisturising cream containing 15% white soft natural barrier and reduce flare-ups of dry, itchy, paraffin and 6% liquid paraffin. sensitive, ultra-sensitive, reactive, eczema and Indications dermatitis prone skin. The emollient rich formula Dry skin conditions. contains white soft paraffin and fractionated Sizes coconut oil to soothe, hydrate and calm the skin. 50g, 500g Indications Price Repairing the skin’s protective barrier and restoring £2.25; £5.20 the skin’s moisture helps to protect sensitive skin. Re-classified with a CE mark, Elave Sensitive Emelpin Ointment Intensive Cream has indications for use in the Vitame Ltd treatment of eczema and other dry, itchy skin Description conditions. Regular use can manage dry, itchy skin Contains emulsifying wax and yellow soft paraffin. in patients with eczema and dermatitis prone skin Indications reducing flare-ups. For dry-skin conditions. Sizes Sizes 50g and 125g (tube), 500g (pump) 125g, 500g Price Price £4.65 and £8.35, £14.55 (Retail price) £3.08, £3.97

Clinical titles for health professionals www.quaybooks.co.uk

Dermatology Handbook 2021–2022 77 Dermatology Handbook

Emollin Spray Epaderm Ointment CD Medical Mölnlycke Health Care Description Description A spray-on emollient, applying a mix of pure White Emollient ointment containing liquid paraffi n, Soft Paraffi n BP and Liquid Paraffi n BP to the skin. yellow soft paraffi n and emulsifying wax . Free from water, fragrance, SLS, lanolin, parabens, Indications and preservatives. Spray-on delivery allows For the treatment of eczema, psoriasis and all other hands-free application, ideal for tender, vulnerable dry skin conditions, and for use with dry or wet skin and hard-to-reach places. wrapping techniques. Indications Sizes For use on dry, scaly, sore or damaged skin, 125g; 500g; 1kg including but not limited to: eczema, psoriasis, Price ichthyosis, lichen sclerosus, £3.85; £6.53; £12.42 (DT) radiation associated dermatitis, and lymphoedema. Epimax Isomol Gel Sizes Aspire Pharma 150ml; 240ml Description Price An emollient for the relief of eczema, psoriasis, and £4.00; £6.39 other dry skin conditions. It contains 15% isopropyl myristate and 15% liquid paraffi n. It is free from Enopen sodium lauryl sulphate (SLS), lanolin, parabens, and Ennogen Pharma Ltd perfumes. Description Indications Moisturising cream with ingredients including For use in eczema, psoriasis and other white soft paraffi n 13.2% w/w and light liquid dry skin conditions . paraffi n 10.5% w/w . Sizes Indications 100g, 500g To protect and moisturise dry and damaged skin Price conditions, including dry and chapped skin, £1.99, £2.92 eczema, infl amed or itchy skin, sunburn and dermatitis. Epimax Moisturising Cream Sizes Aspire Pharma 50g, 150g, 500g, 1050g pump Description Price An emollient for daily use as an all-purpose, £1.40, £3.98, £5.99, £11.62 replenishing moisturiser. Also suitable for the relief of eczema, psoriasis, and other dry skin Epaderm Cream conditions, it can be used by all ages (including Mölnlycke Health Care children over the age of one month). It contains Description 14.5% white soft paraffi n, 12.6% light liquid Emollient cream containing glycerine, liquid paraffi n, and 1% liquid anhydrous lanolin. It can paraffi n, yellow soft paraffi n and emulsifying wax. be used as a soap substitute and is free from Indications sodium lauryl sulphate (SLS), For the treatment of eczema, psoriasis and all other parabens, and perfumes. dry skin conditions . Indications Sizes For use in eczema, psoriasis and other 50g (pump); 500g (pump); 150g (pump) dry skin conditions. Price Sizes £1.71; £7.01; £3.58 100g, 500g

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Price Indications £1.99, £2.99 For use in eczema, psoriasis and other dry skin conditions. Epimax Oatmeal Cream Sizes Aspire Pharma 100g, 500g Description Price An emollient for the relief of eczema, £0.75, £2.49 psoriasis and other dry skin conditions. It can be used as a soap substitute for Epimax Paraffi n-free Ointment skin washing. It contains avena sativa Aspire Pharma (oat) kernel fl our. It is free from sodium Description lauryl sulphate (SLS), lanolin, parabens Emollient for the relief of eczema, psoriasis, and and perfumes. other dry skin conditions. It can be used as a bath Indications additive or as a soap substitute. It contains 38% For use in eczema, psoriasis and other dry skin hydrogenated castor oil and is free from sodium conditions. lauryl sulphate (SLS), lanolin, parabens, and Sizes perfumes. 1 00g, 500g Indications Price For use in eczema, psoriasis and other dry skin £1.99, £2.99 conditions. Sizes Epimax Ointment 500g Aspire Pharma Price Description £4.99 An emollient for the relief of eczema, psoriasis and other dry skin conditions. It can be used as a Exmaben Cream bath additive or soap substitute for skin washing. Ascot Pharma It contains 40% liquid paraffi n and 30% yellow Description soft paraffi n. It is free from sodium lauryl sulphate Contains liquid paraffi n light (105mg per 1g) and (SLS), lanolin, parabens and perfumes. white soft paraffi n (132mg per 1g) . Indications Sizes For use in eczema, psoriasis and other dry skin 500g conditions. Price Sizes £4.25 125g, 500g Price Exmalatum Cream £1.92, £2.99 Ascot Pharma Description Epimax Original Cream Contains liquid paraffi n light (60mg per 1g) and Aspire Pharma white soft paraffi n (150mg per 1g) . Description Sizes An emollient for the relief of eczema, 500g psoriasis, and other dry skin conditions. Price It contains 15% white soft paraffi n and £4.45 6% liquid paraffi n. It can be used as a soap substitute and is free from sodium Need an extra copy? lauryl sulphate (SLS), lanolin, parabens, www.dermatologyhandbook.co.uk and perfumes.

80 Dermatology Handbook 2021–2022 Kind to skin. Kind to budgets.Emollients

White soft paraffin

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Recommend a range that gives your patients the choice they need: ✓ Similar formulations to the best-known emollient brands ✓ The cream formulations can be used as a soap substitute ✓ Fully recyclable 500g tottles (top-down bottles)* ✓ Paraffin-free ointment option available ✓ Free from SLS, parabens and perfumes ✓ The full range is available OTC ®

www.epimax.co.uk

Economise without compromise Epimax Range Product Information Presentation: Creams and gels available in a 500g Flexi-dispenser or 100g tube, burns. Fabric that has been in contact with these products burns more easily and is ointments available in a 500g or 125g tub (Epimax Ointment only). Main ingredients: a serious fire hazard. Avoid contact with the eyes. Talk to your doctor or healthcare White soft paraffin, light liquid paraffin, anhydrous lanolin, Avena sativa (oat) kernel professional before use if the skin is broken, badly cracked, infected or bleeding. flour; Isopropyl myristate , yellow soft paraffin, Polyoxyethylene, hydrogenated castor Contraindications: Patients with known hypersensitivity to any ingredient, including: oil. Indications: All products: As an emollient for the relief of dry skin in eczema, Lanolin, Cetostearyl Alcohol, and Hydroxybenzoates, Phenoxyethanol, Isopropyl psoriasis and other dry skin conditions. Creams: For use as a soap substitute Gels: Palmitate and Benzyl Alcohol, Triethanolamine; Side effects: Rarely mild reactions For the relief of dry or chapped skin which may also be itchy or inflamed. Ointments: such as skin rash can occur. Allergic reactions. Product classi cation: Class I Bath additive or soap substitute. Method of use: Adults, Elderly and Children: apply Medical Devices. Cost: Epimax Moisturising Cream: £2.99 (500g), £1.99 (100g) [NHS to the skin areas as frequently as required. As a soap substitute: Use as required Price List]; License holder: Aspire Pharma Ltd, Unit 4, Rotherbrook Court, Bedford instead of soap. As a bath additive: melt 4g in hot water and add to the bath. Dosage: Road, Petersfield, Hampshire, GU32 3QG, UK. Date reviewed: February 2021. Use as required. Warnings: Do not smoke or go near naked flames – risk of severe Version number: 1010451581 v 6.0.

References: * Our 500g creams and gel formulations are packaged in tottles and our ointments in 500g tubs 1. http://mims.co.uk (accessed March 2021) 1010451113Dermatology8 v 1.0 March 2021 Handbook 2021–2022 81 Dermatology Handbook

ExmaQS Cream dry skin conditions . Ascot Pharma Sizes Description 250g, 500g Contains liquid paraffi n light (60mg per 1g) and Price white soft paraffi n (150mg per 1g) . £1.83—250g, £3.66—500g Sizes 500g Hydromol Ointment Price Alliance Pharmaceuticals Ltd £2.95 Description A 3-in-1, all‐purpose emollient, bath additive and ExoCream soap substitute, which contains no fragrances, Galen Limited colourings, additives or preservatives and is suitable Description for all ages . Acts as an emollient which soft ens and moisturises Indications dry skin, restoring the skin’s normal protective Hydromol Ointment is used topically for the function and acting as a barrier to irritants. It management of dry skin, a feature present in all forms contains white soft paraffi n 14.5%, light liquid of eczema, psoriasis and other dry skin conditions . paraffi n 12.6%, hypoallergenic anhydrous lanolin Sizes 1%, and is fragrance free. 100g, 1kg Th e paraffi n creates a breathable hypoallergenic Price layer of oil on the skin surface to prevent water £3.20; £8.31 evaporating while the lanolin heals and soft ens the top layers of the epidermis, soothing infl amed skin Infaderm Therapeutic Oil and preventing further fl are-ups. Ceuta Healthcare Group May also be used as a gentle facial cleanser, Description avoiding foaming soaps which can be potential Infaderm Th erapeutic Oil can be used as a bath irritants. oil or emollient. It contains almond oil (30%) and Indications liquid paraffi n (69.9%). For the symptomatic relief of dry skin conditions, Indications where the use of an emollient is indicated, such For dry and scaling skin conditions . as fl aking, chapped skin, ichthyosis, traumatic Sizes dermatitis, sunburn, the dry 250ml stage of eczema and certain Price dry cases of psoriasis. £33.75 Sizes 50g (tube); 125g (tub); 350g Kamillosan (tub); 500ml (pump) Omega Pharma Price Description £1.05; £2.33; £4.17; £3.99 Kamillosan contains chamomile, which soothes redness, soreness and infl ammation associated with Fifty-50 a wide range of skin conditions . Ennogen Pharma Ltd Indications Description For the prevention and treatment of sore nipples in An emollient containing white soft paraffi n breast feeding mothers, prevention and treatment of and liquid paraffi n, to help the skin retain more nappy rash and chafe; and chapped hands and other moisture. sore skin conditions . Indications Sizes For the treatment of eczema, psoriasis and all other 50g

82 Dermatology Handbook 2021–2022 Emollients

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Price 500g pot); £14.79 (1%, 500g pot); £14.99 (2%, 500g Contact supplier pot); £14.79 (1%, 500g); £14.99 (2%, 500g) (DT) KreaMoint 50:50 Ointment MyriBase Gel Essential Healthcare Galen Limited Description Description Contains liquid paraffi n (500mg per 1g) and white A protective, hydrating emollient for the treatment soft paraffi n (500mg per 1g) . of dry skin conditions. It contains a higher oil Sizes content than an emollient cream, is light to the 500g touch and non-greasy, with the ease of absorption Price of a gel. It encourages rehydration and soft ening of £3.17 dry skin by restoring the oils that provide the natural occlusive barrier within the epidermis, Lipobase Cream thus reducing drying as a result of the evaporation Astellas Pharma Ltd of water diff using from the underlying layers. It Description contains isopropyl myristate 15% and liquid Lipobase is an emollient with a bland base for paraffi n 15% and is free of fragrances and use in conjunction with topical corticosteroids or colourings. May be used as an adjunct to other to gradually reduce the topical dosage of Locoid topical treatments. Lipocream. It may also be used where a continuously Indications alternating application of the active product and the For use as regular fi rst-line treatment and base is required, as in prophylactic therapy . prophylaxis of dry or chapped Indications skin conditions that may also be For the treatment of mild skin lesions, such as pruritic or infl amed. pruritus or dry, scaly skin, in conditions where Sizes topical corticosteroid is not warranted . 100g; Sizes 500ml (pump) 50g Price Price £2.12; £4.66 £1.46 Ovelle Emulsifying Ointment Menthoderm Ennogen Pharma Ltd Derma UK Description Description Contains emulsifying wax (300mg per 1g), liquid A Sodium Lauryl Sulfate (SLS) free menthol in paraffi n (200mg per 1g) and white soft paraffi n aqueous cream. It can be used to soothe and cool (500mg per 1g) . heated, dry, irritated and itchy skin conditions. Th e Sizes preservative undecylenic acid also helps to protect 100g, 500g dry and irritated skin against fungal infection. Th ere Price are three strengths: 0.5%, 1% and 2% menthol . £1.88, £3.70 Indications To cool and soothe heated, irritated and itchy Pure Health skin. Lexon UK Sizes Description 100g (tube); 500g (tamper evident pots) , 500g Liquid paraffi n (500mg per 1g) and white soft (pump) paraffi n (500mg per 1g) . Price Sizes £3.20 (1%, 100g); £3.85 (2%, 100g); £14.59 (0.5%, 500g

84 Dermatology Handbook 2021–2022 Emollients

Price Indications £3.66 For radiation-induced dermatitis. Sizes QV Cream 6g, 1g Ego Pharmaceuticals Price Description Contact supplier A rich, protective cream that replenishes and helps repair dry skin. Th is 24-hour moisturising cream is Revamil Balm also pH balanced, fragrance free, lanolin free, colour Oswell Penda Pharmaceutical free, non-comedogenic, dermatologically tested and Description hypoallergenic. Protects the skin by reducing the itching and Indications soreness resulting from irritation. As a result of For the relief and treatment of dry skin conditions, balm use, skin redness and infl ammation are such as dermatitis, eczema, psoriasis, xerosis or prevented. Th is rich emollient can be used long ichthyosis. QV Cream’s hydrating and term as an alternative to steroid cream, and is free emollient properties help relieve dry from parabens and silicone. skin. Indications Sizes For a variety of complex blistering conditions, 100g, 500g, 1050g venous eczema, infected superfi cial wounds, and Price fi rst- and second-degree burns. £2.08, £5.96, £12.14 Sizes 15g and 50g (tube); QV Skin Lotion 2g (10-pack sachets) Ego Pharmaceuticals Price Description £3.52; £9.99; £7.99 (DT) A light, 24-hour moisturising lotion to help prevent and relieve dry skin. It is pH balanced, fragrance free, Revamil Hand Cream colour free, non-comedogenic, hypoallergenic, and has Oswell Penda Pharmaceutical a dermatological formula. Description Indications A rich emollient containing 10% medical grade For the treatment and relief of dry skin conditions, antimicrobial honey for sensitive skin. Enriched such as dermatitis, eczema, psoriasis, xerosis or with almond oil, Revamil Hand Cream leaves skin ichthyosis. Suitable for sensitive skin as well as feeling soft , smooth and silky. It is quick absorbing infants and the elderly. and non-greasy. Parabens and SLS free. Sizes Indications 250ml, 500ml (pump dispenser) For dry, damaged skin and nails. Price Sizes £3.19; £5.32 100ml (tube) Price R1 Cooling Gel and R2 £7.99 Protectant Lotion Water-Jel Systems Europe Soffen Cream Description Vitame Ltd R1 and R2 is a two-part radiation advanced Description skincare system. Step 1, cool the skin and provide Contains liquid paraffi n light 10.5% and white soft intensive hydration with a R1 a water-based gel. paraffi n 13.2%. Step 2. Protect the skin and add moisturise with Indications R2 lotion. For dry-skin conditions.

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Sizes Unguentum M also contains sorbic acid which has 500g an antibacterial effect. Price Indications £4.79 For the symptomatic treatment of dermatitis, nappy rash, ichthyosis, eczema, protection of raw Thirty-30 and abraded skin areas, pruritus and related skin Ennogen Pharma Ltd conditions where dry scaly skin is a problem, and as Description a pre-bathing emollient for dry/eczematous skin, to An emollient containing 30% emulsifying wax and alleviate the effects of drying. 30% yellow soft paraffin. Sizes Indications 50g, 100g, 200ml (pump pack), 500g For the treatment of eczema, psoriasis and all other Price dry skin conditions. £1.41—50g, £2.78—100g, £5.50—200ml, £8.48— Sizes 500g 125g, 250g, 500g Price ZeroAQS Emollient Cream £3.81—125g, £4.29—250g, £6.47—500g Thornton & Ross Description Ultrabase An SLS free, 2-in-1 leave on emollient and wash that Derma UK adds moisture to the skin for the relief of flaking dry Description skin conditions. An emollient cream which may be used for a wide Indications variety of dry skin conditions. It contains white soft For use as an effective emollient and as a skin paraffin 10% w/w. cleanser for the relief of flaking dry conditions. Indications Sizes For general use as an emollient, also approved for 500g use as a diluent for dermatological preparations and Price a vehicle for other dermatological medicaments. £3.29 Ultrabase may also be alternated with topical corticosteroids when the latter are being gradually Zerobase Emollient Cream withdrawn and may be continued alone after Thornton & Ross complete withdrawal of the topical corticosteroid. Description Sizes A moisturising and protective emollient cream and 500g (pump dispenser) wash providing symptomatic relief for red, inflamed Price or dry skin. £8.67 (DT) Indications For red, inflamed or dry skin. For eczema, the Unguentum M Cream cream can also be applied before a bath to stop the Almirall Ltd skin drying further. It can be used as an alternative Description to soap. Unguentum M has emollient properties and can Sizes be used as a protective cream. It is an ambiphilic 50g (tube), 500g (pump pack) topical preparation with emollient properties, Price combining the high lipid content of an ointment £1.04—50g, £5.26—500g with the water-miscible characteristics of a cream. The high lipid content reduces water loss from the Subscribe to NRC visit skin and this hydrating effect permits recovery from www.magsubscriptions.com dermatitis, eczema and dry or scaly skin conditions.

86 Dermatology Handbook 2021–2022 Emollients

Zerocream Emollient Cream Price Thornton & Ross £2.25; £4.90 Description An emollient cream with 27% paraffins for the Zeroguent Emollient Cream relief of symptoms of flaking, dry skin, ichthyosis, Thornton & Ross dermatitis, dry stage of eczema and dry cases of Description psoriasis. It can be used as an alternative to soap. A rich emollient cream and wash that contains Indications soya bean oil for protecting and hydrating dry scaly Used to moisture and soften dry skin in eczema, dry skin. It also offers symptomatic relief of dermatitis, cases of psoriasis and other dry skin conditions. It ichthyosis, eczema, nappy rash, protection of dry is suitable for all ages and may also be used as a skin skin areas, pruritus. cleanser or bath additive. Indications Sizes Used as a barrier and moisturiser for the 50g (tube), 500g (pump pack) symptomatic relief of dermatitis, ichthyosis, eczema, Price nappy rash, protection of dry skin areas, pruritus £1.17—50g, £4.08—500g and related skin conditions where dry scaly skin is a problem. It can be used as a pre-bathing emollient Zeroderm Ointment or as an alternative to soap to alleviate drying Thornton & Ross effects. Description Sizes Zeroderm Ointment is a rich three-in-one 100g (tube), 500g (tub) emollient that can be used as a leave-on moisturiser, Price soothing bath treatment and as a moisturising £2.33—100g, £6.99—500g soap substitute. Zeroderm Ointment is free from additives, preservatives, colours and sodium lauryl sulphate. Moisturisers (humectants) Indications Used to moisturise and soften dry skin in eczema, AproDerm Colloidal Oat Cream dry cases of psoriasis and other dry skin conditions. Fontus Health Sizes Description 125g, 500g AproDerm Colloidal Oat Cream is suitable from Price birth and is free from paraffin, SLS, parabens, £2.41—125g, £4.10—500g benzyl alcohol, fragrances and colours. It contains 1% avena sativa kernel flour which restores and Zerodouble Emollient Gel protects the skin barrier, cleanses it by absorbing Thornton & Ross dirt and dead skin cells and has a buffering action to Description help maintain the skin’s normal pH levels. Double the moisturising action. A non-greasy gel to Indications soften, smooth and rehydrate dry skin conditions. Suitable from birth for eczema, psoriasis and other Contains 30% emollient and 10% humectant. dry skin conditions. Indications Sizes Highly moisturising emollient gel for dry skin 100ml; 500ml (pump) conditions, as may be found in eczema, psoriasis, Price dermatitis, ichthyosis, elderly pruritus, and other £2.74; £5.80 dry skin conditions. It can also be used as an alternative to soap. Subscribe to JWC visit Sizes 100g (tube); 500g www.magsubscriptions.com

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Aquadrate 10% w/w Cream Aveeno Lotion Alliance Pharmaceuticals Ltd Johnson & Johnson Ltd Description Description Aquadrate is a smooth textured, unperfumed, white Formulated with naturally active colloidal oatmeal, to off-white cream, containing, amongst other this easily absorbed, fragrance-free, non-greasy lotion things, 10% w/w urea in white soft paraffin. relieves dry and sensitive skin. Regular use provides Indications long-lasting protection. For the management of ichthyosis, xerosis, atopic It is suitable for adults and babies from 3 months who dermatitis/eczema, contact dermatitis, psoriasis/ may be prone to eczema. seborrheic dermatitis, keratosis and pruritus. Indications Sizes For the treatment of dry, eczema-prone skin. 100g Sizes Price 500ml £4.45 Price £13.79 (RRP) Aquaphor Beiersdorf UK Ltd Balneum Cream Description Almirall Ltd Clinically proven to help support the skin’s own Description regeneration process. Creates a protective barrier Balneum Cream contains ingredients such as that allows passage of water vapour. Preservative 5% urea and ceremide 3. Urea retains water and and fragrance-free, reducing the chance of further increases skin moisture. Ceramide 3 helps restore irritation and gentle enough to use on babies. the barrier function of your skin. Contains Panthenol, Glycerin and Bisabalol. Indications Indications Balneum Cream is designed for daily use to relieve Helps support the natural recovery of very dry, dry and very dry skin conditions. rough or cracked skin. Sizes Sizes 50g, 500g (pump packs) 45ml (balm), Price 250ml (spray) £2.85—50g, £9.97—500g Price £9.00, £16.00 Calmurid Cream Galderma (UK) Aveeno Cream Description Johnson & Johnson Ltd Calmurid contains urea at a concentration of 10% Description and has keratolytic, antimicrobial, antipruritic and Formulated with naturally active colloidal oatmeal hydrating effects on the skin. Lactic acid also has and fragrance free. This cream is proven to restore keratolytic, hydrating and antimicrobial properties. the epidermal barrier and is clinically proven to Treatment of ichthyotic patients shows a parallel soothe and relieve dry, irritated skin from day between clinical improvement and increase in the one. It is also suitable for adults and babies from 3 otherwise depressed water-binding capacity of the months who may be prone to eczema. horny layer. Indications Indications For the treatment of dry, eczema-prone skin. For the correction of hyperkeratosis and dryness Sizes in ichthyosis and allied conditions characterised by 100ml (tube), 300ml (pump pack), 500ml dry, rough, scaly skin. Price Sizes £7.28, £14.63, £16.20 (RRP) 100g

88 Dermatology Handbook 2021–2022 THE #1 IN EmollientsUSA*

FOR DRY, ROUGH SKIN WORLD’S 1ST OINTMENT SPRAY

NEW SPR AY

BEFORE AFTER DRY, ROUGH SKIN AQUAPHOR SKIN

* Source IQVIADermatology 06/2009 - 05/2020 Handbook - Dry, cracked 2021–2022 skin segment (dermatologist recommended brand) 89 EUCERIN.CO.UK Dermatology Handbook

Price (lotion) £5.75 Price £9, £13 and £16; £9.50 and £15 CeraVe Moisturising Cream L’Oreal Active Cosmetics Division Cetaphil Restoraderm Skin Description Restoring Body Moisturiser CeraVe Moisturising Cream is a rich, oil-free cream Galderma (UK) specifically formulated to moisturise sensitive skin Description that is dry to very dry and prone to irritation. Suitable Complementing the body wash, this non-greasy, for use on eczema and atopic skin. Enriched with quick-absorbing moisturiser is specially developed three essential ceramides (ceramide 1, 3 and 6-II), to restore the skin’s moisture and soothe dry, itchy glycerin and hyaluronic acid, it helps restore the skin’s and eczema-prone skin. Free of preservatives natural barrier. Containing patented MVE delivery and fragrances, it uses advanced technological technology, it allows gradual release of the formula formulations to enhance the skin’s ability to retain to help deliver controlled, long-lasting hydration moisture and restore the natural barrier function. for up to 24 hours. The formula is hypo-allergenic, Indications fragrance-free, paraben-free and SLS free, and has a For very dry and eczema-prone skin. non-greasy, quick-dress texture. Sizes Indications 295ml For dry and very dry skin. Suitable for use on Price eczema and atopic skin. Suitable for children (aged Contact supplier 3+) and adults. Can be used on body and face. Sizes ClearZal Hard Skin Remover 50ml and 177ml (tube), 340g and 454g (pot) Zeon Price Description £4.00; £8.50; £12.00; £14.50 ClearZal is a hard skin and callous remover containing urea 7%, salicylic acid 4% and CeraVe Moisturising Lotion trichloroacetic acid 2%. L’Oreal Active Cosmetics Division Indications Description For hard skin and calluses. CeraVe Moisturising Lotion is a lightweight, oil-free Sizes lotion specifically formulated to moisturise sensitive 100g skin that is dry to very dry and prone to irritation. Price Suitable for use on eczema and atopic skin. Enriched £6.41 with three essential ceramides (ceramide 1, 3 and 6-II), glycerin and hyaluronic acid, it helps restore Dermatonics Dry Skin Balm the skin’s natural barrier. Containing patented MVE Dermatonics delivery technology, it allows gradual release of Description the formula to help deliver controlled, long-lasting Dermatonics Dry Skin Balm is a 10% urea-based hydration for up to 24 hours. The formula is hypo- moisturiser with a modern carrier base. It absorbs allergenic, fragrance-free, paraben-free and SLS free, easily to reduce callus and anhidrosis quickly and and has a non-greasy, quick-dress texture. effectively. Free of parabens. Indications Indications For dry and very dry skin. Suitable for use on For the treatment of rough, dry and anhydrotic skin. eczema and atopic skin. Suitable for children (aged For patients 12 years old and over. 3+) and adults. Can be used on body and face. Sizes Sizes 500ml 177ml, 340g and 4545g (cream); 236ml and 473ml

90 Dermatology Handbook 2021–2022 Emollients

Price and night. £5.75; £11.75 Indications For regular fi rst-line treatment and prophylaxis Dermatonics Once Heel Balm of dry or chapped skin Dermatonics conditions that may also be Description pruritic (itchy) or infl amed . Dermatonics Once Heel Balm, which requires Sizes just once daily application, is a 25% urea-based 100g (tube), 500g (pump moisturiser with a modern carrier base. It has a less dispenser) greasy feel and absorbs easily to reduce callus and Price anhidrosis quickly and eff ectively. Free of parabens . £2.65—100g, £6.29—500g Indications Th e once-a-day treatment for callused, anhydrotic, Epimax ExCetra Cream fi ssured, and hard footskin for patients with and Aspire Pharma without diabetes. Description Sizes An emollient for the relief of eczema, psoriasis, and 75ml, 200ml other dry skin conditions. It can be used as a soap Price substitute for washing; and contains 13.2% white £3.60—75ml, £8.50—200ml soft paraffi n, and 10.5% light liquid paraffi n. It is free from sodium lauryl sulphate (SLS), lanolin, Dexeryl parabens, and perfumes . Pierre Fabre Indications Description For use in eczema, psoriasis and other Dexeryl ingredients include glycerol, a humectant dry skin conditions . that improves the elasticity of the stratum corneum, Sizes and white soft paraffi n and liquid paraffi n, which act 100g, 500g as protective emollients to restore the skin barrier . Price Indications £1.75; £2.95 To help relieve the signs and symptoms of xerosis (skin dryness) in skin diseases such as ichthyosis or Eucerin Replenishing Face atopic dermatitis. Cream Sizes Beiersdorf UK Ltd 250g, 500g Description Price For daily care of dry and very dry, tight facialskin. £3.16—250g, £5.90—500g Can be used under makeup or aft er shaving. Fragrance free Doublebase Dayleve Gel Indications Dermal Laboratories Ltd Dry, tight facial skin . Description Sizes Doublebase Dayleve Gel is a long-lasting highly 50ml emollient and protective hydrating base. It may also Price be used as an adjunct to other topical treatments. Contact supplier Th e oily ingredients, isopropl myristate and liquid paraffi n, encourage rehydration and soft ening of Eucerin Urea Repair 5% Urea dry skin by forming an occlusive barrier within the Original Cream skin surface, thus reducing drying as a result of the Beiersdorf UK Ltd evaporation of water diff using from the underlying Description layers. Can be used as little as twice a day, morning Intensive moisturiser specially formulated with

Dermatology Handbook 2021–2022 91 Dermatology Handbook

5% urea for daily care of dry skin. Actively helps repair the skin's natural protective barrier to prevent replenish the urea lost when the skin becomes dry further moisture loss. The formula has been and improves skin’s ability to retain moisture. clinically and dermatologically proven to deliver Indications immediate relief and intense, long-lasting Very dry skin. Particularly suitable for reducing moisturisation, delaying dryness and roughness for roughness and cracking on hands and elbows. up to 48 hours. Sizes Indications 75ml Dry to very dry skin. Also suitable for Price mature skin and those with diabetes, £9.50 psoriasis and keratosis pilaris. Sizes Eucerin Urea Repair Plus 10% 250ml (lotion) Urea Foot Cream Price Beiersdorf UK Ltd £14.00 Description Easily absorbed oil-in-water emulsion protectsthe Flexitol 10% Urea Cream skin and helps prevent further moisture loss. Can be Thornton & Ross used daily. Description Indications Flexitol 10% Urea Cream contains 10% urea in a Dry, extremely dry, rough and chapped feet, suitable blend of emollients and skin conditioning agents to for calluses, minor cracking and pressure marks. provide moisturisation and hydration. Sizes Indications 100ml For the relief of rough, dry and anhidrotic skin Price conditions. £11.00 Sizes 150g, 500g Eucerin Urea Repair Plus 5% Price Urea Hand Cream £5.00—150g, £11.77—500g (DT) Beiersdorf UK Ltd Description Flexitol 25% Urea Heel Balm With 5% urea to restore skin’s natural balance and Thornton & Ross provide long lasting moisturisation. Use as often as Description required. Contains 25% urea, as well as other skin nourishing Indications ingredients to deeply penetrate into the skin for Very dry, chapped hands. intense moisturisation and hydration. It is suitable Sizes for general and diabetic foot care. 50ml Indications Price For the symptomatic treatment of foot anhidrosis £9.00 and is medically proven to provide relief from dry, cracked skin on heels and feet. Eucerin Urea Repair Plus 10% Sizes Urea Lotion 40g, 75g, 200g, 500g Beiersdorf UK Ltd Price Description £2.75; £3.80; £9.40; £14.75 (DT) Gives very dry, rough body skin the daily care it needs. It contains a unique combination of Need an extra copy? ingredients (urea, ceramide and other natural www.dermatologyhandbook.co.uk moisturising factors), which bind moisture in and

92 Dermatology Handbook 2021–2022 Emollients

Flexitol Hand Balm winter itch and ichthyosis (symptoms may include Thornton & Ross very dry, red or itchy skin). Description Sizes Provides long-lasting moisturisation and rapid 100g, 200g hydration for the relief of very dry hands. The Price highly effective, non-greasy formulation easily £4.50; £8.20 (DT) absorbs to improve skin hydration. Suitable for daily use. Apply morning and night for best results. GlucoRx Allpresan Basic Indications GlucoRx For dry hands. Description Sizes GlucoRx Allpresan is a urea-based foot foam used 56g for the specific treatment of dry skin in patients with Price diabetes mellitus. Its unique formulation means that Contact supplier it can be used on the whole foot, including between toes and around wound edges. GlucoRx Allpresan Flexitol Hard Skin & Callus Basic boosts the skin’s natural barrier function, thus Balm protecting against skin infections and ulcerations. Thornton & Ross The Basic contains 5% urea. Description Indications An intensely softening balm that has been For dry, sensitive foot skin in patients with diabetes. formulated to hydrate and remove hard skin build Sizes up without the need for filling. It contains 22% urea 125ml; 300ml and a blend of exfoliating acids which penetrate and Price exfoliate hard or callused skin without harming the £5.50; £9.75 skin underneath. It works to restore moisturising ingredients to the skin, promoting the appearance of GlucoRx Allpresan Intensive healthy looking skin and softer feet within 3 days. GlucoRx Indications Description To hydrate and remove hard skin. Suitable for GlucoRx Allpresan is a urea-based foot foam diabetics. used for the specific treatment of very dry skin Sizes in patients with diabetes mellitus. Its unique 56g formulation means that it can be used on the whole Price foot, including between toes and around wound Contact supplier edges. GlucoRx Allpresan Intensive boosts the skin’s natural barrier function, thus protecting against Flexitol Skin Balm skin infections and ulcerations. The Intensive Thornton & Ross contains 10% urea. Description Indications Flexitol Skin Balm contains urea in a blend of For very dry to chapped foot skin in patients with emollients and skin conditioning agents, providing diabetes. moisturisation for very dry skin on the arms, legs, Sizes elbows and back. Suitable for daily use, Skin Balm 125ml; 300ml is non-greasy and easily absorbed, helping protect Price skin while restoring and maintaining ideal skin £5.50; £9.75 hydrations levels. Indications Subscribe to BJCN visit To alleviate the symptoms of eczema, psoriasis, www.magsubscriptions.com dermatitis, anhidrotic skin (xerosis), scaly skin,

Dermatology Handbook 2021–2022 93 Dermatology Handbook

Hydromol Cream supports the microbiome balance of the skin as Alliance Pharmaceuticals Ltd well as restores and preserves the skin barrier. Th e Description formula is developed using a minimum number Sodium Pyrrolidone 2.5%. of ingredients selected for their effi cacy and Indications safety, with no perfumes or parabens. Th e new Used topically for the treatment of dry skin, a texture quickly absorbs to ease and speed up daily feature present in all forms of dermatitis/eczema application without being greasy, leaving a non- and all degrees of ichthyosis and senile pruritus. sticky feeling and is a high water based formulation Sizes with La Roche-Posay Th ermal Spring Water . 50g, 100g, 500g Indications Price Dry skin susceptible to eczema. Suitable for very £2.28; £4.26; £12.41 dry skin prone to itching, scratching and extreme dryness. Suitable for sensitive skin in babies, Hydromol Intensive children and adults . Alliance Pharmaceuticals Ltd Sizes Description 200ml; 400ml Yellow soft paraffi n 32%; emulsifying wax 25.5%; Price liquid Paraffi n 42.5% . £15.00; £20.00 Indications For the management of ichthyosis, xerosis, atopic Miclaro Oat Cream & Lotion dermatitis/eczema, contact dermatitis, psoriasis/ Galen Limited seborrheic dermatitis, keratosis and pruritus . Description Sizes Formulated with naturally active colloidal oatmeal 30g, 100g for the relief of dry and sensitive skin. Th e natural Price starches found in the oatmeal help cleanse and £1.67; £4.45 maintain the skin’s natural balance, soothing infl ammation and redness, while the proteins and imuDERM emollient lipids contained in oats moisturise dry and irritated Clinisupplies skin by preventing trans epidermal water loss. Th e Description lotion is easily absorbed, non-greasy and relieves Soothing, protecting and hydrating emollient cream dry and sensitive skin with regular use. Th e cream containing urea 5% and glycerine 5%. Apply plenty restores the epidermal barrier while soothing and of product to achieve results . relieving dry and irritated skin. Both the cream and Indications lotion contain avena sativa kernel fl our 1%, are Eczema, psoriasis, dermatitis and other dry-skin fragrance free and are suitable for adults and conditions. children over the age of 3 months. Sizes Indications 500g For the treatment of dry, eczema- Price prone skin. £6.55 Sizes 300ml (pump) cream only; Lipikar Baume AP+M 500ml (pump) La Roche Posay Price Description £3.80; £3.99 A lipid replenishing balm for dry to very dry skin that is suitable for babies, children and adults. To advertise call Ed Croome Enriched with Aqua Posae Filiformis, a new and 020 7333 1741 exclusive patented ingredient, the formulation

94 Dermatology Handbook 2021–2022 The TrustsaverEmollients Emollient range offers up to 46% The quality you savings expect at prices for your CCG1* you won’t

Like The Trustsaver Emollient range of products are like-for-like for compared to Epaderm® Ointment2, E45 Cream®3, AVEENO® Cream4, Like AVEENO® Lotion5, DoublebaseTM Shower Gel6 and DoublebaseTM Gel7

*50g presentation of Exocream is 46% less expensive than 50g E45 cream Also available to buy online References: 1. MIMS online. Last accessed March 2021. 2. Epaderm® Ointment Instructions for Use. http://www.molnlycke.co.uk/contentassets/ 55f668e86f634f9e84fb783db188cc55/ifu-epaderm-ointment.pdf. Accessed March 2021. 3. E45 Cream® Summary of Product Characteristics. December 2020. 4. AVEENO® Cream online. https://www.aveeno.co.uk/products/Cream. Accessed March 2021. 5. AVEENO® Lotion online. https://www.aveeno.co.uk/products/lotion. Accessed March 2021. 6. Doublebase Shower Gel® Summary of Product Characteristics. 20th November 2019. 7. Doublebase™ Gel Summary Summary of Product Characteristics. December 2019.

ExoCream® , Miclaro™ Oat Cream, Miclaro™ Oat Lotion, MyriBase™ Emollient Shower Gel, MyriBase™ Gel, Rapilose® Gel and Salivix® Spray are registered trademarks of Penlan Healthcare Limited. Epaderm® Ointment is a registered trademark of Medlock Medical Ltd. E45 Cream® is a registered trademark of Reckitt Benckiser corporate services Ltd. AVEENO® Cream and AVEENO® Lotion are registered trademarks of Johnson & Johnson Limited. Doublebase™ Shower Gel and Doublebase™ Gel are registered trademarks of Diomed Developments Limited. Visit the Trustsaver website for further information on Galen’s emollient portfolio www.trustsaver.co.uk MAT-TRU-UK-000146 Date of Preparation March 2021 Dermatology Handbook 2021–2022 95 Dermatology Handbook

Nutraplus free, colour free, preservative free, water free, Galderma (UK) lanolin free, and non-comedogenic. Description Indications Nutraplus is a moisturising and protective cream For the relief and treatment of very dry skin containing urea, a recognised hydrating agent conditions such as dermatitis, eczema, psoriasis, that has been widely used topically to treat dry or xerosis or ichthyosis. damaged skin. Sizes Indications 450g For the treatment of dry or damaged skin. Price Sizes £5.75 100g Price Ultraveen Itch Relief Cream £4.37 Dermatonics Description Oilatum Cream Ultraveen Itch Relief Cream synergistically Th ornton & Ross combines 5% urea with Colloidal Oatmeal to Description provide rapid itch relief . A rich moisturising cream that forms a protective Indications fi lm over the skin to signifi cantly reduce itching For the treatment of itchy, dry, irritated skin. for 8 hours, while also soothing, soft ening and Suitable for adults and children. rehydrating the skin. Sizes Indications 125ml, 500ml Specially developed to treat eczema and dry skin Price conditions. £3.49; £11.05 Sizes 150g, 500ml Zeroveen Cream Price Th ornton & Ross £3.06, £5.28 Description A 2-in-1, non-greasy, moisturising emollient cream Oilatum Junior Cream containing natural oatmeal, that is SLS, fragrance Th ornton & Ross and paraben free. Description Indications A rich moisturising cream that is clinically proven For use in the management of dry skin conditions to signifi cantly reduce itching for 8 hours while also as may be found in eczema, psoriasis, dermatitis, soothing, soft ening and rehydrating the skin. ichthyosis, elderly pruritus and other dry skin Indications conditions. To treat eczema and related dry skin conditions Sizes among babies and children. 100g, 500g (pump) Sizes Price 150ml; 350ml; 500ml £2.74; £5.89 Price £3.06; £4.65; £5.28 Independent Nurse QV Intensive Ointment Register for free access to news Ego Pharmaceuticals Description and features Soothing and non-greasy, this highly emollient balm www.independentnurse.co.uk is suitable for areas of very dry skin. It is fragrance

96 Dermatology Handbook 2021–2022 Emollients

The magazine for primary care and community nursing

For primary care and community nurses www.independentnurse.co.uk IN THIS ISSUE News Breaking news, expert opinion, London GPs switch to electronic prescription Every practice will change over to this service in a bid clinical best practice to save time and resources p4 News HIV tests available over the counter Independent Nurse is the essential magazine for primary care and Are these expensive kits making up for cuts in free community nurses. It publishes evidence-based clinical features testing? p4 Clinical Journals For primary care and community nurses focused on the needs of frontline nurses, and practical resources that Mark Greener details the www.independentnurse.co.uk latest clinical studies IN THIS ISSUE News inform readers’ professional development. It also includes analysis relevant to primary care More investment in training needed nurses p14 Nurse apprenticeships come under scrutiny from and opinion on the most important news stories affecting the NHS. Clinical the RCN p4 News Addressing colic Sexual assault victims offered Elizabeth Tinsley discusses life-long care Counselling will now be how to spot and treat this available to all victims p4 condition in infants p17 News Service reforms What’s included? ‘desperately Professional needed’ Treating encephalitisNHS think tanks have in The healthy man written to the prime project minister demanding  Comprehensive coverage of key news stories a long-term funding A new initiative focused on settlement p5 primary careClinical settings improving physical health Journals This complex and potentially fatal conditionMark Greener can rounds also up leave patients with permanent brain injury. for men with psychotic the latest research from  Here’s what primary care nurses need healthto know care journals aboutp12 encephalitis, and its aftermathp24 Diagnosis, treatment and prescribing advice illness p33 Iodine deficiency: Britain’s Professional Diabetes training Ruth Miller explains how hidden nutrition crisis she designed a programme Sara Patience provides important information on this vital mineral, the best sources of it and how  Guidance on education and careers to improve standards in nurses can ensure that their patients eat more of it p28 diabetes care p32

JOB OF THE MONTH RESOURCES Events and training for Nurse practitioner,Sussex West primary carep35 nurses p37 NEWS FOCUS: Why are sexual Gestational diabetes mellitus: How to treat overactive bladder NEWS FOCUS:How social media Dysphagia: addressinghealth services struggling? p8Answeringcauses and management parents’p15 questionssyndrome p19 affects mental health p10 medication difficulties p20 on childhood atopic eczema p29 Free online access available Cover.indd 1 07/06/2018 15:45

Cover.indd 1 09/08/2018 11:57 Visit www.independentnurse.co.uk for more information Dermatology Handbook 2021–2022 97 Dermatology Handbook

Moisturisers with anti- Price inflammatories £7.50; £14.00; £8.00 Adex Gel Dermol 500 Lotion Dermal Laboratories Ltd Dermal Laboratories Ltd Description Description Adex Gel is a simple, novel, first-line treatment Dermol 500 is an antimicrobial for dry skin prone to inflammation. It is a highly emollient for direct application moisturising and protective emollient, which onto the skin and is suitable for contains an anti-inflammatory medicinal substance, use as a soap substitute. It contains emollient oils nicotinamide, to help reduce inflammation and (5%) in a non-greasy aqueous system, together redness. Adex Gel does not contain steroids and can with the well-known and effective antiseptics be used all over the body for as long as necessary, benzalkonium chloride and chlorhexidine whether only occasionally, such as during eczema dihydrochloride. Its antimicrobial properties flares. assist in preventing infection, whether from Indications Staphlycoccus aureus, which often complicates For the treatment and routine management of eczema and associated pruritus, or secondary mild-to-moderate atopic eczema, various forms of infection caused by scratching. As a non-ionic eczema, contact dermatitis emollient soap substitute, it cleanses the skin, and psoriasis. helping to remove surface debris without removing Sizes the skin’s natural oils. 100g (tube), 500g (pump) Indications Price For the management of dry and pruritic skin £2.69 (100g); £5.99 (500g) conditions, especially eczema and dermatitis. Sizes 500ml (pump) Moisturisers with Price antimicrobials £6.04 Cicaplast Baume B5 Dermol Cream La Roche Posay Dermal Laboratories Ltd Description Description A multi-purpose, pro-recovery soothing and Dermol Cream is an antimicrobial emollient cream protecting cream with an antibacterial action that that can also be used as a soap substitute. It contains accelerates epidermal restoration. Suitable for 20% of emollient oils in a non-greasy aqueous adults, children and babies, it is formulated to help cream, as well as the well-known and effective soothe everyday irritations and dry patches and is antiseptics, benzalkonium chloride and quickly absorbed leaving no sticky residue. chlorhexidine dihydrochloride. Its antimicrobial Indications properties assist in preventing Can be used on all kinds of everyday skin irritations infection, whether from and minor injuries, including chapped lips, dry or Staphlyococcus aureus, which often cracked skin, grazes and burns. Suitable on even the complicates eczema and associated most sensitive skin, including those needing extra pruritus, or secondary infection antibacterial protection against feelings of irritation caused by scratching. and itchiness and should be applied to the entire Indications lesion as often as necessary. For the management of dry and Sizes pruritic skin conditions, especially eczema and 40ml and 100ml (Baume B5); 40ml (Baume B5 SPF50+) dermatitis.

98 Dermatology Handbook 2021–2022 Emollients When a plain emollient just isn’t enough…

…Adex Gel has an Added Extra anti-infl ammatory, nicotinamide.

Whether patients need support stepping up from a plain emollient or stepping down from topical corticosteroids, Adex Gel can help maintain the condition of the skin and relieve fl ares. ✓ A highly moisturising and protective emollient with an added anti-infl ammatory for dry, i n fl a m e d skin conditions including mild to moderate eczema, contact dermatitis and psoriasis. ✓ For continuous use, to help prevent and treat fl ares. ✓ Can be used all over the body including on the face. Suitable for patients aged 1 year +. ✓ Does not contain topical corticosteroids.

Prescribe Adex Gel and see the results AdexGel.com

‘Adex’ is a registered trademark. Date of preparation: March 2020. Essential Information about this product, including adverse reactions, precautions, contra-indications and method of use is available from the manufacturer: Dermal Laboratories, Tatmore Place, Gosmore, Hitchin, Herts, SG4 7QR, UK. Legal classifi cation: Medical Device – Class III.

AdverseDermatology events should beHandbook reported to 2021–2022Dermal. www.dermal.co.uk 99 ADXPR208/MAR20 Dermatology Handbook

Sizes and scaling skin conditions where an antipruritic 100g (tube), 500g (pump pack) and/or hydrating effect is required. It may also be Price used for the continued treatment and follow-up £2.86—100g, £6.63—500g treatment of these skin diseases. Sizes Eczmol 100g, 500g (pump pack) Thornton & Ross Price Description £3.29—100g, £14.99—500g A moisturising and antimicrobial emollient cream, which can also be used as an alternative to soap. E45 Itch Relief Cream It forms a protective barrier on the skin and helps Reckitt Benckiser Healthcare UK to retain moisture in deeper layers of the skin. The Description active ingredient, clorhexidine gluconate, is an E45 Itch Relief Cream contains urea and antimicrobial which helps combat germs on the skin lauromacrogols. Urea is a physiological product that make certain types of eczema worse. derived from human protein metabolism. It is found Indications naturally in the skin and, when applied topically, Helps to prevent and treat dryness and itching can increase the horny layer’s capacity to retain which are common problems for people with water. Lauromacrogols act as a topical anaesthetic eczema and dry skin conditions. and have an antipruritic effect. Sizes Indications 250ml For the treatment of pruritis, eczema, dermatitis and Price scaling skin conditions where an antipruitic and/ £3.70 or hydrating effect is required. The cream may also be used for the continued treatment and follow-up treatment of these skin diseases. Moisturisers with Sizes antipruritics 50g, 100g, 500g (pump pack) Price Balneum Plus Cream Contact supplier Almirall Ltd Description Balneum Plus Cream has been shown to increase Washes & shower the lipid content of the epidermis, thus soothing preparations with and smoothing the skin. Urea is a physiological antimicrobials product derived from human protein metabolism. It is found naturally in the skin, but patients with Dermol 200 Shower Emollient eczema and psoriasis have decreased levels of it. Dermal Laboratories Ltd Urea is not allergenic and is well tolerated at a Description concentration of 5%. When applied topically, it Dermol 200 is an antimicrobial shower can increase the horny layer’s capacity to retain emollient for direct application onto water. Balneum Plus Cream has also been shown the skin and is suitable for use as a soap to increase skin hydration and, when used as substitute. It contains 5% emollient recommended, provides hydration for 24 hours. oils and the well-known and effective Lauromacrogols act as a topical anaesthetic antiseptics, benzalkonium chloride and have an antipruritic effect, with good local and chlorhexidine dihydrochloride, tolerability. in a non-greasy aqueous system. Indications Its antimicrobial properties assist in preventing For the treatment of pruritus, eczema, dermatitis infection, whether from Staphylococcus aureus,

100 Dermatology Handbook 2021–2022 Emollients

the pathogen that often complicates eczema and the skin's natural moisturisers. With a low PH to associated pruritus, or secondary infection caused preserve the natural acidity of the skin, and 10% by scratching. As a non-ionic emollient soap Revamil medical grade honey, it offers antibacterial substitute, it also cleanses the skin, helping to protection. Free of silicone, parabens and SLS. remove surface debris without removing the skin's Indications natural oils. For all age groups and skin types. Indications Sizes For the management of dry and pruritic skin 500ml; 1000ml conditions, especially eczema and dermatitis. Price Sizes £6.99; £12.99 200ml Price £3.55 Dermol Wash Dermal Laboratories Ltd Description Dermol Wash is an antimicrobial emollient for direct application onto the skin and is suitable for use as a soap substitute. It contains 5% of emollient oils in a non-greasy aqueous system that also contains the following two antiseptics: benzalkonium chloride and chlorhexidine dihydrochloride. Its antimicrobial properties assist in preventing infection, whether from Staphylococcus aureus, the pathogen that often complicates eczema and associated pruritus, or secondary infection caused by scratching. As it contains a non-ionic emollient soap substitute, the skin will be cleansed, helping to remove surface debris without removing the skin’s natural oils. Indications For the management of dry and pruritic skin conditions, especially eczema and dermatitis. Sizes 200ml Price £3.55 Revamil Gentle Hand Wash Oswell Penda Pharmaceutical Description A gentle hand wash with Aloe Barbadensis to soothe and calm the skin. Used regularly, it will help improve hand hygiene without removing

Dermatology Handbook 2021–2022 101 Dermatology Handbook Medical equipment

These are used alongside topical therapies, or to increase comfort or protection for a person with a skin condition and for sun protection. Included is camouflage for those who wish to cover disfigurement.

ryotherapy is commonly used to treat a as many times as necessary. It is safe, cheap and can be superficial benign lesion, most commonly practised at home as machines can be purchased for actinic keratosis, viral warts, seborrhoeic home use.3 Ckeratosis, and other benign lesions.1 The term Phototherapy equipment, including UV-devices ‘cryotherapy’ refers to the removal of skin lesions by for full-body or partial-body irradiation, provide high freezing them with liquid nitrogen. Electrosurgery standards of therapeutic efficacy with a variety of is used to stop bleeding or destroy abnormal skin light sources. The BAD photodermatology working by a device in which a direct current is used to group has issued regional guidelines on phototherapy heat the cautery probe. Hyfrecators, which are low- administration and care.4 powered medical apparatuses, emit low-power, Photodynamic therapy (PDT) for pre-malignant high-frequency electrical pulses via an electrode and some non-melanoma skin lesions is as safe and mounted on a hand piece, directly to the affected effective as cryosurgery, and has better cosmetic results area. This results in destruction of cutaneous lesions according to guidance from the National Institute including benign moles, common viral warts, for Health and Care Excellence (NICE).5 NICE seborrhoeic warts, skin tags, solar keratosis and recommends PDT routinely for basal-cell carcinoma spider naevi. Hyfrecators can treat more conditions and pre-malignant lesions, such as actinic (solar) than electrocautery and cryotherapy, including keratosis and Bowen’s disease. telangiectasias and unwanted hair growth.2 Hyperhidrosis is a condition in which overactive References sweat glands cause excessive sweating at inappropriate 1. Cryotherapy. British Association of Dermatologists, 2018. https://tinyurl.com/ltmkxqx (accessed March 2020) times in specific parts of the body. It most commonly 2. Electrosurgery. DermNet NZ, 2011. https://tinyurl. com/ occurs on the palms (palmar hyperhidrosis), but y8fcnula (accessed March 2020) can also present on the soles of the feet (plantar 3. Treatment options. Hyperhidrosis Support Group, 2018. hyperhidrosis), armpits (axillae), face, head, groin https://tinyurl.com/7lpta59 (accessed March 2020) 4. Phototherapy. British Association of Dermatologists, 2015. and back. Iontophoresis is an electrical stimulation https://tinyurl.com/ybzypgmq (accessed March 2020) treatment for palmar, plantar and axillary 5. National Institute for Health and Care Excellence (NICE). hyperhidrosis. A direct current administers ionised Photodynamic therapy for non-melanoma skin tumours (including premalignant and primary non-metastatic skin tap water topically onto the skin. Iontophoresis works lesions), 2006. https://www.nice. org.uk/guidance/IPG155 by the theory that the electrical current and mineral (accessed March 2020) particles in the water act together to thicken the outer layer of the skin, thereby stopping the flow of sweat, by blocking sympathetic nerves transmission in sweat glands or changing cellular secretory physiology. There is some evidence that iontophoresis decreases the pH in the sweat duct, which may contribute to eccrine gland dysfunction.3 Nearly all patients achieve complete cessation of sweating after 4–7 treatments. The amount of time for which the sweating stops varies from a few days to several weeks. The treatment can be repeated

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Cryotherapy Sizes One size Closed Probes Price Brymill Cryogenic Systems (UK) Ltd Contact supplier Description Closed probes are available to fit the size, shape or CryoPro section of the lesion to be treated. Mini probes are Schuco International (London) for lesions in eyelid margins, near the eyes or outer Description ear canal. Conical probes can be inserted into larger The CyroPro offers a great solution to cryosurgery or ulcerated lesions. Ball probes are for ulcerated through the application of liquid nitrogen to tumours and underlying bony structures. Flat remove warts, moles and skin tags. This is achieved probes are for vascular lesions. through either spray or probes with the selection Indications of applicators provided with the CryoPro Mini and For the treatment of cutaneous lesions and inside Maxi as standard. body cavities. Indications Sizes For the treatment of lesions responsive to Various cryotherapy. Price Sizes Contact supplier Mini: 350ml, 12–14 hours static holding time. Maxi: 500ml, 20–24 hours static holding time Cry-Ac Price Brymill Cryogenic Systems (UK) Ltd £515.00; £525.00 (ex. VAT) Description Cry-Ac is a liquid nitrogen cryosurgery device that CryoSuccess can be used to apply a controlled amount of liquid Schuco International (London) nitrogen to a wide range of common skin lesions. Description Cry-Ac has a greater capacity and longer holding A simple effective hand-held cryotherapy device for time than Cry-Ac-3. accurate treatment of skin lesions, making it ideal Indications for general practice, dermatology, podiatry and For the treatment of a wide range of common minor surgery applications. skin conditions including verrucas (warts), actinic Indications keratosis, molluscum, papilloma (skin tags), For the treatment of skin lesions responsive to lentigines (age spots) and basal cell carcinoma. cryotherapy. Sizes Sizes 500ml (capacity) One size Price Price Contact supplier £675 (ex. VAT) Cryo Tweezers Liquid Nitrogen Storage & Brymill Cryogenic Systems (UK) Ltd Withdrawal Description Brymill Cryogenic Systems (UK) Ltd The cryo tweezers control freezing easily and accurately. Description Indications A complete range of liquid nitrogen storage For the localised treatment of skin tags. dewars, along with two different decanting options

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(withdrawal tube or withdrawal device) depending Price on the size of the dewar, are available. The necessary Contact supplier personal protective equipment (gloves, goggles and aprons) is also available for the safe decanting of Bovie A950 liquid nitrogen. Brymill Cryogenic Systems (UK) Ltd Indications Description For the safe storage and decanting of liquid A cost-effective high-frequency desiccator nitrogen. providing 60W of cutting power and coagulation Sizes capabilities – ample for LLETZ/LEEP or most From 5–50L other cutting procedures performed in the doctor’s Price office. The easy-touch colour-coded membrane Contact supplier pad on the front panel allows for quick and easy selection of each setting; it can thus be left Open Sprays in bipolar mode and the three-button pencil Brymill Cryogenic Systems (UK) Ltd connected to the machine. Description Indications Open sprays consist of apertures, spray extensions A mono and bipolar machine with cut and and adapters. Apertures are used to treat cutaneous blend facility for the removal of tissue and for lesions. Apertures A–D are for accurate controlled the haemostasis and destruction of tissue using treatments of lesions of different sizes. The advanced desiccation or fulguration techniques. acne aperture is for acne and cryopeel. The super Sizes spray tip allows for concentrated streamlined spray, All-in-one hyfrecator enabling lesions to be treated faster. Price Indications Contact supplier For the treatment of cutaneous lesions. Sizes Bovie Derm 102 Various Brymill Cryogenic Systems (UK) Ltd Price Description Contact supplier An economical, 10W, high-frequency desiccator, adjustable in 1/10thW increments. It is designed to give practitioners the ability to perform in-office, Hyfrecators minor skin procedures at a more cost-effective price using monopolar or bipolar techniques. If you Bovie A940 need to use a foot control, medical equipment just Brymill Cryogenic Systems (UK) Ltd plug it in. There is no need to purchase a separate Description handpiece for foot control situations. For ultimate A 40W high-frequency desiccator that removes the safety and to prevent accidental grounding, a need to go through a multi-step process to change reusable patient plate is included. The Derm102 is from low to high power. packaged ready to use. The unique digital power control system allows Indications you to change from low to high by simply rotating In-office, minor skin procedures such as the power control knob or pushing the up/down the removal of skin tags, benign lesions and buttons on the hand-piece. premalignant lesions. Indications Price For haemostasis and the destruction of tissue using Contact supplier desiccation or fulguration techniques. Sizes www.quaybooks.co.uk All-in-one hyfrecator

Dermatology Handbook 2021–2022 105 Dermatology Handbook

Coa-Comp M Price Schuco International (London) £895 (ex. VAT) Description A lightweight, cost-effective automatic electro- coagulator for any surgical environment demanding Iontophoresis precise bipolar coagulation. Indications Hidrex ClassicION For precise, rapid coagulation of surgical bleeds in Iontophoresis Machine general surgery, orthopaedic, dermatology, vascular, Avanor Healthcare Ltd thyroid, ENT, plastics, paediatrics, thoracic and Description neurosurgery. A dedicated iontophoresis machine for treating Sizes hyperhidrosis. It uses tap water to pass a safe, One size painless electrical current through the areas of the Price body to reduce and treat excessive sweating. This £2500 (ex. VAT) machine offers both a set pulsed and direct current setting, as well as three memory point profiles, static Hyfrecator 2000 shock protection and automatic detection of over Schuco International (London) treatment. Description Indications Electrodessication, fulguration and coagulation, For treating hyperhidrosis. 0–35W mono and bipolar. Sizes Indications Underarms; hands and feet; hands, feet and For rapid, precise destruction of all types of underarms. cutaneous malformation including telangiectasia Price and unwanted hair growth. £399; £399; £425 (+VAT, trade prices) Used in dermatology, vasectomy, podiatry, maxillofacial, plastic surgery, GU medicine, Hidrex ConnectION gynaecology and veterinary. Iontophoresis Machine Sizes Avanor Healthcare Ltd 3 packages: system; FS (including footswitch Description and footswitch handle); FSB (including A dedicated iontophoresis machine for treating footswitch, footswitch handle and reusable bipolar hyperhidrosis, with accessories for treating forceps) underarms, hands and feet. It uses tap water to pass Price a safe, painless electrical current through the areas £1175 (ex. VAT); £1395 (ex. VAT); £1590 (ex. VAT) of the body to reduce and treat excessive sweating. Includes pulsed current setting for sensitive Surtron 120 treatments, direct current setting for intense Schuco International (London) treatments, variable pulse setting for increased Description efficiency, static shock protection and automatic An electrosurgical unit for minimally invasive detection of over treatment. Suitable for patients surgical procedures. Offers flexibility of separate cut over 5 years of age. and coagulation settings, as well as a combined cut Indications and coagulation setting. For treating hyperhidrosis. Indications Sizes For rapid precise destruction of skin lesions and for Underarms; hands and feet; hands, feet and many minor surgical procedures. underarms. Sizes Price One size £539; £549; £569 (+VAT, trade prices)

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Idromed 5GS Sizes Avanor Healthcare Ltd Contact supplier Description Price A dedicated iontophoresis machine for treating Contact supplier hyperhidrosis in the hands and feet. It uses tap water to pass a safe, painless electrical current through the areas of the body to reduce and treat excessive sweating. Narrowband UVB and UVA Includes direct current for intense treatments, static shock protection, simple controls, and clear text LCD MEDLight N-LINE Pro display. Therapy World (MGC) Indications Description For treating hyperhidrosis. The N-LINE Pro is a full-body cabinet with a Sizes novel oval shape, adapting to the outline of the Hands and feet. human body and thus enhancing even irradiation Price distances and optimal distribution of UV light. £399 +VAT (trade price) It is equipped with either 40 PUVA tubes, 20 PUVA and 20 Narrow Band UVB tubes as a Idromed 5PS Combination, or 40 Narrow Band UVB (311 nm) Avanor Healthcare Ltd tubes. It has an innovative dosing system with four Description special overhead UV sensors (allowing optimal A dedicated iontophoresis machine for treating treatment of the tall or obese patient), a quiet hyperhidrosis. It uses tap water to pass a safe, painless ventilation system and modern touch screen. There electrical current through the body areas to reduce are numerous patient safety features, including a and treat excessive sweating. Features pulsed current security cover in front of the tubes and an electric setting for sensitive skin areas, static shock protection, sensor that switches the cabinet off should the simple controls and clear text LCD display. patient open the door. Indications Indications For treating hyperhidrosis. For the treatment of all types of psoriasis, vitiligo, Sizes pruritus, acne vulgaris, vitamin D deficiency Underarms; hands and feet; hands, feet and and other clinical situations responsive to UV underarms. therapy. Price Sizes £565; £575; £595 (+VAT, trade prices) One size Price Contact supplier MED testing equipment MEDLight N-LINE t MEDLight MED-Tester Mini Therapy World (MGC) Therapy World (MGC) Description Description The N-Line t is for UVA or narrow band UVB A compact MED tester is available for narrow treatment of the hands and/or feet, or by slight band UVB. The handheld device has the adjustment for the whole legs. same characteristics as the UVB tubes within Indications phototherapy cabins, allowing its readings to be For the treatment of all types of psoriasis, pruritus, used for correct dosage. acne vulgaris, vitamin D deficiency and other Indications clinical situations responsive to UV therapy. MED testing for determining minimal erythemic Sizes dose (MED). Module or full mobile unit

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Price Price Contact supplier £3700 MEDLight Psor-COMB Ambulight PDT Multi Therapy World (MGC) Spirit Healthcare Ltd Description Description The Psor-COMB is a powerful light source that Ambulight PDT Multi is a reusable, rechargeable emits a special quality of light, providing active ambulatory LED light device for the administration UV energy direct to lesions on the scalp, while of PDT. It allows for up to three replaceable heads to its toothed plastic housing means that high UV be used to treat up to three lesions at any one time. energy is always supplied at an optimal treatment It allows for use with multiple patients and offers a distance. The patient initiates and maintains therapy good economic case. by combing the scalp against the growth of hair. Indications Moistening of the scalp is recommended as wet skin For the treatment of non-melanoma skin cancer. absorbs more UV light. Sizes Indications Ambulatory PDT Light MultiOne size For effective UV treatment of scalp psoriasis Price (irrespective of how much hair the patient has), Unit: £500.00; One treatment head: £50.00 alopecia areata and smaller skin areas. Sizes Treviolux One size Therapy World (MGC) Price Description Contact supplier An innovative Photodynamic Therapy (PDT) Machine featuring normal PDT, pulsed PDT for reduced treatment pain, compact daylight PDT Photodynamic therapy when effective daylight is unavailable. It is used with a licenced photosensitiser, such as Metvix from Aktilite CL128 Lamp Galderma or Ameluz from Biofrontera. Galderma (UK) Price Description Contact supplier The Aktilite CL128 lamp with light-emitting diodes (LEDs) is intended for use in photodynamic therapy in combination with Metvix (methyl aminolevulinate) cream 160mg/g. The LED array is placed in a rectangular pattern and is coupled to a matching array of lenses that produce a collimated red light beam. The lamp emits a light of high uniformity with a narrow spectrum at approximately 630nm, which can be adjusted by a control panel. The light dose used is 37 J/cm2 and is combined with Metvix cream. The dose is averaged over the treatment area. To be used with professional protective glasses and patient protective goggles. Indications For the use in photodynamic therapy (PDT) in combination with Metvix 160mg/g cream. Sizes One size

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Systemic therapy is given when a skin condition is not adequately responding to topical treatment or is moderate to severe. Careful supervision and monitoring for adverse events will generally be carried out in secondary care or as shared primary/secondary care, according to national and local guidelines

ystemic treatments are prescribed in therapy in dermatology generally requires supervision, dermatology for skin conditions that are assessed monitoring for adverse reactions and interactions with as severe and are not responding to topical other drugs.1 The British Association of Dermatologists therapy.S Systemic treatments include antibiotics, (BAD) produces clinical standards3 and the National antifungals, antivirals, immunosuppressants Institute for Health and Care Excellence (NICE) (such as systemic corticosteroids, ciclosporin and produces accredited guidelines for systemic therapies methotrexate) and retinoids. Immunosuppressants used to treat moderate-to-severe skin conditions, which and retinoids are initiated and prescribed by contain evidence-based information on indications, side dermatology consultants or GPs with an extended effects, patient monitoring and information. Current role in dermatology (GPwERs), depending on local guidelines include biological and systemic therapies in policy. Systemic treatments may be monitored in psoriasis (2020), acitretin (2010), azathioprine (2011), secondary care or by shared care with primary care. ciclosporin (2019), and methotrexate (2016).2 The Biologic therapies are protein molecules produced only biologic licensed in the UK for atopic dermatitis by recombinant DNA technology, which target the is Dupilumab. Other non-biologic systemic treatments, specific sites in the immune-pathogenesis pathway of apremilast and dimethyl fumarate are available for the diseases. patients with moderate psoriasis. Systemic therapy with They have a specific action on the immune system, immunosuppressant therapy suppresses the immune compared with other systemic therapies which improve response to varying degrees, while other therapies, disease but do not target the causative factors. Biologics such as retinoids and biologics, modulate the immune have a lesser side effect profile compared with the responses. As with any systemic treatment, there is traditional immune-suppressants. Long-term safety a risk of potentially serious side effects, as well as profile will continue to be assessed with future large specific special precautions. The BAD produces patient clinical studies.1,2 information leaflets on all systemic treatments.4 The rationale for prescribing any systemic Systemic retinoids are indicated for severe acne and medication for skin conditions should always be guidance given by the BAD on isotretinoin (2010).3 explained carefully to the patient, with adequate Isotretinoin is teratogenic. In women of childbearing information and counselling given before and during potential, is well understood and the pregnancy a course of systemic treatment. Patients will often be prevention protocol must be strictly adhered to, receiving treatments over months, so it is important which is defined by the Medicines and Healthcare that all health professionals involved with the patient Products Regulatory Agency (MHRA).5 This includes understand their responsibilities. Shared care protocols all females consenting to two forms of contraception are used between dermatology departments and and a monthly pregnancy test, with the individual primary care for ongoing monitoring. prescription being issued every 28 days. Acne is Systemic treatments should be prescribed based known to be associated with an increased risk of on the patient’s age, weight and ability to eliminate psychiatric disorders, and there have been reports of the drug via hepatic and renal routes. Systemic drug psychiatric disorders including depression and suicidal

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behaviour associated with isotretinoin treatment for • Immunosuppressants: methotrexate acne. A review of isotretinoin and psychiatric adverse • Retinoids: isotretinoin. reactions concluded that the available study data were References insufficient to establish a causal association between 1. Smith CH, Yiu ZZ, Bale T et al. British Association of Dermatologists guidelines for biologic therapy in psoriasis isotretinoin and psychiatric disorders; however, an 2017. British Journal of Dermatology 2020; 183: 6328–637 association could also not be ruled out. Patients 2. Nygaard U, Vertergaard C, Deleuran M. Emerging on isotretinoin should be routinely screened and Treatment Options in Atopic Dermatitis: Systemic monitored. Education and patient awareness are key to Therapies. Dermatology 2017; 233 (5): 344–357 3. British Association of Dermatologists (BAD). Clinical patients and prescribers making informed decisions on Guidelines 2018. https://tinyurl.com/ycss7ecz (accessed treatment with isotretinoin, which is used to treat acne March 2021) that cannot be treated with other medicines.6 4. British Association of Dermatologists (BAD). Patient information Leaflets (PILs). https://tinyurl.com/ybzs3feu Before starting and prescribing any systemic (accessed March 2021) treatments for patients with skin conditions, it is always 5. Medicines and Healthcare products Regulatory Agency advisable to consult the latest datasheet or summary of (MHRA). Oral retinoids: pregnancy prevention—reminder product characteristics as well as adhering to national of measures to minimise teratogenic risk, 2014. https:// tinyurl.com/yd3xh9wd (accessed March 2021) and local guidelines. All systemic treatments should be 6. Medicines and Healthcare products Regulatory Agency recorded on approved documentation and any adverse (MHRA). Isotretinoin: reminder of important risks and reactions reported. Information on adverse drug precautions. 2020. https://bit.ly/38zQn5d (accessed March 2021) reactions is coordinated by the Commission on Human 7. Yellow Care Medicines and Healthcare products Regulatory Medicines and the MHRA. Any reactions to any drugs Agency 2018. https://tinyurl.com/nv88e9h (accessed March should be reported by the yellow card system, which 2021) receives reports of suspected adverse drug reactions 8. Biologics and Immunomodulators register. BADBIR. 2020 http://www.badbir.org (accessed March 2021) (ADRs) or side effects from health professionals and 9. Vermeulen FM, Gerbens LA, Bosma AL et al. TREatment patients.7 The easiest and quickest way to report an of ATopic eczema (TREAT) Registry Taskforce: consensus ADR is to complete the electronic yellow card form on how and when to measure the core dataset for atopic eczema treatment research registries. British Journal of (www.yellowcard.gov.uk). Dermatology 2019, 181(3): 492–504 Biologic therapies in psoriasis are additionally monitored the BAD Biologics and Immunomodulator Register (BADBIR), which assesses the long-term effects of biologics. All patients in the UK receiving therapies for psoriasis should be registered with BADBIR.8 Patients are followed up via their dermatologist as BADBIR assess their clinical details. The TREatment of ATopic eczema (TREAT) Registry Taskforce core dataset for research registries for paediatric and adult patients with AE, who are receiving phototherapy and systemic treatments (including the biologic therapy, dupliumab).9 Non-proprietary systemic treatments include: • Acne treatments: co-cyprindiol • Antibiotics: flucloxacillin, erythromycin, doxycycline, oxytetracycline, minocycline, tetracycline • Antifungals: fluconazole, griseofulvin, itraconazole, terbinafine • Antihistamines: cetirizine, loratadine, chlorphenamine, fexofenadine • Antivirals: aciclovir

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Acne oral treatments Tetralysal 300 Galderma (UK) Dianette Description Bayer PLC Tetralysal contains 408mg of lymecycline, Description equivalent to 300mg tetracycline base. Dianette blocks androgen receptors and reduces Tetracyclines provide bacteriostatic action at the androgen synthesis both by negative feedback on available plasma and tissue concentrations and the hypothalamic-pituitiary-ovarian systems and by are effective against intracellular and extracellular the inhibition of androgen-synthesising enzymes. organisms. Their mechanism of action is based Although it also acts as an oral contraceptive, on the inhibition of ribosomal protein synthesis. it is not recommended in women solely for Tetracyclines block the access of the bacterial contraception and should be reserved for women aminoacyl-tRNA to the mRNA-ribosome complex requiring treatment for the androgen- dependent by binding to the 30S subunit of the ribosome, skin conditions described. thus preventing the addition of amino acids to the Indications growing peptide chain in protein synthesis. When Treatment of moderate to severe acne related to given at therapeutically attainable concentrations, androgen-sensitivity (with or without seborrhoea) their toxic effect is limited to the bacterial cells. and/or hirsutism, in women of reproductive age. The exact mechanisms by which tetracyclines For the treatment of acne, Dianette should only reduce lesions of acne vulgaris have not been be used after topical therapy or systemic antibiotic fully elucidated, however, the effect appears treatments have failed. Since Dianette is also a to result in part from antibacterial activity. hormonal contraceptive, it should not be used in Following oral administration, the drugs inhibit combination with other hormonal contraceptives. the growth of susceptible organisms (mainly Sizes Propionibacterium acnes) on the surface of Available in blister packs containing 21 tablets the skin and reduce the concentration of free Price fatty acids in sebum. The reduction in free fatty £7.71 (63 tablets) acids in sebum may be an indirect result of the inhibition of lipase-producing organisms which Minocin MR convert triglycerides into free fatty acids or Mylan maybe a direct result of interference with lipase Description production in these organisms. Free fatty acids Minocin MR capsules contain the active ingredient are comedogenic, and are believed to be a possible minocycline as minocycline hydrochloride, which is cause of the inflammatory lesions, e.g. papules, a semi-synthetic derivative of tetracycline. pustules, nodules, cysts, or acne. However, other Indications mechanisms also appear to be involved because For the treatment of acne. clinical improvement of acne vulgaris with Sizes oral tetracycline therapy does not necessarily 100mg (56 capsules) correspond with a reduction in the bacterial flora Price of the skin or a decrease in the free fatty acid £20.08 content of sebum. Indications Subscribe to JAN Tetralysal is indicated for the treatment of infections www.magsubscriptions.com/jan caused by tetracycline-sensitive organisms, including acne and soft-tissue infections.

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Sizes and tinea pedis) where oral therapy is considered 408mg (28 or 56 capsules) appropriate due to the site, severity or extent of the Price infection. Oral Lamisil is indicated in the treatment £6.95, £11.53 of onychomycosis. Sizes 250mg Alopecia treatments Price £21.30 (14 tablets), £41.09 (28 tablets) Propecia Organon Pharma (UK) Limited Sporanox Description Janssen-Cilag Ltd Propecia contains finasteride 1mg, which is Description a competitive and specific inhibitor of type II Sporanox is a triazole derivative with a broad 5α-reductase. It inhibits a process responsible for spectrum of antifungal activity that inhibits the miniaturisation of the scalp hair follicles, which can growth of a broad range of fungi that are pathogenic lead to reversal of the balding process. in humans. Indications Indications For the treatment of men with male pattern hair loss For the treatment of pityriasis versicolor and (androgenetic alopecia) to increase hair growth and dermatophytoses caused by organisms susceptible prevent further hair loss. to itraconazole (Trichophyton spp., Microsporum Sizes spp., Epidermophyton floccosum), e.g. tinea pedis, 1mg (x28 and x84) tinea cruris, tinea corporis, tinea manuum, and Price onychomycosis caused by dermatophytes and/or Contact supplier yeasts. Sporanox is also indicated for the treatment of candidosis (vaginal and oral), histoplasmosis and systemic fungal conditions. Antifungals (oral) Sizes Capsules: 100mg. Oral liquid: 10mg/ml (150ml) Lamisil Price Novartis Pharmaceuticals UK Ltd Contact supplier Description Terbinafine is an allylamine which has a broad spectrum of antifungal activity. At low Antihistamines concentrations terbinafine is fungicidal against dermatophytes, moulds and certain dimorphic Benadryl Allergy fungi. The activity versus yeasts is fungicidal or McNeil Products fungistatic depending on the species. Terbinafine Description interferes specifically with fungal sterol biosynthesis Benadryl Allergy contains acrivastine which at an early step. This leads to a deficiency in provides provides symptomatic relief in conditions ergosterol and to an intracellular accumulation of believed to depend wholly or partly upon the squalene, resulting in fungal cell death. triggered release of histamine. It is a potent Indications competitive histamine H1 antagonist which lacks For the treatment of fungal infections of the skin significant anti-cholinergic effects, and has a low and nails caused by Trichophyton (eg. T. rubrum, potential to penetrate the central nervous system. It T.mentagrophytes, T. verrucosum T. violaceum), is a non sedating antihistamine. Microsporum canis and Epidermophyton Indications floccosum. Oral Lamisil is indicated in the For the symptomatic relief of allergic rhinitis, treatment of ringworm (tinea corporis, tinea cruris including hay fever and also indicated for chronic

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idiopathic urticaria. NeoClarityn Sizes Organon Pharma (UK) Limited 8mg (x12) Description Price NeoClarityn contains desloratadine, which is a £4.99 (RRP) non-sedating, long-acting histamine antagonist with selective peripheral H1-receptor antagonist activity. Cyproheptadine (Periactin) After oral administration, desloratadine selectively 4mg Tablets blocks peripheral histamine H1-receptors because Teva UK the substance is excluded from entry to the central Description nervous system. Each Cyproheptadine Hydrochloride 4 mg Tablet Indications contains cyproheptadine hydrochloride equivalent NeoClarityn 5mg film-coated tablets are to 4 mg anhydrous cyproheptadine hydrochloride. indicated in adults and adolescents over the age It is a serotonin and histamine antagonist with of 12 years for the relief of symptoms associated anticholinergic and sedative properties. with allergic rhinits and urticaria. NeoClarityn Indications oral solution is indicated in adults, adolescents For a wide range of anti allergic and antipruritic and children over the age of 1 year for the relief activity. It can be used in the treatment of acute of symptoms associated with allergic rhinitis and and chronic allergic and pruritic conditions, such urticaria. as dermatitis, including neurodermatitis and Sizes neurodermatitis circumscripta; eczema; eczematoid Oral solution: 30ml; 50ml; 60ml; 100ml; 120ml; dermatitis; dermatographism; mild, local allergic 150ml; 225ml; 300ml. Tablets: 5mg reactions to insect bites; hay fever and other Price seasonal rhinitis; perennial allergic and vasomotor Contact supplier rhinitis; allergic conjunctivitis due to inhalant allergens and foods; urticaria; angioneurotic Phenergan oedema; drug and serum reactions; anogenital Sanofi UK pruritus; pruritus of chicken pox. Description Sizes Phenergan is a potent, long-acting antihistamine 4mg with additional anti-emetic central sedative and Price anticholinergic properties. Contact supplier Indications For use as symptomatic treatment for allergic Mizollen conditions of the upper respiratory tract and Sanofi UK skin including allergic rhinitis, urticaria and Description anaphylactic reactions to drugs and foreign Mizollen contains mizolastine, which possesses proteins; as an adjunct in preoperative sedation in antihistamine and anti-allergic properties due to surgery and obstetrics; and as an antiemetic. For a specific and selective antagonism of peripheral short-term use: sedation and treatment of insomnia histamine H1 receptors. in adults; and as a paediatric sedative. Phenergan Indications injection specifically has an additional indication as For the symptomatic relief of seasonal allergic an adjunct in preoperative sedation in surgery and rhinoconjunctivitis (hay fever), perennial allergic obstetrics and as a paediatric sedative. rhinoconjunctivitis and urticaria. Sizes Sizes 10mg (56 pack) tablets, 25mg (14 pack) tablets, 10mg Elixir (100ml), 10 ampules injection Price Price £6.92 (x30 pack) £2.96, £4.65, £2.85, £6.75

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Piriton idiopathic urticaria. GSK Consumer Healthcare Sizes Description Oral solution: 0.5mg/ml (200ml); tablets: 5mg (30 Piriton contains chlorphenamine maleate which is a tablets) potent antihistamine (H1-antagonist). Price Indications £5.37; £3.93 For symptomatic control of all allergic conditions responsive to antihistamines, including hay fever, Zirtek vasomotor rhinitis, urticaria, angioneurotic oedema, UCB Pharma food allergy, drug and serum reactions, insect bites. Description Also indicated for the symptomatic relief of itch Zirtek contains cetirizine, a human metabolite of associated with chickenpox. hydroxyzine. It is a potent and selective antagonist Sizes of peripheral H1-receptors. In vitro receptor Tablet allergy: 30 tabs, 60 tabs. Syrup: 1x150ml binding studies have shown no measurable affinity Price for other than H1-receptors. In addition to its Tablets: £3.99, £6.99 anti-H1 effect, cetirizine was shown to display anti- Syrup: £4.99 allergic activities. Indications Tavegil For the relief of symptoms of chronic idiopathic Thornton & Ross urticarial; and seasonal and perennial rhinitis. Description Sizes Tavegil (clemastine) is an H1-recptor antagonist. Tablets: 10mg (7); 10mg (21); 10mg (30). Solution: It belongs to the benzhydryl ether group of 1mg/ml 150ml; 1mg/ml 200ml; 1mg/ml 70ml antihistamines. Tavegil inhibits selectively Price the histamine receptors of the H1 type and £2.12; £3.18; £8.74; £2.12; £4.58; £6.98 reduces capillary permeability. It exerts a potent antihistaminic and antipruritic effect with a fast onset and long duration of action up to 12 hours. Antivirals (oral) Indications Allergic rhinitis, including hay fever and Valtrex perennial rhinitis, and vasomotor rhinitis. Allergic GlaxoSmithKline UK dermatoses, including pruritus, atopic eczema and Description contact dermatitis. Urticaria, angioneurotic oedema Valtrex contains valaciclovir, an antiviral, which is and drug allergy. the L-valine ester of aciclovir. Aciclovir is a purine Sizes (guanine) nucleoside analogue. 1.34mg Indications Price Valtrex is indicated for the treatment of herpes £9.58 (60 tablets) zoster (shingles) and ophthalmic zoster in immunocompetent adults and herpes zoster Xyzal in adult patients with mild or moderate UCB Pharma immunosuppression. Also, for the treatment and Description suppression of HSV infections of the skin and Xyzal contains levocetirizine, which is the (R) mucous membranes. Valtrex is also indicated for enantiomer of cetirizine, and is a potent and the prophylaxis of CMV infection and disease selective antagonist of peripheral H1-receptors. following solid organ transplantation in adults and Indications adolescents. For the symptomatic treatment of allergic rhinitis Sizes (including persistent allergic rhinitis) and chronic 250mg, 500mg

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Price patients who are candidates for systemic therapy. £123.28 (250mg, 60 tab); £20.59 (500mg, 10 tab); Sizes £86.30 (500mg, 42 tab) 300mg/2ml (pre-filled syringe) Price Zovirax Oral £1264.89 (2 filled syringes) GlaxoSmithKline UK Description Zovirax contains aciclovir, which is a synthetic Biologics (psoriasis and purine nucleoside analogue with in vitro and in vivo psoriatic arthritis) inhibitory activity against human herpes viruses, including herpes simplex virus (HSV) types I and II Benepali and varicella zoster virus (VZV). Biogen Idec Indications Description Indicated for the treatment of herpes simplex virus A biosimilar medicinal product to Etanercept infections of the skin and mucous membranes, (Enbrel). including initial and recurrent genital herpes Indications (excluding neonatal HSV and severe HSV For the treatment of active and progressive psoriatic infections in immunocompromised children), arthritis in adults and adults with moderate suppression (prevention of recurrences) of recurrent to severe plaque psoriasis (see Enbrel for full herpes simplex infections in immunocompetent indications). patients, prophylaxis of herpes simplex infections Sizes in immunocompromised patients and for the 25mg/0.5ml solution for injection in pre-filled treatment of varicella (chickenpox) and herpes syringe; 50mg/ml solution for injection in pre-filled zoster (shingles) infections. syringe or pre-filled pen Sizes Price Zovirax Suspension (200mg/5ml); Zovirax Double £328.00 (x4); £656.00 (x4) Strength suspension (400mg/5ml) Price Cosentyx £29.56 (Zovirax Suspension: 200mg/5ml, 125ml); Novartis Pharmaceuticals UK £33.02 (Zovirax Double Strength suspension: Description 400mg/5ml, 100ml) Secukinumab is a fully human IgG1/κ monoclonal antibody that selectively binds to and neutralises the proinflammatory cytokine interleukin-17A (IL- Biologics (atopic eczema) 17A). Secukinumab works by targeting IL-17A and inhibiting its interaction with the IL-17 receptor, Dupixent which is expressed on various cell types including Sanofi UK keratinocytes. As a result, secukinumab inhibits the Description release of proinflammatory cytokines, chemokines Dupilumab is a recombinant human IgG4 monoclonal and mediators of tissue damage and reduces IL- antibody that inhibits interleukin-4 and interleukin-13 17A-mediated contributions to autoimmune and signaling. Dupilumab inhibits IL-4 signaling via the inflammatory diseases. Clinically relevant levels Type I receptor (IL-4Rα/γc), and both IL-4 and IL-13 of secukinumab reach the skin and reduce local signaling through the Type II receptor (IL-4Rα/IL- inflammatory markers. As a direct consequence 13Rα). IL-4 and IL-13 are key type 2 (including Th2) treatment, secukinumab reduces erythema, cytokines involved in atopic dermatitis. induration and desquamation present in plaque Indications psoriasis lesions. Dupixent is indicated for the treatment of Indications moderate-to-severe atopic dermatitis in adult For the treatment of moderate to severe plaque

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psoriasis in adults who are candidates for systemic to respond to, or who have a contraindication therapy. Cosentyx alone or in combination with to, or are intolerant to other systemic therapy, methotrexate (MTX) is indicated for the treatment including ciclosporin, methotrexate or psoralen and of active psoriatic arthritis in adult patients when ultraviolet-A light (PUVA). Enbrel in combination the response to previous disease-modifying with methotrexate is indicated for the treatment anti-rheumatic drug (DMARD) therapy has of moderate to severe active rheumatoid arthritis been inadequate. Also indicated for anklosing in adults when the response to disease-modifying sponodylitis. antirheumatic drugs, including methotrexate Sizes (unless contraindicated), has been inadequate. 150mg solution for injection in pre-filled syringe or Treatment of polyarthritis (rheumatoid factor pre-filled pen positive or negative) and extended oligoarthritis Price in children and adolescents from the age of 2 years £1218.78 (x2) who have had an inadequate response to, or who have proved intolerant of, methotrexate. Treatment Enbrel of chronic severe plaque psoriasis in children Pfizer Ltd and adolescents from the age of 6 years who are Description inadequately controlled by, or are intolerant to, Enbrel (etanercept) is a fully human soluble other systemic therapies or phototherapies. TNF receptor fusion protein. TNF is a dominant Sizes cytokine in the inflammatory process of rheumatoid 10mg powder and solvent for solution for injection arthritis. Elevated levels of TNF are also found in (paediatric dosing only); 25mg powder and solvent the synovium and psoriatic plaques of patients for solution for injection; 50mg solution for with psoriatic arthritis and in serum and synovial injection in pre-filled syringe; 25mg solution for tissue of patients with ankylosing spondylitis. In injection in pre-filled syringe; 50mg solution for plaque psoriasis, infiltration by inflammatory cells, injection in pre-filled pen including T-cells, leads to increased TNF levels in Price psoriatic lesions compared with levels in uninvolved £143.00; £375.50; £715.00; £357.50; £715.00 skin. Etanercept is a soluble TNF receptor that is a competitive inhibitor of TNF binding to its Erelzi cell surface receptor, thereby inhibiting biological Sandoz activity of TNF. This product entry refers to Enbrel, Description not biosimilars of etanercept. A biosimilar medicinal product to Etanercept Indications (Enbrel). For the treatment of active and progressive psoriatic Indications arthritis in adults when the response to previous For the treatment of active and progressive psoriatic disease-modifying antirheumatic drug therapy arthritis in adults and adults with moderate has been inadequate. Ankylosing spondylitis (AS): to severe plaque psoriasis (see Enbrel for full treatment of adults with severe active AS who indications). have had an inadequate response to conventional Sizes therapy. Non-radiographic axial spondyloarthritis: 25mg solution for injection in pre-filled syringe, treatment of adults with severe non-radiographic 50mg solution for injection in pre-filled syringe or axial spondyloarthritis with objective signs of pre-filled pen inflammation as indicated by elevated C-reactive Price protein (CRP) and/or magnetic resonance imaging £328.00; £656.00 (x4) (MRI) evidence, who have had an inadequate response to nonsteroidal anti-inflammatory drugs Need an extra copy? (NSAIDs). Plaque psoriasis: treatment of adults www.dermatologyhandbook.co.uk with moderate to severe plaque psoriasis who failed

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Flixabi (Remicade). Biogen Idec Indications Description For the treatment of psoriatic arthritis and psoriasis A biosimilar medicinal product to Infliximab (see Remicade for full indications). (Remicade). Sizes Indications 100mg powder for concentration, solution in vial For the treatment of psoriatic arthritis and psoriasis Price (see Remicade for full indications). £377.66 Sizes 100mg powder for concentration in infusion Kyntheum solution LEO Pharma Price Description £377.00 Brodalumab is a recombinant fully human monoclonal immunoglobulin IgG2 antibody Humira that binds with high affinity to human IL-17RA AbbVie and blocks the biological activities of the pro- Description inflammatory cytokines IL-17A, IL-17F, IL-17A/F Adalimumab is a Tumour Necrosis Factor alpha heterodimer and IL-25, resulting in inhibition of the (TNF-α) inhibitor. Adalimumab binds specifically to inflammation and clinical symptoms associated with TNF and neutralises the biological function of TNF psoriasis. IL-17RA is a protein expressed on the cell by blocking its interaction with the p55 and p75 cell surface and is a required component of receptor surface TNF receptors. Adalimumab also modulates complexes used by multiple IL-17 family cytokines. biological responses that are induced or regulated IL-17 family cytokine concentrations have been by TNF, including changes in the levels of adhesion reported to be increased in psoriasis. Blocking molecules responsible for leukocyte migration. IL-17RA inhibits IL-17 cytokine-induced responses Indications resulting in normalisation of inflammation in the For the treatment of moderate to severe chronic skin. plaque psoriasis in adult patients who are candidates Indications for systemic therapy. Also, for the treatment of For the treatment of moderate to severe plaque severe chronic plaque psoriasis in children and psoriasis in adult patients who are candidates for adolescents from 4 years of age who have had systemic therapy. an inadequate response to or are inappropriate Sizes candidates for topical therapy and phototherapies. 210mg solution for injection in pre-filled syringe Finally, for the treatment of active and progressive Price psoriatic arthritis in adults when the response to £1280.00 (x2) previous disease-modifying, anti-rheumatic drug therapy has been inadequate. Remicade Sizes Merck Sharp & Dohme Ltd 20mg solution for injection in pre-filled syringe; Description 40mg and 80mg solution for injection in pre-filled Remicade (Infliximab) has customised dosing syringe or pre-filled pen based on a person’s individual weight and can help Price provide quick symptom relief. It can also help with £704.28 the relief of day-to-day symptoms and help stop the progression of joint damage. Inflectra Indications Pfizer Ltd For treatment of moderate-to-severe plaque Description psoriasis in adult patients who failed to respond to, A biosimilar medicinal product to Infliximab or who have a contraindication to, or are intolerant

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to other systemic therapy including cyclosporine, phototherapies. Psoriatic arthritis: indicated alone methotrexate or psoralen and ultraviolet A (PUVA). or in combination with MTX for the treatment Sizes of active psoriatic arthritis in adult patients when 100mg powder for concentrate. the response to previous non-biological disease- Price modifying anti-rheumatic drug (DMARD) therapy Contact supplier has been inadequate. Sizes Remsima 45mg and 90mg solution for injection in pre-filed Celltrion Healthcare UK Limited syringe Description Price One vial contains 100mg of infliximab, a £2147.00 chimeric human-murine IgG1 monoclonal antibody produced in murine hybridoma cells by Talz recombinant DNA technology. Eli Lilly and Company Indications Description For the treatment of psoriatic arthritis and psoriasis. Ixekizumab is an IgG4 monoclonal antibody that Sizes binds with high affinity (<3 pM) and specificity 100mg powder for concentrate to interleukin 17A (both IL-17A and IL-17A/F). Price Elevated concentrations of IL-17A have been Contact supplier implicated in the pathogenesis of psoriasis by promoting keratinocyte proliferation and activation. Stelara Neutralisation of IL-17A by ixekizumab inhibits Janssen-Cilag Ltd these actions. Description Indications Ustekinumab is a fully human IgG1κ monoclonal For the treatment of moderate to severe plaque antibody that binds with specificity to the psoriasis in adults who are candidates for systemic shared p40 protein subunit of human cytokines therapy. interleukin (IL)-12 and IL-23. Ustekinumab Sizes inhibits the bioactivity of human IL-12 and IL-23 80mg/ml pre-filled syringe or pen by preventing p40 from binding to the IL-12Rβ1 Price receptor protein expressed on the surface of £2250 (x2) immune cells. Ustekinumab cannot bind to IL- 12 or IL-23 that is already bound to IL-12Rβ1 Tremfya cell surface receptors. Thus, ustekinumab is not Janssen-Cilag Ltd likely to contribute to complement- or antibody- Description mediated cytotoxicity of cells with IL-12 and/or Guselkumab is a human IgG1λ monoclonal IL-23 receptors. antibody (mAb) that binds selectively to the Indications interleukin 23 (IL-23) protein with high specificity For the treatment of moderate to severe plaque and affinity. IL-23, a regulatory cytokine, affects psoriasis in adults who failed to respond to, or the differentiation, expansion and survival of T who have a contraindication to, or are intolerant cell subsets and innate immune cell subsets, which to other systemic therapies including ciclosporin, represent sources of effector cytokines, including methotrexate (MTX) or psoralen and ultraviolet IL-17A, IL-17F and IL-22 that drive inflammatory A (PUVA). Paediatric plaque psoriasis: indicated disease. Levels of IL-23 are elevated in the skin of for the treatment of moderate to severe plaque patients with plaque psoriasis. In in vitro models, psoriasis in adolescent patients from the age of 12 guselkumab was shown to inhibit the bioactivity years and older, who are inadequately controlled of IL-23 by blocking its interaction with cell by, or are intolerant to, other systemic therapies or surface IL-23 receptor, disrupting IL-23-mediated

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signaling, activation and cytokine cascades. consisting of 11 amino acids. It is an Guselkumab exerts clinical effects in plaque immunosuppressive agent licensed for the psoriasis through blockade of the IL-23 cytokine prevention of graft rejection following heart, kidney, pathway. pancreas, bone marrow and lung in transplants. Indications Benificial effects of ciclosporin therapy have also For the treatment of moderate to severe plaque been shown in patients with severe psoriasis, atopic psoriasis in adults who are candidates for systemic dermatitis, rheumatoid arthritis and nephrotic therapy. syndrome, conditions that may be considered to Sizes have an immunological mechanism. 100mg solution for injection in pre-filed syringe Indications Price Neoral is indicated in patients with severe atopic £2250 dermatitis when systemic therapy is required. Neoral treatment should be initiated by physicians with experience in the diagnosis and treatment of Immunosuppressants atopic dermatitis. Sizes Methotrexate Capsules: 10mg, 25mg, 50mg, 100mg Hospira UK Price Description £18.25—10mg (60 cap); £18.37—25mg (30 cap); Methotrexate is an antimetabolite, which acts £35.97—50mg (30 cap), £68.28—100mg (30 cap) principally by competitively inhibiting the enzyme, dihydrofolate reductase. In the process of DNA synthesis and cellular replication, folic acid must Psoriasis (oral) be reduced to tetrahydrofolic acid by this enzyme, and inhibition by methotrexate interferes with Skilarence tissue cell reproduction. Actively proliferating Almirall Ltd tissues such as malignant cells are generally more Description sensitive to this effect of methotrexate. It also The anti-inflammatory and immunomodulating inhibits antibody synthesis. Methotrexate also has effects of dimethyl fumarate and its metabolite immunosuppressive activity, in part possibly as a monomethyl fumarate are not fully elucidated but result of inhibition of lymphocyte multiplication. are thought to be mainly due to the interaction Indications with the intracellular reduced glutathione of cells For use in the control of severe recalcitrant psoriasis directly involved in the pathogenesis of psoriasis. which is not responsive to other forms of therapy. A This interaction with glutathione leads to the single, weekly oral, IM or IV dosage of 10-25mg is inhibition of translocation into the nucleus and recommended, which can be adjusted according to the transcriptional activity of the nuclear factor the patient’s response. kappa-light-chain-enhancer of activated B-cells Sizes (NF-κB). The main activity of dimethyl fumarate 2.5mg, 10mg and monomethyl fumarate is considered to be Price immunomodulatory, resulting in a shift in T helper £1.68—2.5mg (box of 28), £37.93—10mg (box of cells (Th) from the Th1 and Th17 profile to a Th2 100) phenotype. The inflammatory cytokine production is reduced with induction of proapoptotic events, Neoral inhibition of keratinocyte proliferation, reduced Novartis Pharmaceuticals UK Ltd expression of adhesion molecules, and diminished Description inflammatory infiltrate within psoriatic plaques. Neoral contains ciclosporin (also known as Indications ciclosporin A), which is a cyclic polypeptide For the treatment of moderate to severe psoriasis in

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adults in need of systemic medication. retinol and retinoic acid are capable of reversing Sizes hyperkeratotic and metaplastic skin changes. 30mg (42 tablets), 120mg (90 tablets and 180 However, these effects are generally only obtained tablets) at dosages associated with considerable local or Price systemic toxicity. Acitretin, a synthetic aromatic £89.04; £190.80; £381.60 derivative of retinoic acid, has a favourable therapeutic ratio, with a greater and more specific Otezla inhibitory effect on psoriasis and disorders of Celgene Limited epithelial keratinisation. The usual therapeutic Description response to acitretin consists of desquamation (with Apremilast, an oral small-molecule inhibitor of or without erythema) followed by more normal phosphodiesterase 4 (PDE4), works intracellularly re-epithelialisation. Acitretin is the main active to modulate a network of pro-inflammatory and metabolite of etretinate. anti-inflammatory mediators. PDE4 is a cyclic Indications adenosine monophosphate (cAMP)-specific PDE For the treatment of severe extensive psoriasis, and the dominant PDE in inflammatory cells. PDE4 which is resistant to other forms of therapy, inhibition elevates intracellular cAMP levels, which palmo-plantar pustular psoriasis, severe congenital in turn down-regulates the inflammatory response ichthyosis and severe Darier’s disease (keratosis by modulating the expression of TNF-α, IL- follicularis). 23, IL-17 and other inflammatory cytokines. Cyclic Sizes AMP also modulates levels of anti-inflammatory 10mg, 25mg cytokines such as IL-10. These pro- and anti- Price inflammatory mediators have been implicated in Contact supplier psoriatic arthritis and psoriasis. Indications Roaccutane For the treatment of moderate to severe chronic Roche Products Ltd plaque psoriasis in adult patients who failed to Description respond to or who have a contraindication to, or Isotretinoin is a stereoisomer of all-trans retinoic are intolerant to other systemic therapy including acid (tretinoin). The exact mechanism of action of cyclosporine, methotrexate or psoralen and isotretinoin has not yet been elucidated in detail, ultraviolet-A light (PUVA). Also for the treatment but it has been established that the improvement alone or in combination with disease modifying observed in the clinical picture of severe acne is antirheumatic drugs (DMARDs). associated with suppression of sebaceous gland Sizes activity and a histologically demonstrated reduction 20mg, 30mg in the size of the sebaceous glands. Furthermore, a Price dermal anti-inflammatory effect of isotretinoin has £550 (56 tabs); £265.18 (14-day treatment pack) been established. Indications Severe forms of acne (such as nodular or conglobate Retinoids (oral) acne or acne at risk of permanent scarring) resistant to adequate courses of standard therapy with Acitretin (Neotigason) 10mg systemic anti-bacterials and topical therapy. and 25mg Capsules Sizes Teva UK Capsules (soft)10mg, 20mg (30 cap) Description Price Retinol (Vitamin A) is known to be essential for £14.54; £20.02 normal epithelial growth and differentiation, though the mode of this effect is not yet established. Both www.dermatologyhandbook.co.uk

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Toctino Stiefel, a GSK Company Description Toctino contains a retinoid alitretinoin. The pharmacological action of retinoids may be explained by their effects on cell proliferation, cell differentiation, apoptosis, angiogenesis, keratinisation, sebum secretion and immunomodulation. Unlike other retinoids, which are specific agonists of either RAR or RXR receptors, alitretinoin binds to members of both receptor families. The mechanism of action of alitretinoin in chronic hand eczema is unknown. Alitretinoin has demonstrated immunomodulatory and anti-inflammatory effects that are relevant to skin inflammation. Indications For the treatment of adults who have severe chronic hand eczema that is unresponsive to treatment with potent topical corticosteroids. Patients in whom the eczema has predominantly hyperkeratotic features are more likely to respond to treatment than those in whom the eczema predominantly presents as pompholyx. Sizes 10mg, 30mg Price £411.43 (30 cap)

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These treatments target and treat skin disease in the epidermis through the stratum corneum, available in a variety of formulations depending on the area of the body and patient preference

ild-to-moderate inflammatory skin Agency (MHRA), which gives precise instructions conditions are treated with topical on the amount to be applied (and any potential side therapies. Topical therapy is prescribed effects). It is important for patients to follow these forM treatment and symptomatic relief, and sometimes precise instructions, as applying too much does not for maintenance to prevent flares. Topical treatments increase efficacy; conversely, patients often apply too target skin disease through the stratum corneum, with little owing to unfounded fears concerning topical potentially fewer side effects compared with systemic side effects, particularly with topical steroids, which therapy. is known as ‘steroid phobia’. A correct application Topical therapies are formulations with active of topical therapies is essential to minimise any ingredients that are delivered to the skin by a variety potential side effects. For example, one method for of vehicles, also referred to as bases. These include advising patients on the appropriate amount of topical creams, gels, liquids, lotions, ointments, pastes, paints corticosteroids is the fingertip unit (FTU). and solutions. The choice of vehicle is important, This is the amount of ointment or cream expressed as it may affect the degree of hydration of the skin, from a 5mm nozzle tube, applied from the distal finger have a mild anti-inflammatory effect and affect the crease to the tip of the palmer aspect of the index penetration of the active ingredient.1 The choice of finger. One FTU will cover an area equivalent to two vehicle is an essential factor in patient choice; for flat hand areas of the affected area.3 example, an ointment preparation is preferable for dry Patients may rarely experience sensitisation to and scaly skin, whereas a cream is preferable for moist certain topical therapies, which should be assessed areas. Scalp conditions are best treated with lotions, and recorded by the prescribing clinician. If a patient which are more effective on hairy areas. should be considered for dermatology referral, patch The penetration of the active ingredient into the skin testing may be required as an investigation. If a contact is influenced by several factors. These include body site; allergy is diagnosed by patch testing, topical treatments for example, the skin of the palms is very thick and the containing the excipient should be avoided.1 facial skin is more permeable than the rest of the body. Patient education and support is crucial so patients Increasing skin temperature will increase absorption of understand treatment expectations, and patient topical therapies. Dry skin will decrease absorption of adherence will be enhanced by a healthcare professional topical therapies, as thick plaques and scale will act as investing time in helping patients understand how a barrier. to use and apply topical treatments. Effectiveness of However, in certain skin conditions the skin loses topical treatments is often compromised by incorrect some of its protective features (such as in bullous application. Patients also need to understand how disorders). The relative solubility and concentration long to use a topical treatment for, and healthcare gradient of the active ingredient is variable within professionals should give patients realistic expectations the vehicle; one example is the different potencies of of when to expect a response to treatment. A practical topical corticosteroids.2 suggestion for reviewing a common skin condition Topical therapies include a patient information treated with topical treatment is 8 weeks for acne, 4 leaflet (PIL) in the product packaging produced weeks for psoriasis and 2 weeks for eczema. Labelling by the pharmaceutical company and regulated by can also be confusing and ‘Apply as directed’ is the Medicines and Healthcare products Regulatory ineffective, if directions are not given. For example,

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‘Use sparingly’ is no longer a direction contained 7. European Dermatology Forum. Guidelines on the treatment of acne. 2012. http://www.euroderm.org/ within the BNF; for topical steroids, the direction (accessed March 2021) ‘Apply thinly’ should be used. 8. Primary Care Dermatology Society (PCDS). PCDS In addition to explanation, a practical treatment pathways. https://tinyurl.com/va6638u (accessed demonstration of how to apply topical products should March 2021) be given. Patient education delivered well by nurses is key with topical therapies in all skin conditions. Current guidelines on the management of chronic inflammatory skin conditions, such as eczema,4,5 psoriasis6 and acne,7 are outlined in UK guidance. Treatment pathways for chronic inflammatory skin conditions (acne, eczema, psoriasis and rosacea) in primary care are available on the Primary Care Dermatology society website (PCDS).8 Non-proprietary tropical treatments include: hydrocortisone, betamethasone valerate, betamethasone valerate/clioquinol (Betnovate-C), betamethasone valerate/neomycin sulphate (Betnovate-N), ichthammol ointment BP, zinc and ichthammol cream, calcipotriol, betamethasone dipropionate and calcipotriol ointment, calamine and coal tar ointment BP, coal tar and salicylic acid ointment BP, coal tar paste BP, zinc and coal tar paste BP, coal tar solution BP, dithranol ointment BP, dithranol paste BP, zinc and salicylic acid paste BP, ketoconazole cream and shampoo, clotrimazole cream, terbinafine cream, aciclovir cream, benzyl benzoate application BP, cetrimide cream, proflavine cream, collodion flexible BP, potassium permanganate solution.

References 1. Joint Formulary Committee. Skin British National Formulary. British National Formulary. BNF 74 Online September 2018. https://tinyurl.com/ yc6d3wun (accessed March 2021) 2. Berth-Jones J. Topical Therapies. In Griffiths C, Barker J, Blekier T, Chalmers R, Creamer D (Eds) Rook’s Textbook of Dermatology (Edition 9). 2016; 18:1–15 3. Long CC, Finlay AY. The finger tip unit: A new practical measure. Clinical and Experimental Dermatology 1991; 16: 6, 444–447 4. National Institute for Health and Care Excellence (NICE). Atopic Eczema in Children: management of atopic eczema in children from birth up to the age of 12 years. NICE Clinical Guideline 57, 2007. https:// tinyurl.com/ov2fza6 (accessed March 2021) 5. Primary Care Dermatology Society (PCDS). Eczema— atopic eczema. https://tinyurl.com/krdcb9e (accessed March 2021) 6. National Institute for Health and Care Excellence (NICE). Psoriasis: assessment and management. Clinical guideline [CG153], 2012. https://tinyurl.com/ycddeobx (accessed March 2021)

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Acne treatments £5.56 Akincare Nicam Gel Skin Med Dermal Laboratories Ltd Description Description Akincare contains triethyl citrate 4% and ethyl Niacin (nicotinic acid) is an essential B complex linoleate 2%. vitamin (B3). Nicotinamide (niacinamide) is the Indications physiologically active form of niacin and has been For the treatment of acne. shown to have beneficial effects on inflammatory Sizes acne. It is considered that these effects are related to 5ml; 25ml; 50ml its significant anti-inflammatory activity. Price Indications £10.00; £13.00; £12.00 For the topical treatment of mild to moderate inflammatory acne vulgaris. Efracea Sizes Galderma (UK) 60g Description Price Efracea contains doxycycline, an antibacterial that £7.10 has been shown to inhibit neutrophil activity and several pro-inflammatory reactions, including those Quinoderm Cream / associated with phospholipase A2, endogenous Quinoderm Cream 5 nitric oxide and interleukin-6. It works by altering Alliance Pharmaceuticals Ltd the pathophysiology of the inflammatory lesions Description of rosacea that is, in part, a manifestation of a Quinoderm contains a combination of the mild neutrophil-mediated process. The OD 40mg keratolytic properties of benzoyl peroxide and the modified release is designed to stay below the antibacterial and antifungal properties of potassium antimicrobial threshold to reduce commonly hydroxyquinoline sulfate in a specially formulated occurring side effects, while retaining an anti- bland water-miscible base. inflammatory action. Indications Indications For acne vulgaris, acneform eruptions, folliculitis. For the reduction of papulopustular lesions in adult Sizes patients with facial rosacea. 5% 50g, 10% 25g and 50g Sizes Price Capsules (50mg), Capsules – modified release Contact supplier (40mg)14 caps, 56 caps Price Antibacterials (acne) £7.99, £21.71 Cepton Medicated Skin Wash Freederm Treatment Boston Healthcare Ltd Diomed Developments Description Description Cepton Medicated Skin Wash Contains nicotinamide (40mg per 1g). contains 1% chlorhexidine. Sizes Indications 25g Treatment and prevention of spots Price and acne.

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Sizes Indications 150ml For the relief of mild to moderate papular-pustular Price acne of the facial area and for the topical treatment £31.45 of papulopustular rosacea. Sizes Dalacin T 30g Pfizer Ltd Price Description £7.48 Dalacin T is an anti-infective treatment for acne. The active constituent, clindamycin, is a known Skinoren antibiotic. Bayer PLC When applied topically, it is found in comedone Description samples at sufficient levels to be active against most Skinoren contains azelaic acid, which inhibits the strains of Propionibacteria acnes. growth of the Propionibacteria involved in the Indications development of acne and the production of acne- For the treatment of acne vulgaris. promoting fatty acids. Azelaic acid also reduces the Sizes multiplication and keratinisation of keratinocytes, Lotion: 30ml, 60ml. and therefore restricts the formation of comedones. Topical solution: 30ml, 50ml Indications Price For the treatment of acne vulgaris. £5.08, £10.16 (lotion); £4.34, £7.23 (topical Sizes solution) 30g Price Zineryt £4.49 (Skinoren); £3.23 (Scheriproct ointment); Astellas Pharma Ltd £1.52 (Scheriproct suppositories) Description Zineryt contains a combination of erythromycin Benzoyl peroxide and zinc. Erythromycin is known to be efficacious, at 4%, in the topical treatment of acne vulgaris. Acnecide The topical use of zinc is established as an aid to Galderma (UK) wound healing. The zinc acetate is solubilised by Description complexing with the erythromycin, and delivery is Acnecide is a 5% preparation of benzoyl peroxide, enhanced by the chosen vehicle. which is an established and effective keratolytic Indications agent with antibacterial properties. It has been For the topical treatment of acne vulgaris. shown to be effective in reducing the local Sizes population of Propionibacterium acnes, leading to a 30ml, 90ml reduction in the production of irritant fatty acids in Price the sebaceous glands. £9.25, £20.02 Indications For the treatment of acne vulgaris. Azelaic acid Sizes 30g; 60g Finacea Price Bayer PLC £5.44; £10.68 Description Finacea contains azelaic acid, an antimicrobial that Subscribe to JWC visit has a direct effect on follicular hyperkeratosis as a therapy for acne. www.magsubscriptions.com

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Benzoyl peroxide/antibacterial Price combinations £12.50 Duac Once Daily Benzoyl peroxide/retinoid Stiefel, a GSK Company combinations Description Duac Once Daily gel has a combination of mild Epiduo Gel keratolytic and antibacterial properties that act Galderma (UK) against inflamed lesions of mild to moderate acne Description vulgaris. Benzoyl peroxide is mildly keratolytic, Epiduo contains a combination of adapalene and acting against comedones at all stages of their benzoyl peroxide. Adapalene is a retinoid-like development. It is an oxidising agent with compound that is a potent modulator of cellular bactericidal activity against Propionibacterium differentiation and keratinisation and has anti- acnes, the organism implicated in acne vulgaris. It is inflammatory properties. This profile suggests that also sebostatic, counteracting the excessive sebum the cell-mediated inflammatory component of production associated with acne. Clindamycin is acne is reduced by adapalene. Benzoyl peroxide a lincosamide antibiotic with bacteriostatic action has been shown to have antimicrobial activity, against Gram-positive aerobes and a wide range of particularly against Propionibacterium acnes, anaerobic bacteria. which is abnormally present in the acne-affected Indications pilosebaceous unit. In addition, benzoyl peroxide For mild to moderate acne vulgaris, particularly has demonstrated exfoliative and keratolytic inflammatory lesions. activities and is sebostatic, counteracting the Sizes excessive sebum production associated with acne. GelDuac 3% (clindamycin phosphate 1%/Benzoyl Indications peroxide 3%): 30g, 60g For the cutaneous treatment of comedones, papules Duac 5% (clindamycin phosphate 1%/Benzoyl and pustules in acne vulgaris. peroxide 5%): 30g, 60g Sizes Price 45g Duac 3%: £13.14 – 30g, £26.28 – 60g Price Duac 5%: £13.14 – 30g, £26.28 – 60g £19.53 Retinoid/antibacterial Effaclar A.I. Breakout combinations Corrector La Roche Posay Aknemycin Plus Description Almirall Ltd Targeted breakout corrector for individual Description blemishes. For oily, blemish-prone skin. An Aknemycin Plus is a combination of a retinoid easy-to-apply, quickly absorbed, targeted SOS and antibacterial in an alcohol base that dissolves treatment to help reduce the appearance of localised sebum. The retinoid tretinoin acts topically as imperfections and blemishes and prevent residual a keratolytic agent by markedly increasing cell marks. Suitable for sensitive skin. Enriched with turnover in the cornified epithelium, including the Niacinamide, Piroctone Olamine and LHA. epithelium of the follicular ducts and comedones. Indications In the first instance, skin irritation, erythema For oily skin and sensitive skin prone to breakouts. and increased vascularisation occur, followed by Helps prevent residual marks from acne. thickening and desquamation of the epithelium. The Sizes renewal time of the cornified epithelium is therefore 15ml shortened. Erythromycin is a macrolide antibiotic

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with bacteriostatic action on all pathogens involved in Isotrexin is eff ective against erythromycin- in the development of acne. When applied topically, resistant strains of P. acnes. Isotrexin is eff ective in it also eff ects a reduction in the concentration treating both infl ammatory and non-infl ammatory of skin surface lipids and shows a direct anti- lesions. Th e isotretinoin component treats the infl ammatory eff ect . comedonal phase of the disease. Th e erythromycin Indications component is eff ective in the treatment of moderate For the treatment of all forms of acne, both infl ammatory acne vulgaris . non-infl ammatory forms with comedones and Indications infl ammatory forms with papules and pustules, For the topical treatment of moderate acne . particularly those associated with very oily skin . Sizes Sizes 30g 25ml Price Price £7.47 £7.05 Treclin Isotrexin Mylan Stiefel, a GSK Company Description Description Treclin is a combination therapy of clindamycin Isotrexin contains both isotretinoin and and tretinoin. Clindamycin is a semisynthetic erythromycin. Isotretinoin is structurally and derivative of the parent compound lincomycin pharmacologically related to vitamin A, which that is produced by Streptomyces lincolnensis and regulates epithelial cell growth and diff erentiation. is predominantly bacteriostatic. Topical tretinoin Th e pharmacological action of isotretinoin has both comedolytic and anti-infl ammatory has not been fully determined. When used eff ects. Tretinoin decreases cohesiveness of systemically, it suppresses sebaceous gland activity follicular epithelial cells resulting in decreased and reduces sebum production. It also aff ects microcomedone formation. Additionally, tretinoin comedogenesis, inhibits follicular keratinisation, stimulates mitotic activity and increased turnover suppresses Propionibacterium acnes and reduces of follicular epithelial cells, causing extrusion of the infl ammation. It is thought that topically applied comedones. isotretinoin stimulates mitosis in the epidermis, Indications reduces intercellular cohesion in the stratum For the topical treatment of acne vulgaris when corneum, contests the hyperkeratosis characteristics comedones, papules and pustules are present in of acne vulgaris and aids desquamation, preventing patients 12 years or older . the formation of lesions. It is also thought that it Sizes mediates the increased production of less cohesive 30g epidermal sebaceous cells. Th is appears to promote Price the initial expulsion and subsequent prevention £11.94 of comedones. Erythromycin is a macrolide antibiotic that acts by interfering with bacterial Retinoids (topical) protein synthesis by reversibly binding to ribosomal subunits, thereby inhibiting translocation of Differin aminoacyl transfer-RNA and inhibiting polypeptide Galderma (UK) synthesis. In the treatment of acne, it is eff ective Description because it reduces the population of P. acnes and Adapalene is a retinoid-like compound that has prevents the release of infl ammatory mediators been demonstrated to have anti-infl ammatory by the bacteria. Resistance of P. acnes to topical properties. erythromycin can occur, but there is evidence that Indications the combination of erythromycin and isotretinoin For the cutaneous treatment of mild to moderate

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acne vulgaris where comedones, papules and Antibacterials (antiseptics pustules predominate. and antibiotics) Sizes 45g Anabact Price Cambridge Healthcare Supplies Ltd £16.43 Description Anabact contains 0.75% metronidazole, which is an established antibacterial agent. It is effective against Alopecia treatments a variety of organisms including anaerobic bacteria, which are responsible for the distressing symptoms Regaine of malodorous thickness wounds. McNeil Products Indications Description For the deodorisation of malodorous fungating Regaine for Men Extra Strength Scalp Foam 5% tumours, gravitational ulcers and pressure ulcers. w/w Minoxidil and Solution contain 5% of the Sizes active ingredient, minoxidil. Regaine for Women 15g, 30g, 40g (gel) contains 2% minoxidil. The mechanism by which Price minoxidil stimulates hair growth is not fully £5.64, £7.89, £15.89 (DT) understood, but it can reverse the hair-loss process of androgenetic alopecia by the following means: Bactroban increasing the diameter of the hair shaft, stimulating GlaxoSmithKline UK anagen growth, prolonging the anagen phase, and Description stimulating anagen recovery from the telegon Bactroban contains mupirocin, an antibiotic. It has phase. A peripheral vasodilator, minoxidil enhances bacteriostatic properties at minimum inhibitory microcirculation to hair follicles. It also stimulates concentrations and bactericidal properties at the expression of vascular endothelial growth factor higher concentrations reached when applied locally. (VEGF), which is indicative of the high metabolic Indications activity observed during the anagen phase. Bactroban 2% cream: indicated for the topical Indications treatment of secondarily infected traumatic lesions Regaine for Men Extra Strength Scalp Foam and such as small lacerations, sutured wounds or Solution are for hereditary hair loss in men aged abrasions (up to 10cm in length or 100cm2 in area), 18–49 (foam) and 18–65 (solution). It is for external due to susceptible strains of Staphylococcus aureus use only and, when used twice a day every day for and Streptococcus pyogenes. between 8 and 16 weeks, 9 out of 10 men say they Bactroban 2% nasal ointment: the elimination kept or re-grew their hair. Regaine for Women is for of nasal carriage of staphylococci, including hereditary hair loss in women aged 18–65. methicillin resistant Staphylococcus aureus Sizes (MRSA). Solution products–60ml (3x60ml). Foam Product– Bactroban ointment 2%: skin infections, eg 73ml equivalent of 60g (3x73ml) Staphylococcus aureus, including methicillin- Price resistant strains, other staphylococci, streptococci. It Contact supplier is also active against Gram-negative organisms such as Escherichia coli and Haemophilus influenzae. Bactroban Ointment is used for skin infections, eg Subscribe to impetigo, folliculitis, furunculosis. Sizes Practice Nursing 15g (cream and ointment), 3g (nasal ointment) www.magsubscriptions.com Price £5.26 (cream and ointment), £4.24 (nasal ointment)

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Betadine Dry Powder Spray Price Ayrton Saunders Ltd £0.63 Description Povidone Iodine 2.5% w/w dry powder spray. Care Hydrogen Peroxide Indications Solution 6% Antiseptic for the treatment and prevention of Thornton & Ross infection in wounds including ulcers, burns, cuts Description and other minor injuries. A mild disinfectant to use as a mouthwash or gargle Sizes for people over 12 years old, or as an effective way 100ml to disinfect minor cuts, wounds and skin ulcers Price on adults, children and the elderly. Pregnant or £9.95 breastfeeding mothers should only use if advised by the doctor. Canesten Hydrocortisone Indications Bayer PLC For use as a mild skin disinfectant, mouthwash or Description gargle. Canesten Hydrocortisone is a combination Sizes of clotrimazole and hydrocortisone acetate. 200ml Clotrimazole belongs to a group of medicines called Price imidazoles, which destroy the fungi and some £0.67 bacteria that cause skin infections. Hydrocortisone acetate is a mild steroid which reduces swelling, Care Hydrogen Peroxide redness and itching associated with inflammation Solution 9% of the skin. Thornton & Ross Indications Description Treatment of inflamed athlete’s foot and fungal A mild disinfectant to use as a mouthwash or gargle sweat rash when accompanied by inflammation and for people over 12 years old, or as an effective way itching. to disinfect minor cuts, wounds and skin ulcers Sizes on adults, children and the elderly. Pregnant or 15g breastfeeding mothers should only use if advised by Price the doctor. £3.26 (Trade price) Indications For use as a mild skin disinfectant, mouthwash or Care Hydrogen Peroxide gargle. Solution 3% Sizes Thornton & Ross 200ml Description Price A mild disinfectant to use as a mouthwash or gargle £0.72 for people over 12 years old, or as an effective way to disinfect minor cuts, wounds and skin ulcers Care Magnesium Sulfate Paste on adults, children and the elderly. Pregnant or BP breastfeeding mothers should only use if advised by Thornton & Ross the doctor. Description Indications A drawing paste for minor skin infections, For use as a mild skin disinfectant, mouthwash or including boils. The whole family can benefit from gargle. Magnesium Sulfate Paste BP. Sizes Indications 200ml For the treatment of boils and minor skin infections.

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Sizes systemic therapy, in the treatment of primary 50g and secondary skin infections caused by sensitive Price strains of Staphylococcus aureus, Streptococcus £1.97 spp. and Corynebacterium minutissimum. Primary skin infections that may be expected to respond to Cetavlex Cream treatment with fusidic acid applied topically include: Derma UK impetigo contagiosa, superficial folliculitis, sycosis Description barbae, paronychia and erythrasma; also such Cetavlex Cream is an antiseptic cream. It contains secondary skin infections as infected eczematoid Cetrimide 0.5% w/w, which has shown to be active dermatitis, infected contact dermatitis and infected against a wide range of bacteria. cuts/abrasions. Indications Sizes Skin disorders such as minor wounds, minor burns, 15g, 30g abrasions and napkin rash. Price Sizes £2.68 – 15g, £4.55 – 30g 50g Price £2.75 (DT) Antifungals (topical) Crystacide Cream 1% Canesten Reig Jofre UK Ltd Bayer PLC Description Description Crystacide contains 1% hydrogen peroxide, which Canesten contains clotrimazole, which is an is a well-known antiseptic agent, and is effective imidazole derivative with a broad spectrum of against most pathogenic microorganisms. antimycotic activity that includes dermatophytes, Indications yeasts and moulds. The mode of action of For the treatment of primary and secondary clotrimazole is fungistatic or fungicidal, depending superficial skin infections caused by organisms on the concentration of clotrimazole at the site of sensitive to hydrogen peroxide. infection. Primarily resistant variants of sensitive Sizes fungal species are very rare; the development 25g, 40g of secondary resistance by sensitive fungi has Price been observed only in very isolated cases under Contact supplier therapeutic conditions. Indications Fucidin For the treatment of all dermatomycoses due to LEO Pharma moulds and other fungi (e.g. Trichophyton spp.); all Description dermatomycoses due to yeasts (Candida spp.); skin Fucidin contains fusidic acid, a potent antibacterial diseases showing secondary infection with these agent. Fusidic acid and its salts show fat and fungi; candidal nappy rash, vulvitis, balanitis, and water solubility and strong surface activity, and intetrigo. exhibit an unusual ability to penetrate intact skin. Sizes Concentrations of 0.03–0.12mcg fusidic acid per 20g, 50g (cream); 20ml (solution); 40ml (pump ml inhibit nearly all strains of Staphylococcus spray) aureus. Topical application is also effective against Price streptococci, corynebacteria, niesseria and certain £2.20, £3.64 (cream); £2.53 (solution); £4.72 (pump clostridia. spray) (Trade price) Indications Indicated either alone or in combination with To advertise call 020 7333 1741

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Daktarin Lamisil AT Spray McNeil Products GlaxoSmithKline Consumer Healthcare Description Description Daktarin contains miconazole nitrate, an imidazole Lamisil contains terbinafine, an allylamine which antifungal agent that may act by interfering with has a broad spectrum of antifungal activity. At low the permeability of the fungal cell membrane. It concentrations terbinafine is fungicidal against possesses a wide antifungal spectrum and has some dermatophytes, moulds. Its activity against yeasts antibacterial activity. is fungicidal or fungistatic, depending on the Indications species. Terbinafine interferes specifically with For the treatment of athlete’s foot; for the treatment fungal sterol biosynthesis at an early step. This leads of mycotic infections of the skin and nails and to a deficiency in ergosterol and an intracellular superinfections due to Gram-positive bacteria. The accumulation of squalene, resulting in fungal cell oral gel is indicated for oral treatment of fungal death. infections of the oropharynx and gastrointestinal Indications tract. The treatment of tinea pedis (athlete’s foot) and Sizes tinea cruris caused by Trichophyton (eg, T. rubrum, Cream (30g); spray (100g); powder (20g), gel (15g, T. mentagrophytes, T. verrucosum, T. violaceum) 80g) and Epidermophyton floccosum. Price Sizes £1.82; £2.58; £3.17; £3.23 (gel 15g); £4.38 (gel 80g) 15ml, 30ml (1% spray) Price Lamisil AT Gel £5.88 GlaxoSmithKline Consumer Healthcare Description Lamisil Once cutaneous Lamisil contains terbinafine, an allylamine which solution has a broad spectrum of antifungal activity. At low GlaxoSmithKline Consumer Healthcare concentrations terbinafine is fungicidal against Description dermatophytes and moulds. The activity against Lamisil contains terbinafine, an allylamine which yeasts is fungicidal or fungistatic, depending on has a broad spectrum of antifungal activity. At low the species. Terbinafine interferes specifically with concentrations terbinafine is fungicidal against fungal sterol biosynthesis at an early step. This leads dermatophytes, moulds. Its activity against yeasts to a deficiency in ergosterol and an intracellular is fungicidal or fungistatic, depending on the accumulation of squalene, resulting in fungal cell species. Terbinafine interferes specifically with death. fungal sterol biosynthesis at an early step. This leads Indications to a deficiency in ergosterol and an intracellular The treatment of tinea pedis (athlete’s foot), tinea accumulation of squalene, resulting in fungal cell cruris and tinea corporis (ringworm) caused by death. Trichophyton (eg, T. rubrum, T. mentagrophytes, Indications T. verrucosum, T. violaceum) and Epidermophyton Treatment for tinea pedis (athlete’s foot). Indicated floccosum. for adults (18 years of age and over). Sizes Sizes 15g 4g Price Price £6.41 £10.21

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Loceryl and adults: wash affected areas and leave for 3-5 Galderma (UK) minutes before rinsing. Usually, a palmful of Description shampoo suffices for one wash. Loceryl is a topical antimycotic that contains Sizes amorolfine belonging to a new chemical class its 60ml; 100ml; 120ml fungicidal action is based on an alteration of the Price fungal cell membrane, targeted primarily on sterol Contact supplier biosynthesis. The ergosterol content is reduced, and at the same time unusual sterically non-planar Nystatin sterols accumulate. Amorolfine is a broad-spectrum Typharm antimycotic. It is highly active against yeast, Description dermatophytes, moulds, dermatiacea and dimorphic Nystatin (formally Nystaform) contains a fungi. combination of nystatin and chlorhexidine. Nystatin Indications is a fungistatic and fungicidal antibiotic, primarily For the treatment of onychomycosis caused by effective against Candida albicans. Chlorhexidine is dermatophytes, yeasts and moulds. active against a wide range of bacteria. Sizes Indications 2.5ml, 5ml For the treatment of infected dermatoses where Price fungal (particularly monilial) and/or bacterial £7.26; £9.08 infections are present. Sizes Mycota 30g Thornton & Ross Price Description £4.99 (DT) An SLS free, 2-in-1 leave on emollient and wash that adds moisture to the skin for the relief of flaking dry Pevaryl skin conditions. Janssen-Cilag Ltd Indications Description For use as an effective emollient and as a skin Pevaryl contains econazole nitrate, which is a cleanser for the relief of flaking dry conditions. broad-spectrum antimycotic with activity against Sizes dermatophytes, yeasts and moulds. A clinically Cream (25g); powder (75g) relevant action against Gram-positive bacteria has Price also been found. £3.30; £4.90 Indications For the treatment of fungal infections of the skin. Nizoral Anti-dandruff Shampoo Sizes Thornton & Ross 30g Description Price Nizoral with Ketoconazole combats the fungus that Contact supplier causes dandruff and quickly relieves from itching and flaking. Clinically proven to control itching and Trosyl Nail solution flaking. For freedom from dandruff (treatment and Pfizer Ltd prevention). Starts working from the first hair wash. Description Can give visible results in 2 weeks. Tioconazole is an imidazole that is active Indications against commonly occurring dermatophyte For the prevention and treatment of the scalp and yeast-like fungal species. It is fungicidal in condition dandruff. For topical administration. murine models vs Candida spp., T. rubrum and Ketoconazole shampoo 2% is for use in adolescents T. mentacrophytes. In vitro, it is fungicidal to

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pathenogenic dermatophytes, yeasts and other Price fungi. £13.50 (DT) Indications For the topical treatment of nail infections due to Zovirax susceptible fungi (dermatophytes and yeasts) and GlaxoSmithKline UK bacteria. Description Sizes Zovirax contains aciclovir, which is an antiviral Solution 285 mg/ml (12 ml) agent that is highly active in vitro against herpes Price simplex virus (HSV) types I and II and varicella £27.38 zoster virus (including initial and recurrent genital herpes and herpes labialis). Indications Antivirals (topical) Zovirax Tablets 200mg: indicated for the treatment of herpes simplex virus infections of the skin and Fenistil Cold Sore Cream mucous membranes, including initial and recurrent Omega Pharma genital herpes (excluding neonatal HSV and severe Description HSV infections in immunocompromised children), Fenistil contains penciclovir, which has suppression (prevention of recurrences) of recurrent demonstrable in vivo and in vitro activity herpes simplex infections in immunocompetent against herpes simplex viruses (types 1 and 2) patients, prophylaxis of herpes simplex infections and varicella zoster virus. In virus-infected cells in immunocompromised patients and treatment of penciclovir is rapidly and efficiently converted varicella (chickenpox) and herpes zoster (shingles) into a triphosphate (mediated via virus-induced infections. thymidine kinase). Zovirax tablets 800mg: indicated for the treatment Indications of varicella (chickenpox) and herpes zoster Fenistil Cold Sore Cream is indicated for the (shingles) infections (excluding neonatal HSV and treatment of herpes simplex virus infections of the severe HSV infections in immunocompromised lips and face (herpes labialis) in adults and children children). Recommended in children over the age over 12 years of age. of 6. Sizes Zovirax cream: indicated for the topical treatment 2g of herpes simplex virus infections of the skin, Price including initial and recurrent genital herpes and £3.70 herpes labialis. Do not use in eyes. Zovirax I.V.: indicated for the treatment of herpes MolluDab simplex infections in immunocompromised Alliance Pharmaceuticals Ltd patients and severe initial genital herpes in the Description non-immunocompromised, prophylaxis of herpes MolluDab is used externally against molluscum simplex infections in immunocompromised contagiosum, a skin lesion caused by a virus. patients, treatment of varicella zoster infections, MolluDab causes cells which are affected by the herpes encephalitis and herpes simplex infections in virus to dissolve and thereby produces a defence the neonate and infant up to 3 months of age. reaction of the skin in the region affected by Sizes molluscum contagiosum. 2g, 10g (cream); 200mg (25 tabs), Indications 800mg (35 tabs) For the treatment of molluscum contagiosum. Price Sizes £4.63, £13.96 (cream); £2.85 (25 tabs), £10.50 (35 2ml tabs); £16.70 (infusions 250mg powder in vial, 5); £17.00 (500mg powder in vial, 5)

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Corticosteroid compounds Corticosteroid scalp preparations Corticosteroid compounds - Mild potency (group 1) Corticosteroid scalp preparations - Potent (group 3) Eurax HC Cream Thornton & Ross Betacap Scalp Application Description Dermal Laboratories Ltd Eurax HC Cream's dual action formula works to Description provide fast relief from itching that lasts up to 10 Betacap Scalp Application complies with the hours, while also reducing inflammation and swelling. specification given in the monograph for Indications betamethasone valerate scalp application BP. For relief of inflammation and itching associated Betacap Scalp Application includes a coconut- with: mild to moderate eczema, dermatitis, and oil related emollient ingredient to reduce the insect bites. drying effect that a standard alcoholic vehicle Sizes may otherwise have on the scalp. The vehicle also 15g contains isopropyl alcohol, which has antiseptic Price activity. £2.17oi Indications For the topical treatment of dermatoses of the scalp, Corticosteroid compounds – such as psoriasis and seborrhoeic dermatitis, that Potent (group 3) are unresponsive to less potent corticosteroids. Sizes Diprosalic Ointment 100ml Organon Pharma (UK) Limited Price Description £3.75 Diprosalic contains betamethasone dipropionate, a synthetic fluorinated corticosteroid equivalent to Betnovate Scalp Application 0.05% betamethasone. It also contains 3% salicylic GlaxoSmithKline UK acid. It is active topically, and produces a rapid and Description sustained response in inflammatory dermatoses that Betamethasone valerate is potent corticosteroid normally respond to topical corticosteroid therapy. with topical anti-inflammatory activity and It is also effective in less responsive conditions, such pruritic manifestations of steroid responsive as psoriasis of the scalp and chronic plaque psoriasis dermatoses. of the hands and feet, but not in widespread plaque Indications psoriasis. Topical salicylic acid softens keratin, Steroid-responsive dermatoses of the scalp, such loosens cornified epithelium and desquamates the as psoriasis and seborrhoeic capitis, inflammation epidermis allowing more rapid access to the dermis associated with severe dandruff. than when applying steroid alone. Sizes Indications Scalp application (100ml) For the treatment of hyperkeratotic and dry Price corticosteroid-responsive dermatoses where the £4.99 cornified epithelium may resist penetration of the steroid. Clinical and practical Sizes titles for healthcare 30g, 100g professionals Price Contact supplier www.quaybooks.co.uk

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Bettamousse Indications RPH Pharmaceuticals AB For short-course treatment of steroid-responsive Description dermatoses of the scalp, such as psoriasis, that do Bettamousse contains betamethasone, a not respond satisfactorily to less active steroids . glucocorticosteroid that has topical anti- Sizes infl ammatory activity . 100g Indications Price For steroid-responsive dermatoses £11.06 of the scalp, such as psoriasis. Sizes Dermovate Scalp Application 100g GlaxoSmithKline UK Price Description £9.75 Dermovate contains clobetasol propionate, a highly active corticosteroid with topical anti-infl ammatory Diprosalic Scalp Application activity. Th e major eff ect of clobetasol propionate on Organon Pharma (UK) Limited skin is a non-specifi c anti-infl ammatory response, Description which is partially due to vasoconstriction and Diprosalic scalp applications contain the decrease in collagen synthesis . dipropionate ester of betamethasone, equivalent Indications to 0.5% betamethasone, which is a glucocorticoid Use in short courses for conditions which do not synthetic fl uorinated corticosteroid exhibiting the respond satisfactorily to less active steroids. Indicated general properties of corticosteroids, and 2.0% for use in steroid responsive dermatoses of the scalp, w/w salicylic acid, which has keratolytic properties. such as psoriasis and recalcitrant dermatoses . Th e lotion is applied topically to the scalp in the Sizes treatment of hyperkeratotic and scaling conditions, 30ml, 100ml where its keratolytic action facilitates penetration of Price the corticosteroid. £3.07 (30ml), £10.42 (100ml) Indications For the treatment of hyperkeratotic and dry corticosteroid-responsive dermatoses of the Corticosteroid/antibacterial scalp where the cornifi ed epithelium may resist combinations penetration of the steroid. Sizes Corticosteroid/antibacterial - 100ml Mild potency (group 1) Price Contact supplier Canesten HC Bayer PLC Corticosteroid scalp Description preparations - Very potent Canesten HC is a broad-spectrum antimycotic and (group 4) is a combination of clotrimazole (an imidazole derivative) and hydrocortisone (a glucocorticoid). Clarelux Clotrimazole is a broad-spectrum antifungal. Pierre Fabre It also exhibits activity against Trichomonas, Description Staphylococcus, Streptococcus and Bacteroides. Clarelux is a very potent topical corticosteroid Indications containing clobetasol propionate. It has anti- For the rapid relief of skin infections with infl ammatory, antipruritic and vasoconstrictive coexisting symptoms of infl ammation, such as properties. itching, including all dermatomycoses caused by

138 Dermatology Handbook 2021–2022 Topical treatments BettamousseTM 1mg/g (0.1%) Cutaneous foam Betamethasone BettamousseTM is used for the treatment of steroid-responsive dermatoses of the scalp, such as psoriasis. Topical application by massaging into the affected areas. Contains betamethasone valerate, a glucocorticosteroid which has topical anti-infl ammatory activity. BettamousseTM is a registered trademark of RPH Pharmaceuticals AB.

Product Information License Number: PL 36301/0036 Supply classifi cation: POM MA Holder: RPH Pharmaceuticals AB, Box 603, 101 32 Stockholm, Sweden. Information about this product, including adverse reactions, precautions, contra-indications, and method of use can be found at: www.medicines.org/emc

For any enquiries please contact RPH Pharmaceuticals AB [email protected] Tel: 0845 023 0467 www.recipharm.com

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dermatophytes (e.g. Trichophyton spp.), moulds and (Ointment—30g) other fungi, all dermatomycoses caused by yeasts (Candida spp.), skin diseases showing secondary Fucidin H Cream infection with these fungi and the treatment of LEO Pharma nappy rash where infection is due to Candida Description albicans, candidal vulvitis, candidal balanitis and Fucidin H Cream combines the potent topical candidal intertrigo. antibacterial action of fusidic acid with the Sizes anti-inflammatory and antipruritic effects of 30g hydrocortisone. Concentrations of 0.03–0.12µg/ Price ml of fusidic acid inhibit nearly all strains of £2.42 (Trade price) Staphylococcus aureus. Topical application of fusidic acid is also effective against Streptococcus, Daktacort Corynebacterium, Neisseria and certain clostridia. Janssen-Cilag Ltd Indications Description Fucidin H cream is indicated in eczema and Daktacort is a compound of hydrocortisone and dermatitis with secondary bacterial infections, miconazole nitrate. Miconazole is a potent broad- including atopic eczema, primary irritant spectrum antifungal and antibacterial agent with dermatitis, and allergic and seborrhoeic marked activity against dermatophytes, pathogenic dermatitis where the organisms responsible are yeasts (e.g. Candida spp.) and many Gram-positive known to be or are believed to be sensitive to bacteria, including most strains of Streptococcus fusidic acid. and Staphylococcus. Hydocortisone is a widely used Sizes topical anti-inflammatory of value in the treatment 30g, 60g of inflammatory skin conditions including atrophic Price and infantile eczema, contact sensitivity reactions £6.02 –30g, £12.05 – 60g and intertrigo. Indications Nystatin HC For the topical treatment of inflamed dermatoses Typharm where infection by susceptible organisms and Description inflammation coexist, e.g. intertrigo and infected Nystatin HC (formally Nystaform HC) contains eczema. Moist or dry eczema or dermatitis a combination of nystatin, chlorhexidine and including atopic eczema, primary irritant or contact hydrocortisone. Nystatin is a fungistatic and allergic eczema or seborrhoeic eczema, including fungicidal antibiotic that is primarily effective against that associated with acne. Intertriginous eczema Candida albicans. Chlorhexidine is effective against including inframammary intertrigo, perianal and a wide range of bacteria. Hydrocortisone exercises a genital dermatitis. Organisms that are susceptible vasoconstrictive effect, thus reducing inflammation to miconazole are dermatophytes and pathogenic and oedema, and has an antipruritic effect. yeasts (e.g. Candida spp.). Also, many Gram-positive Indications bacteria including most strains of Streptococcus and For the treatment of infected dermatoses where Staphylococcus. The properties of Daktacort indicate fungal (particularly monilial) and/or bacterial it is particularly for the initial stages of treatment. infections are present. Once the inflammatory symptoms have disappeared Sizes (after about 7 days), treatment can be continued where 30g necessary with Daktarin Cream or Daktarin Powder. Price Sizes £5.29 (DT) Cream—15g, 30g. Ointment—30g Price To advertise call 020 7333 1741 £3.17 (Cream—15g), £2.49 (Cream—30g), £2.50

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Terra-Cortril Ointment Corticosteroid/antibacterial - Intrapharm Laboratories Moderate potency (group 2) Description Terra-Cortril Ointment possesses both the anti- Trimovate inflammatory activity of 1% hydrocortisone and Ennogen Pharma Ltd the broad-spectrum antibacterial activity of 3% Description oxytetracycline, which is active against a wide Trimovate contains clobetasone butyrate, a topically variety of Gram-positive and Gram-negative active corticosteroid, combined with antibiotics organisms. (nystatin and oxytetracycline), providing a broad Indications spectrum of antibacterial and anti-candidal activity Terra-Cortril Ointment is indicated for adults in against many of the organisms associated with the following disorders: exuding and secondarily infected dermatoses. infected eczema including atopic eczema, primary Indications irritant dermatitis, allergic and seborrhoeic For the treatment and management of steroid- dermatitis. responsive dermatoses where candidal or bacterial Sizes infection is present or suspected or likely to occur, 30g and the use of a more potent topical corticosteroid Price is not required. These include infected eczemas, £5.01 intertrigo, napkin rash, anogenital pruritis and seborrhoeic dermatitis. Timodine Sizes Alliance Pharmaceuticals Ltd 30g Description Price For the treatment of dermatoses, including £12.45 intertrigo, eczema, seborrhoeic dermatitis, atopic dermatitis, and pruritis ani et vulvae, in which Corticosteroid/antibacterial - infection with Candida albicans is a factor. For the Potent (group 3) treatment of severe nappy rash in which infection with C. albicans is a factor. Fucibet Cream Indications LEO Pharma For the treatment of dermatoses, including Description intertrigo, eczema, seborrhoeic dermatitis, Fucibet Cream combines the well-known ‘housewife’s’ eczema, and pruritis ani et vulvae, in anti-inflammatory and antipruritic effects of which infection with Candida albicans is a factor. betamethasone with the topical antibacterial action For the treatment of severe nappy rash in which of fusidic acid. Betamethasone valerate is a topical infection with C. albicans is a factor. steroid that is rapidly effective in inflammatory Sizes dermatoses that normally respond to this form of 30g therapy. More refractory conditions can often be Price treated successfully. When applied topically, fusidic £3.37 (DT) acid is effective against Staphylococcus aureus, Streptococcus, Corynebacterium, Neisseria and certain clostridia and Bacteroides. Concentrations Independent Nurse of 0.03-0.12µg/ml inhibit nearly all strains of S. Register for free access to news aureus. The antibacterial activity of fusidic acid is not diminished in the presence of betamethasone. and features Indications www.independentnurse.co.uk Fucibet Cream is indicated for the treatment of eczematous dermatoses including atopic eczema,

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infantile eczema, discoid eczema, stasis eczema, contact albicans. eczema and seborrhoeic eczema when secondary Sizes bacterial infection is confirmed or suspected. 2g; 5g (professional sample packs); 15g; 30g; 50g Sizes Price Cream: 30g, 60g Contact supplier Price £6.38—30g, £12.76—60g Synalar C Reig Jofre UK Ltd Fucibet Lipid Cream Description LEO Pharma Synalar contains fluocinolone acetonide (a synthetic Description anti-inflammatory corticosteroid), and clioquinol Fucibet Lipid Cream combines the well-known (a broad-spectrum antifungal and antibacterial anti-inflammatory and antipruritic effects of agent). Its mechanism of action is related to betamethasone with the topical antibacterial action vasoconstriction and suppression of membrane of fusidic acid. Betamethasone valerate is a topical permeability, miotic activity, the immune response steroid that is rapidly effective in inflammatory and release of inflammatory mediators. dermatoses that normally respond to this form of Indications therapy. More refractory conditions can often be For the treatment of inflammatory dermatoses treated successfully. When applied topically, fusidic including eczema, dermatitis, seborrhoea and acid is effective against Staphylococcus aureus, intertrigo where secondary fungal and/or bacterial Streptococcus, Corynebacterium, Neisseria and infection is present or likely to occur. certain clostridia and Bacteroides. Concentrations Sizes of 0.03-0.12µg/ml inhibit nearly all strains of S. 15g aureus. The antibacterial activity of fusidic acid is Price not diminished in the presence of betamethasone. £2.66 Indications For the treatment of eczematous dermatoses Synalar N including atopic eczema, discoid eczema, stasis Reig Jofre UK Ltd eczema and seborrhoeic eczema when secondary Description bacterial infection is confirmed or suspected. Synalar contains fluocinolone acetonide (a synthetic Sizes anti-inflammatory corticosteroid), and neomycin 30g (a broad-spectrum antifungal and antibacterial Price agent). Its mechanism of action is related to £5.62 vasoconstriction and suppression of membrane permeability, miotic activity, the immune response Lotriderm and release of inflammatory mediators. Organon Pharma (UK) Limited Indications Description For the treatment of inflammatory dermatoses Lotriderm Cream contains the dipropionate ester including eczema, dermatitis, seborrhoea and of betamethasone, a glucocorticoid exhibiting intertrigo where secondary fungal and/or bacterial the general properties of corticosteroids, and infection is present or likely to occur. clotrimazole, which is an imidazole antifungal Sizes agent. 30g Indications Price For the short-term topical treatment of tinea £4.36 infections due to Trichophyton rubrum; T. mentagrophytes; Epidermophyton floccusum and www.dermatologyhandbook.co.uk Microsporum canis; candidiasis due to Candida

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Corticosteroids Sizes 30g Corticosteroids - Mild potency Price (group 1) £1.71 Dermacort Corticosteroids - Moderate Marlborough Pharmaceuticals potency (group 2) Description The cream formulation of Dermacort was developed Betnovate RD in order to optimise the release and partition of GlaxoSmithKline UK its active ingredient, hydrocortisone, into the skin Description which is presented as a saturated or near saturated Betamethasone is a corticosteroid with topical anti- solution in aqueous propylene glycol, which inflammatory activity. Betamethasone valerate ready represents the continuous phase of the emulsion diluted (Betnovate RD) preparations are indicated system. It has been shown, by the vasoconstrictor for maintenance treatment once an acute episode assay on normal skin, that in this environment, has been treated effectively with a continuous course a 0.1% concentration of the hydrocortisone is of betamethasone valerate (Betnovate). equivalent to the 1% concentration where the drug Indications substance is in suspension. Clinical studies have Use in adults, elderly and children over 1 year to confirmed that 0.1% Dermacort is equivalent to treat atopic dermatitis (including infantile atopic 1.0% hydrocortisone cream BP/BPC whilst the dermatitis), nummular dermatitis (discoid eczema), reduced strength of Dermacort increases the margin prurigo nodularis, psoriasis (excluding widespread of safety. plaque psoriasis), lichen simplex chronicus Indications (neurodermatitis) and lichen planus, seborrhoeic For topical treatment of skin irritations, contact dermatitis, irritant or allergic contact dermatitis, dermatitis, allergic contact dermatitis and rashes discoid lupus erythematosus, adjunct to systemic due to reactions to plants, insect bite, jewellery, steroid therapy in generalised erythroderma and toiletries, deodorants, soaps and detergents. insect bite reactions. Dermacort is also indicated for the treatment of Sizes mild to moderate eczema. 100g (cream and ointment) Sizes Price 15g £3.15 Price £2.83 (DT) Eumovate GlaxoSmithKline UK Mildison Lipocream Description Astellas Pharma Ltd Clobetasone butyrate is a moderately potent Description topical corticosteroid indicated for the relief of the Mildison contains hydrocortisone and has the inflammatory and pruritic manifestations of steroid pharmacological actions of a corticosteroid responsive dermatoses. classified as mildly potent. Strength i.e.1% w/w Indications hydrocortisone. Use in adults, elderly, children and infants for Indications the relief of the inflammatory and pruritic For the treatment of eczema and dermatitis of manifestations of steroid responsive dermatoses all types including atopic eczema, otitis externa, such as topic dermatitis, irritant or allergic contact primary irritant and allergic dermatitis, intertrigo, dermatitis, seborrhoeic dermatitis, nappy rash, prurigo nodularis, seborrhoeic dermatitis and insect photodermatitis, otitis externa, prurigo nodularis bite reactions. and insect bite reactions. Eumovate may be used as

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maintenance therapy between courses of one of the Price more potent topical steroids. £5.99 (DT) Sizes 30g, 100g Synalar 1 in 4 Dilution Price Reig Jofre UK Ltd £1.86 (30g), £5.44 (100g) Description Synalar contains fluocinolone acetonide, a synthetic Fludroxycortide 4micrograms/ anti-inflammatory corticosteroid prepared as a 1 square cm tape 7.5cm in 4 dilution. Its mechanism of action is related to Typharm vasoconstriction and suppression of membrane Description permeability, miotic activity, the immune response Fludroxycortide Tape (previously known and release of inflammatory mediators. as Haelan Tape) is a transparent medicated Indications surgical tape impregnated with fludroxycortide, For the treatment of a wide variety of inflammatory, which is a moderately potent corticosteroid. pruritic and allergic skin disorders, particularly Fludroxycortide Tape is an occlusive topical suitable for eczema and dermatitis, atopic eczema, steroid. Adjunctive therapy for chronic, localised, seborrhoeic eczema, discoid eczema, otitis externa, recalcitrant dermatoses that may respond to topical contact dermatitis, neurodermatitis, prurigo, corticosteroids. psoriasis (excluding widespread chronic plaque Indications psoriasis), lichen planus, discoid lupus erythematous. To help treat difficult cases of dermatitis and eczema Sizes especially when the skin is dry and scaly. It is also 50g used in wound care to help prevent the development Price of proud flesh, technically known as excessive £4.84 granular tissue, which can hinder wound healing. Sizes Ultralanum 20cm; 50cm (roll) Zeon Price Description £13.67; £18.75 (DT) Ultralanum plain cream and ointment both contain the active ingredient fluocortolone, which is a type Fludroxycortide Cream of medicine known as a topical corticosteroid. Typharm Corticosteroids are medicines used for reducing Description inflammation. When fluocortolone is applied to Fludroxycortide Cream contains fludroxycortide, the skin it works by acting inside the skin cells a fluorinated synthetic moderately potent topical to decrease the release of these inflammatory corticosteroid. As with other topical steroids, the substances. This reduces swelling, redness and itch. therapeutic effect is primarily the result of its anti- Indications inflammatory activities. For treatment of steroid responsive skin conditions. Indications Sizes For the treatment of eczema and dermatitis of 50g all types, including childhood and adult atopic Price eczema, photodermatitis, primary irritant and Contact supplier allergic dermatitis, lichen planus, lichen simplex, prurigo nodularis, discoid lupus erythematus, Subscribe to necrobiosis lipoidica, pretibal myxoedema and erythroderma. Journal of Aesthetic Nursing Sizes www.magsubscriptions.com 60g

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Corticosteroids - Potent corticosteroids, Cutivate cream is indicated (group 3) for the relief of the inflammatory and pruritic manifestations of atopic dermatitis under the Betnovate supervision of a specialist. Expert opinion should be GlaxoSmithKline UK sought prior to the use of Cutivate cream in other Description corticosteroid-responsive dermatoses in children. Betamethasone valerate is potent corticosteroid Sizes with topical anti-inflammatory activity and pruritic 15g, 30g (ointment and cream) manifestations of steroid responsive dermatoses. Price Indications £2.27 (15g), £4.24 (30g) Use in adults, elderly and children over 1 year to treat atopic dermatitis (including infantile atopic Diprosone dermatitis), nummular dermatitis (discoid eczema), Organon Pharma (UK) Limited prurigo nodularis, psoriasis (excluding widespread Description plaque psoriasis), lichen simplex chronicus Diprosone contains betamethasone dipropionate, (neurodermatitis) and lichen planus, seborrhoeic a synthetic fluorinated corticosteroid equivalent dermatitis, irritant or allergic contact dermatitis, to 0.05% betamethasone. It is active topically and discoid lupus erythematosus, adjunct to systemic produces a rapid and sustained response. Topical steroid therapy in generalised erythroderma and corticosteroids such as this are effective in the insect bite reactions. treatment of a range of dermatoses due to their anti- Sizes inflammatory and antipruritic actions. 30g, 100g (ointment), 30g, 100g (cream), 100ml Indications (lotion) For the treatment of eczema and dermatitis of all Price types, including atopic eczema, photodermatitis, Ointment: £1.43 (30g), £4.05 (100g). Cream: £1.43 lichen planus, lichen simplex, prurigo nodularis, (30g), £4.05 (100g). Lotion: £4.58 (100ml) discoid lupus erythematosus, necrobiosis lipoidica, pretibial myxodema and erythroderma. It is also Cutivate effective in less responsive conditions, such as GlaxoSmithKline UK psoriasis of the scalp and chronic plaque psoriasis of Description the hands and feet, but excluding widespread plaque Cutivate contains fluticasone propionate which psoriasis. is a potent topical corticosteroid with anti- Sizes inflammatory, antipruritic and vasoconstrictive Cream: 5g; 30g; 100g. Lotion: 30ml; 100ml properties. Price Indications Contact supplier Adults: relief of the inflammatory and pruritic manifestations of corticosteroid-responsive Elocon dermatoses; these include the following: atopic Organon Pharma (UK) Limited dermatitis, nummular dermatitis (discoid eczemas), Description prurigo nodularis, psoriasis (excluding widespread Elocon contains mometasone furoate, which plaque psoriasis), lichen simplex chronicus exhibits marked anti-inflammatory and anti- (neurodermatitis) and lichen planus, seborrhoeic psoriatic activity. dermatitis, irritant or allergic contact dermatitis, Indications discoid lupus erythematosus, an adjunct to systemic For the treatment of inflammatory and pruritic steroid therapy in generalised erythroderma, insect manifestations of psoriasis (excluding widespread bite reactions, miliaria (prickly heat). plaque psoriasis) and atopic dermatitis. Children: for children and infants aged 3 months Sizes and over who are unresponsive to lower potency Cream/ointment: 30g; 100g. Scalp lotion: 30ml

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Price Synalar Contact supplier Reig Jofre UK Ltd Description Locoid Synalar contains fluocinolone acetonide, which is Astellas Pharma Ltd a synthetic anti-inflammatory corticosteroid. Its Description mechanism of action is related to vasoconstriction Locoid contains hydrocortisone butyrate, which and suppression of membrane permeability, miotic is a potent topical corticosteroid; 0.1% w/w activity, the immune response and release of hydrocortisone butyrate. Locoid Scalp Lotion inflammatory mediators. contains 0.1% hydrocortisone butyrate, a potent Indications topical corticosteroid. For the treatment of a wide variety of inflammatory, Indications pruritic and allergic skin disorders, particularly For the treatment of conditions that are responsive suitable for eczema and dermatitis, atopic eczema, to topical corticosteroids, e.g. eczema, dermatitis seborrhoeic eczema, discoid eczema, contact and psoriasis. The scalp lotion is indicated for the dermatitis, neurodermatitis, prurigo, psoriasis treatment of scalp conditions that are responsive to (excluding widespread chronic plaque psoriasis), topical corticosteroids, e.g. eczema, dermatitis and lichen planus, discoid lupus erythematous. psoriasis. Sizes Sizes Cream/ointment: 30g, 100g. 30g, 100g (cream, ointment and lipocream); 100ml Gel: 30g, 60g (scalp lotion) Price Price Cream/ointment: £4.14—30g, £11.75—100g. Gel: £1.60, £4.93 (cream and ointment); £1.69, £5.17 £5.56—30g, £10.02—60g (lipocream); £6.83 (scalp lotion) Corticosteroids - Very potent Metosyn (group 4) Reig Jofre UK Ltd Description Dermovate Metosyn contains fluocinonide, which is a synthetic GlaxoSmithKline UK anti-inflammatory corticosteroid. Its mechanism of Description action is related to vasoconstriction and suppression of Dermovate contains clobetasol propionate, a very membrane permeability, miototic activity, the immune potent corticosteroid with topical anti-inflammatory response and release of inflammatory mediators. activity. The major effect of clobetasol propionate on Indications skin is a non-specific anti-inflammatory response, For the treatment of a wide variety of local partially due to vasoconstriction and a decrease in inflammatory, pruritic and allergic disorders of the collagen synthesis. skin. It is indicated for the following conditions: Indications eczema and dermatitis, atopic eczema, seborrhoeic Use in adults, elderly and children over 1 year for eczema, discoid eczema, otitis externa, contact the short-term treatment only of more resistant dermatitis, neurodermatitis, prurigo, psoriasis inflammatory and pruritic manifestations of steroid (excluding widespread chronic plaque psoriasis), responsive dermatoses unresponsive to less potent lichen planus, discoid lupus erythematous. It is corticosteroids. These include such as psoriasis particularly suitable for dry, scaly lesions. (excluding widespread plaque psoriasis), recalcitrant Sizes eczemas, lichen planus, discoid lupus erythematosus 25g, 100g and other skin conditions which do not respond Price satisfactorily to less potent steroids. Cream: £3.96—25g, £13.34—100g Sizes Ointment: £3.50—25g, £13.15—100g 30g, 100g

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Price moderate to severe atopic dermatitis in adults £2.69 (30g), £7.90 (100g) E who are not adequately responsive to or are intolerant of conventional therapies such as topical corticosteroids. Children (2 years of age Eczema treatments and above): treatment of moderate to severe atopic dermatitis in children who fail to respond Elidel adequately to conventional therapies such as Mylan topical corticosteroids. Maintenance treatment: Description treatment of moderate to severe atopic dermatitis Pimecrolimus is a lipophilic anti-infl ammatory for the prevention of fl ares and the prolongation of ascomycin macrolactam derivative and a cell fl are-free intervals in patients experiencing a high selective inhibitor of the production and release frequency of disease exacerbations (i.e. 4 or more of pro-infl ammatory cytokines. Its skin-selective times per year) who have had an initial response pharmacological profi le is diff erent to that of to a maximum of 6 weeks’ treatment of twice-daily corticosteroids. tacrolimus ointment (lesions cleared, almost cleared Indications or mildly aff ected). Protopic 0.03% ointment is Elidel can be used in the short term for the indicated in adults, adolescents and children from treatment of the signs and symptoms of atopic the age of 2 years. Note: Protopic 0.1% is licensed eczema and intermittently in the long term for the for adults and adolescents (16 years of age and prevention of progression to fl ares . above). It is not licensed for children. Sizes Sizes 30g, 60g, 100g 30g, 60g (0.03% and 0.01%) Price Price 30g—£19.69, 60g—£37.41, 100g—£59.07 £23.33 and £42.55 (0.03%); £25.92 and £47.28 (0.01%) Protopic Astellas Pharma Ltd Description Hirsutism treatments Th e mechanism of action of tacrolimus in atopic dermatitis is not fully understood. While Vaniqa the following have been observed, the clinical Almirall Ltd signifi cance of these observations in atopic Description dermatitis is not known. Via its binding to a specifi c Vaniqa contains elornithine, which irreversibly cytoplasmic immunophilin (FKBP12), tacrolimus inhibits ornithine decarboxylase, an enzyme inhibits calcium-dependent signal transduction involved in the production of the hair shaft by the pathways in T cells, thereby preventing the hair follicle. Vaniqa has been shown to reduce the transcription and synthesis of IL-2, IL-3, IL-4, IL-5 rate of hair growth . and other cytokines such as GM-CSF, TNFα Indications and IFNγ. In patients with atopic For the treatment of facial hirsutism in adult dermatitis, improvement of skin lesions during women. treatment with tacrolimus ointment was associated Sizes with reduced Fc receptor expression on Langerhans 60g cells and a reduction of their hyperstimulatory Price activity towards T cells. Tacrolimus ointment does £56.87 not aff ect collagen synthesis in humans . Indications Need an extra copy? Adults and adolescents (16 years of age and www.dermatologyhandbook.co.uk above): fl are treatment. Adults: treatment of

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Hyperhidrosis Price £9.50 (30ml); £12.50 (50ml); £9.95 (30ml), £9.95 Dysport (wipes) (RRP including VAT) Ipsen Description Hyperhidrosis washes Dysport is Clostridium botulinum toxin type A Haemagglutinin complex, which blocks peripheral Perspi-Guard Odour Control cholinergic transmission at the neuromuscular Bodywash junction by a presynaptic action at a site Avanor Healthcare Ltd proximal to the release of acetylcholine. The Description toxin acts within the nerve ending to antagonise This body wash has been formulated to treat those events that are triggered by Ca2+ which bromhidrosis (malodorous sweating) by cleansing culminate in transmitter release. It does not the skin and eliminating body odours from affect postganglionic cholinergic transmission commonly affected problem areas, such as or postganglionic sympathetic transmission. The underarms, feet and groin. It contains Triclosan, action of toxin involves an initial binding step which targets and reduces the odour-causing whereby the toxin attaches rapidly and avidly to bacteria that build up on the skin during sweating. the presynaptic nerve membrane. Secondly, there Indications is an internalisation step in which toxin crosses For the treatment of bromhidrosis particularly the presynaptic membrane, without causing involving underarms, feet and groin. onset of paralysis. Finally, the toxin inhibits the Sizes release of acetylcholine by disrupting the Ca2+ 200ml mediated acetylcholine release mechanism, thereby Price diminishing the endplate potential and causing £4.95 (RRP including VAT) paralysis. Indications Severe primary axillary hyperhidrosis unresponsive Insecticides and to topical antiperspirants or antihydrotics. parasiticidals Sizes 300 units, 500 units Chemists’ Own Head Lice Price R & D Healthcare £92.40; £308.00 Description Contains dimeticone 4%, silicone, as a head lice Perspi-Guard Maximum treatemnt. The shampoo contains natural neem oil, Strength Antiperspirant eucalyptus oil, wheat proteins and margosa extract Avanor Healthcare Ltd to help keep head lice at bay. Description Indications A topical solution for hyperhidrosis (excessive For protecting against head lice. sweating). It offers protection from both sweat Sizes and odour, while remaining gentle on the skin. 100ml Containing aluminum chloride and aluminum Price chlorohydrate, the concentrated formulation £5.90 requires application once or twice per week. Indications Derbac–M For the treatment of hyperhidrosis, particularly Reckitt Benckiser Healthcare UK involving axillae, hands or feet. Description Sizes Derbac M Liquid contains malathion, a widely Spray (30ml; 50ml); roll-on (30ml); wipes (7pk) used organophosphorus insecticide that inhibits

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cholinesterase. It is effective against a wide Price range of insects, but is one of the least toxic £2.98 – 50ml, £6.92 – 150ml organophosphorus insecticides as it is rapidly detoxified by plasma carboxylesterases. Lyclear Indications Omega Pharma For the eradication of head lice and pubic lice, and Description their eggs, and the treatment of scabies. Lyclear contains permethrin, which belongs to a Sizes group of anti-parasitic agents called pyrethroids. 50ml, 200ml Permethrin is rapidly absorbed across the insect Price cuticle. The principal physiological action is the £3.57, £8.44 induction of electrochemical abnormalities across the membranes of excitable cells, leading to sensory Full Marks hyperexcitability, incoordination and prostration. Reckitt Benckiser Healthcare UK When presented in an aqueous base, the ovicidal Description activity of permethrin is increased by the addition Full Marks contains isopropyl myristate and of an alcohol. cyclomethicone. It is a thin, oily liquid, which Indications spreads quickly and completely through the hair to For the treatment of infections with the head louse saturate the scalp and kill head lice and eliminate Pediculus humanus capitis. their eggs. Using the fine-tooth metal comb Sizes provided, the solution is then combed through the 30g hair once the required time has elapsed. Price Indications £7.46 For the treatment of head lice infestations. Sizes Permethrin 5% Cream 100ml, 200ml, 300ml Sandoz Price Description £3.47, £6.36, £8.67 Permethrin induces electrochemical abnormalities across the membranes of the excitable cells of Hedrin susceptible parasites. This leads to sensory hyper- Thornton & Ross excitability, lack of coordination and prostration. Description Indications Hedrin solution contains dimeticone, which is used For the treatment of scabies. in many pharmaceutical and cosmetic preparations. Sizes A 4% concentration has been found to affect the 30g physico-physiological activity of lice. It is less Price effective in its ovicidal activity and therefore two £7.46 applications, 7 days apart, are required. It contains no neurotoxic organophosphate insecticides and Vamousse acts by a physical process that covers the lice and Ceuta Healthcare Group disrupts their ability to manage their water balance Description so that treated insects fail to excrete surplus water. Contains isopropyl alcohol 1.5%, benzyl alcohol 1.5% Its activity is not diminished in insecticide-resistant and is a quick-acting head lice treatment which kills head lice. lice and eggs within 15 minutes of contact. Indications Indications For the eradication of head lice infestations. For head lice. Sizes Sizes 50ml, 150ml 160ml

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Price Price £9.37 £2.77, £3.88

Keratolytics Psoriasis treatments ClearZal Dithranol Zeon Description Psorin Clear Zal is a hard skin remover cream with urea LPC Pharmaceuticals 7%, salicyclic acid, 4% and trichioroacretic acid 2%. Description A triple action formula which removes dead skin Psorin contains dithranol and coal tar; both cells, promotes new growth with an aloe vera base suppress the proliferation of psoriatic tissue. for rapid absorption and increased hydration . Salicylic acid acts as a keratolytic. Th e emollient Indications base helps to promote healing of psoriatic areas . For treatment and removal of callused/keratosed Indications skin on feet . For the topical treatment of psoriasis; sub-acute and Sizes chronic (stable) psoriasis . 100g Sizes Price Ointment: 50g, 100g. Scalp gel: 50g £4.30 Price Contact supplier Molutrex Espère Healthcare Scalp preparations Description Molutrex contains a stable solution of potassium Cocois hydroxide (also known as KOH). Th is agent breaks RPH Pharmaceuticals AB down the hard keratin surface of the skin. When Description painted onto the molluscum blisters this sets off an Cocois is a combination of coal tar, salicylic acid irritant reaction which stimulates the body’s own and sulphur, which are widely used in the treatment immune system to attack the virus. Th e virus is of hyperkeratotic and scaling skin conditions. destroyed and the blisters heal . Coal tar is antipruritic, keratoplastic and a weak Indications antiseptic. Salicylic acid has keratolytic properties. For the treatment of molluscum contagiosum. Sulphur is keratolytic, with weak antiseptic and Sizes parasiticide properties. 3ml Indications Price For the treatment of scaly skin disorders of the £9.99 scalp, such as psoriasis, eczema, seborrhoeic dermatitis and dandruff . Pickles Sizes Optima Consumer Health 40g, 100g Description Price Pickles is a 50% salicylic acid ointment, which should £6.22 – 40g, £11.69 – be used with a corn ring to protect surrounding skin. 100g Indications Corn and calluses. Subscribe to NRC visit Sizes www.magsubscriptions.com 12g, 28g

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Etrivex Sizes Galderma (UK) 250ml Description Price Etrivex contains clobetasol propionate, which £4.74 has anti-inflammatory, antipruritic, and vasoconstrictive properties. Sebco It is a short contact formulation to be applied for Derma UK 15 minutes to a dry scalp. After this time add water, Description lather and rinse the product completely off the scalp. An ointment containing coal tar solution 12% w/w, Indications salicylic acid 2% w/w and sulfur for external use 4% For moderate scalp psoriasis in adults. w/w in a coconut oil base. The mixture of coal tar, Sizes salicylic acid and sulfur reduces itch, helps remove 125ml scaly skin and has antiseptic properties. Sebco is Price used in the treatment of skin diseases which cause £9.15 dry scaly skin on the scalp. These include psoriasis, eczema, seborrhoeic dermatitis and dandruff. It Eucerin Dermo Capillaire Scalp has mild antipruritic, antiseptic and keratolytic Treatment with 5% urea properties and is based on an ointment called Beiersdorf UK Ltd Unguentum Cocois Co. Description Indications Provides an intensive moisturising and calming For the treatment of scaly skin disorders of the effect for a dry and itchy scalp with 5% urea and scalp, such as psoriasis, eczema, seborrheic lactate to help reduce moisture loss. dermatitis and dandruff. Also contains licorice extract and polidocanol to Sizes soothe and reduce itchiness. 40g; 100g Indications Price Scalp dryness, itchiness, tautness, £7.91; £13.38 (DT) roughness, scaliness and sensitivity. Sizes Tar 100ml Price Psoriderm Cream £12 Dermal Laboratories Ltd Description Psoriderm Scalp Lotion Psoriderm Cream is a coal tar preparation. Coal Dermal Laboratories Ltd tar has been used dermatologically for hundreds of Description years and has been shown to be safe and effective Psoriderm Scalp Lotion is a coal tar in the treatment of scaly skin conditions such as shampoo preparation. Coal tar has been used psoriasis. dermatologically for hundreds of years and is widely The precise mechanism of action of coal tar is not used in the treatment of scaly skin conditions such understood, largely as a result of it comprising as psoriasis. The precise mechanism of action of up to 10,000 components. There is evidence that coal tar is not understood, largely as a result of topical application of coal tar improves psoriasis by it comprising up to 10,000 components. There reducing the excessive rate of mitotic epidermal cell is evidence that topical application of coal tar division. improves psoriasis by reducing the excessive rate of Indications mitotic epidermal cell division. For the topical treatment of sub-acute and chronic Indications psoriasis, including psoriasis of the scalp and For the topical treatment of psoriasis of the scalp. flexures.

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Sizes Curatoderm Ointment 225ml Almirall Ltd Price Description £9.42 Curatoderm contains tacalcitol, a vitamin D3 derivative that inhibits keratinocyte hyper- Vitamin D analogues proliferation and induces differentiation of these cells. The normalisation of these mechanisms is the Calcipotriol/Betamethasone basis for its efficacy in the treatment of psoriasis. (Dalbecal) 50mcg/g + In biopsies from patients treated with tacalcitol, 0.5mg/g Ointment specific indicators for inflammation were improved. Teva UK Tacalcitol binds to the keratinocyte vitamin D Description receptor to the same extent as natural active vitamin Calcipotriol is a vitamin D analogue. One D3. gram of ointment contains 50 micrograms of Indications calcipotriol and 0.5 mg of betamethasone (as For the treatment of psoriasis vulgaris. 0.643 mg betamethasone dipropionate). One Sizes gram of ointment contains 50 micrograms of 30g, 100g butylhydroxytoluene (E321). Price Indications £13.40; £30.86 Topical treatment of stable plaque psoriasis vulgaris amenable to topical therapy in adults. Enstilar Cutaneous Foam Sizes LEO Pharma 60ml, 120ml Description Price The active ingredients in Enstilar Cutaneous £14.50; £29.95 Foam are calcipotriol (as monohydrate) and betamethasone (as dipropionate). Enstilar contains Curatoderm Lotion a combination of calcipotriol and betamethasone Almirall Ltd dipropionate. Calcipotriol is a vitamin D analogue. Description In vitro data suggest that calcipotriol induces Curatoderm contains tacalcitol, a vitamin D3 differentiation and suppresses proliferation of derivative that inhibits keratinocyte hyper- keratinocytes. This is the proposed basis for its proliferation and induces differentiation of these cells. effect in psoriasis. Betamethasone dipropionate The normalisation of these mechanisms is the basis is a potent topical corticosteroid with anti- for its efficacy in the treatment of psoriasis. In biopsies inflammatory, antipruritic, vasoconstrictive and from patients treated with tacalcitol, specific indicators immunosuppressive properties, although it does not for inflammation were improved. Tacalcitol binds to cure the underlying condition. the keratinocyte vitamin D receptor to the same extent Indications as natural active vitamin D3. Topical treatment of psoriasis vulgaris in adults. Indications Sizes For the treatment of psoriasis vulgaris. 1 x 60g can Sizes Price 30ml £39.68 Price £12.73 Silkis Galderma (UK) Subscribe to BJN visit Description www.magsubscriptions.com Silkis contains calcitriol which inhibits the proliferation and stimulates differentiation of

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keratinocytes. Calcitriol inhibits proliferation of Sizes T cells and normalises the production of various 30g inflammation factors. Price Indications £5.78 For the topical treatment of mild to moderately severe plaque psoriasis (psoriasis vulgaris) with up Exorex Lotion 5% v/w to 35% of body surface area involvement. Cutaneous Emulsion Sizes Teva UK 100g Description Price Exorex Lotion contains coal tar, an antipruritic and £18.06 keratoplastic. It is a patented formulation containing the active ingredient coal tar solution (5% v/w) in Vitamin D analogues/ a base containing a complex of esterified essential corticosteroid combinations fatty acids. Tar acids have also been shown to have disinfectant properties. Exorex Lotion may be used Dovobet Gel alone, or as part of a more extensive treatment LEO Pharma regimen. Description Indications Dovobet Gel contains a combination of calcipotriol For the treatment of psoriasis of the skin and scalp. and betamethasone dipropionate. Calcipotriol is Sizes a vitamin D analogue. In vitro data suggest that 100ml, 250ml calcipotriol induces differentiation and suppresses Price proliferation of keratinocytes. This is the proposed Contact supplier basis for its effect in psoriasis. Betamethasone dipropionate is a potent topical corticosteroid with anti-inflammatory, antipruritic, vasoconstrictive Rosacea treatments and immunosuppressive properties, although it does not cure the underlying condition. Acea Indications Ferndale Pharmaceuticals Topical treatment of scalp psoriasis in adults. Description Topical treatment of mild to moderate ‘non-scalp’ Acea 0.75% w/w Gel is a water based gel containing plaque psoriasis vulgaris in adults. 0.75% w/w of the active ingredient metronidazole. Sizes Acea Gel is used for the treatment of rosacea, a skin Gel bottle: 60g and 2x60g. condition usually affecting the facial cheeks and Applicator: 60g forehead in which the skin appears redder than Price normal. Acea Gel belongs the group of medicines £37.21 and £69.11; £37.21 Antiprotozoal and Antibacterial Agents, which are used to control infection and inflammation in skin Dovobet Ointment problems. LEO Pharma Indications Description For treatment of acute inflammatory exacerbations Calcipotriol is a vitamin D derivative. In vitro data of rosacea. suggest that it induces differentiation and suppresses Sizes proliferation of keratinocytes. This is the proposed 40g basis for its effect in psoriasis. Price Indications Contact supplier For the topical treatment of plaque psoriasis (psoriasis vulgaris) amenable to topical therapy. To advertise call 020 7333 1741

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Metrogel Rosiced Galderma (UK) Pierre Fabre Description Description Metrogel contains 0.75% metronidazole, which is a Rosiced contains 0.75% metronidazole which topical antibacterial. is active against the inflammatory aspect of Indications rosacea. Metronidazole belongs to the group of For the treatment of acute inflammatory exacerbation nitroimidazoles. It is reduced in sensitive protozoa of rosacea and deodorisation of the smell associated and strictly anaerobic bacteria with formation with malodorous fungating tumours. of acetamide and N-(2-hydroxyethyl)-oxamid Sizes acid. Interaction with DNA leads to inhibition of 40g the nucleic acid synthesis of the microorganisms Price concerned, which results in the death of these agents. £22.63 Indications For the topical treatment of inflammatory Mirvaso papulopustular rosacea. Galderma (UK) Sizes Description 30g Brimonidine is a highly selective alpha2-adrenergic Price receptor agonist that is 1000-fold more selective for £7.50 the alpha2-adrenergic receptor than the alpha1- adrenergic receptor. Cutaneous facial application Rozex of a highly selective alpha2-adrenergic receptor Galderma (UK) agonist reduces erythema through direct cutaneous Description vasoconstriction. Rozex contains 0.75% metroniazole, an antiprotozoal Indications and antibacterial agent that is active against a For the symptomatic treatment of facial erythema of wide range of pathogenic microorganisms. The rosacea in adult patients. mechanisms of action of metronidazole in rosacea Sizes are unknown, but evidence suggests that the effects 30g may be antibacterial and/or anti-inflammatory. Price Indications £33.69 For the treatment of inflammatory papules, pustules and erythema of rosacea. Rosalic AR Intense Sizes La Roche Posay 30g, 40g Description Price Intensive care for skin prone to redness, discomfort £6.60, £9.88 and skin tone changes. Targets skin tone irregularity and helps to prevent its reappearance. Helps Soolantra comfort the look of red skin. Galderma (UK) Indications Description Skin prone to redness. Applied on targeted area Ivermectin is a member of the avermectin class. morning and evening in monotherapy or in Avermectin has anti-inflammatory effects by association with skin tone treatments (oral and inhibiting lipopolysaccharide-induced production topical). of inflammatory cytokines. Anti-inflammatory Sizes properties of cutaneous ivermectin have been 40ml observed in animal models of skin inflammation. Price Ivermectin also causes death of parasites, primarily £19.50 through binding selectively and with high affinity to

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glutamate-gated chloride channels, which occur in Price invertebrate nerve and muscle cells. The mechanism £4.52 of action of Soolantra in treating the inflammatory lesions of rosacea is not known but may be linked Capasal Therapeutic Shampoo to anti-inflammatory effects of ivermectin as well as Dermal Laboratories Ltd causing the death of Demodex mites that have been Description reported to be a factor in inflammation of the skin. Capasal Therapeutic Shampoo has been Indications designed as an aid in the treatment For the topical treatment of inflammatory lesions of of dry, scaly scalp conditions by rosacea (papulopustular) in adult patients. incorporating three ingredients that Sizes are established and widely used in 30g this indication: 0.5% salicylic acid Price (mild keratolytic), 1.0% coconut oil £18.29 (emollient, softening agent and lubricant) and 1.0% distilled coal tar (antipruritic, keratoplastic). Zyomet Indications Concordia International For the treatment of dry, scaly scalp conditions Description such as seborrhoeic eczema, seborrhoeic dermatitis, Zyomet is a 0.75% metronidazole gel. Metronidazole pityriasis capitis, psoriasis, and cradle cap in is an antiprotozoal and antibacterial agent, which children. It may also be used to remove previous is active against a wide range of pathogenic scalp applications. microorganisms. The mechanisms of action of Sizes metronidazole in rosacea are unknown but evidence 250ml suggests that the effects may be antibacterial and/or Price anti-inflammatory. £4.69 Indications Acute inflammatory exacerbations of rosacea. Dandrazol 2% Shampoo Sizes Transdermal 30g Description Price A shampoo containing the active 2% ketoconazole, £12.00 which is a type of medicine called an antifungal. It is used to treat infections with fungi and yeasts. Indications Shampoos For prevention and treatment of dandruff. Sizes Alphosyl 2-in-1 120ml Omega Pharma Price Description £3.38 (Trade price) Alphosyl 2-in-1 contains coal tar, which has keratolytic and keratoplastic properties and aids Dandrazol Anti-dandruff treatment by slowing the excessive epidermal cell Shampoo turnover. Transdermal Indications Description For the treatment of psoriasis, seborrhoeic A shampoo containing the active 2% ketoconazole, dermatitis, scaling and itching (often associated which is a type of medicine called an antifungal. It is with eczema) and dandruff. used to treat infections with fungi and yeasts. Sizes Indications 250ml For dandruff, inflammatory skin conditions with

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greasy, red or scaly areas (seborrhoeic dermatitis) Price and fungal skin infections caused by pityriasis. £11 Sizes 100ml Neutrogena T/Gel Price Johnson & Johnson Ltd £6.19 (Trade prices) Description NeutrogenaT/Gel Therapeutic Shampoo is a Dermax Therapeutic Shampoo fragranced medicated shampoo for the treatment Dermal Laboratories Ltd of itchy, flaky scalp disorders. Regular use helps Description to control these problems, while treating the scalp Dermax Therapeutic Shampoo and caring for your hair. Treatment usually lasts contains benzalkonium chloride, for 6 weeks, after which time improvement should which is adsorbed on to dry be seen. Longer periods of treatment should only skin scales, these being a feature take place under the supervision of a doctor. Active of pityriasis capitis and other ingredients: Neutar 2% solubilised coal tar extract seborrhoeic scalp conditions. The 20mg/ml. scales are loosened and attain a net Indications positive charge, and are then levitated For the effective treatment of dandruff, seborrhoeic into the negatively charged surface of the foam and dermatitis and scalp psoriasis. washed from the hair. Benzalkonium chloride also Sizes acts as a mild antiseptic, which improves clinical 125ml, 250ml performance when the condition is exacerbated by Price the presence of microbes. The major site of action £3.61—125ml, £5.38—250ml against microorganisms appears to be the cell membrane, where permeability is altered. Selsun Indications Chattem For the topical treatment of pityriasis capitis and Description other seborrhoeic scalp conditions, where there is Selsun shampoo contains 2.5% selenium sulphide, scaling and dandruff. which appears to have a cytostatic effect on cells of Sizes the epidermis and follicular epithelium, reducing 250ml corneocyte production. Selsun acts as an anti- Price seborrhoeic agent which effectively controls itching £5.69 and scaling dandruff. It is active against certain dermatophytes, including Pityrosporum orbiculare, Eucerin Dermo Capillaire the organism causing pityriasis versicolor (tinea Calming Shampoo with 5% versicolor). urea Indications Beiersdorf UK Ltd For the treatment of dandruff and seborrhoea Description capitis. Gently cleanses dry and itchy scalp Sizes with 5% urea and lactate, which 50ml, 100ml, 150ml reduce moisture loss. Also contains Price polidocanol for a soothing effect. £1.61, £2.15, £3.06 Indications Scalp dryness, itchiness, tautness, roughness, scaliness and sensitivity. Subscribe to BJCN visit Sizes www.magsubscriptions.com 250ml

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Skin cancer (and actinic Ameluz keratoses) treatments Biofrontera Description Actikerall Following topical application of Ameluz, a Almirall Ltd 5-aminolaevulinic acid, the substance is metabolised Description to protoporphyrin IX, a photoactive compound Actikerall is a combination of fl uorouracil and which accumulates intracellularly in the treated salicylic acid. Th e active substance fl uorouracil (FU) actinic keratosis lesions. Protoporphyrin IX is is a cytostatic agent that has an antimetabolite eff ect. activated by illumination with red light of a suitable Topical salicylic acid has a keratolytic eff ect and wavelength and energy. In the presence of oxygen, reduces the hyperkeratosis associated with actinic reactive oxygen species are formed. Th e latter causes keratosis. damage of cellular components and eventually Indications destroys the target cells. Actikerall is indicated for the topical treatment Indications of slightly palpable and/or moderately thick For the treatment of actinic keratosis of mild to hyperkeratotic actinic keratosis (grade I/II) in moderate intensity on the face and scalp. immunocompetent adult patients . Sizes Sizes 2g 25ml Price Price £184.00 £38.30 Efudix Aldara Mylan Meda Pharmaceuticals Description Description Efudix is a topical cytostatic preparation that exerts Aldara contains imiquimod, an immune response a benefi cial therapeutic eff ect on neoplastic and pre- modifi er. It is eff ective against viral infections neoplastic skin lesions without damaging normal and acts as an anti-tumour agent, principally by skin. Th e pattern of response follows this sequence: induction of alpha interferon and other cytokines. erythema, vesiculation, erosion, ulceration, necrosis Indications and epithelialisation. For the topical treatment of small superfi cial basal Indications cell carcinomas (sBCCs) in adults and clinically For the topical treatment of superfi cial pre- typical, non-hyperkeratotic, non-hypertrophic malignant and malignant skin lesions, keratoses actinic keratoses (AKs) on the face or scalp in including senile, actinic and arsenical forms, immunocompetent adult patients when size keratoacanthoma, Bowen’s disease, superfi cial basal or number of lesions limit the effi cacy and/or cell carcinoma. acceptability of cryotherapy, and other topical Deep, penetrating or nodular basal cell and treatment options are contraindicated or less squamous cell carcinomas do not usually respond to appropriate. It is also indicated for the treatment of Efudix therapy. It should be used only as a palliative external genital and perianal warts (condylomata therapy in cases where no other form of treatment acuminata) in adults. is possible. Sizes Sizes 12-sachet pack 40g Price Price £48.60 £32.90 Need an extra copy? www.dermatologyhandbook.co.uk

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Eucerin Actinic Control MD lesions. Treatment of squamous cell carcinoma in SPF100 situ (Bowen’s disease), when surgical excision is Beiersdorf UK Ltd considered less appropriate. Description Sizes Eucerin Actinic Control MD SPF 100 is 2g a medical device with a high SPF, to help Price with sun protection and prevention of £157.40 Actinic Keratosis and non-melanoma skin cancer. Actinic Keratosis is a pre- Picato cancerous skin disease, in part caused by LEO Pharma sun-indcued UV damage. This product Description includes high UVA and UVB rays to offer protection The active ingredient in Picato gel is ingenol across the entire UV spectrum. With a light fluid mebutate. application, this Actinic Control product is suitable Indications for everyday use and easy to reapply throughout Picato is indicated for the cutaneous treatment the day. of non-hyperkeratotic, non-hypertrophic actinic Indications keratosis in adults. Sun protection and prevention of Actinic Keratosis Sizes and non-melanoma skin cancer. 150microgramme/g 3 x 0.47 single-use tubes; 500 Sizes micrograms/g, 2 × 0.47-g single-use tubes 80ml (cream-fluid) Price Price £65.00 £20.00 Solaraze Metvix Cream Almirall Ltd Galderma (UK) Description Description Solaraze contains diclofenac, a non-steroidal After topical application of Metvix (methyl anti-inflammatory. The mechanism of action of aminolevulinate), porphyrins accumulate diclofenac in actinic keratosis is not known but may intracellularly in the treated skin lesions. The be related to the inhibition of the cycloxygenase intracellular porphyrins (including PplX) are pathway leading to reduced prostaglandin E2 photoactive, fluorescing compounds and, on (PGE2) synthesis. light activation in the presence of oxygen, singlet Indications oxygen is formed, which causes damage to cellular For the treatment of actinic keratosis. compartments, in particular the mitochondria. Sizes Light activation of accumulated porphyrins leads to 50g a photochemical reaction and thereby phototoxicity Price to the light-exposed target cells. £38.30 Indications For the treatment of thin or non-hyperkeratotic Zyclara and non-pigmented actinic keratoses on the face Meda Pharmaceuticals and scalp when other therapies are considered less Description appropriate. Only for treatment of superficial and/ Imiquimod is an immune response modifier. It or nodular basal cell carcinoma; unsuitable for other is the lead compound of the imidazoline family. available therapies due to possible treatment-related Zyclara contains 3.75% imiquimod. morbidity and poor cosmetic outcome, such as Indications lesions on the mid-face or ears, lesions on severely Zyclara is indicated for the topical treatment sun damaged skin, large lesions, or recurrent of clinically typical, non-hyperkeratotic, non-

158 Dermatology Handbook 2021–2022 Topical treatments

hypertrophic, visible or palpable actinic keratosis (AK) Duofilm of the full face or balding scalp in immunocompetent Thornton & Ross adults when other topical treatment options are Description contraindicated or less appropriate. Duofilm is a combination of lactic and salicylic Sizes acid. Lactic acid affects the keratinisation process, Sachets x 28 reducing hyperkeratosis, which is characteristic Price of warts. At high concentrations it can cause £54.74 epidermolysis, leading to the destruction of the keratotic tissue of the wart and of the causative virus. It also has antiseptic properties. Salicylic Wart and callus treatments acid is keratolytic, facilitating desquamation by solubilising the intercellular cement in the stratum Bazuka Extra Strength corneum. Diomed Developments Indications Description For the treatment of warts. Bazuka Extra Strength Gel is a treatment for Sizes verrucas, warts, corns and calluses, suitable for 15ml use by adults, children and the elderly. It contains Price salicylic acid which gently removes the infected skin £4.99 tissue, helping to eliminate the virus. The pain-free gel dries to form a water-resistant, protective barrier Glutarol to inhibit the spread of infection. Dermal Laboratories Ltd Indications Description Warts, verrucae, corns, calluses. Glutarol contains glutaraldehyde, a virucidal that Sizes inactivates the wart virus. On the skin, it also acts 15ml as an anhidrotic, drying the warts and surrounding Price skin, thus reducing the spread of lesions and £6.49 (RRP) simplifying the removal of persistent warts by curettage. Dermatonics Once Callus Indications Removing Balm For the topical treatment of warts, especially plantar Dermatonics warts. Description Sizes Dermatonics Once Callus Removing Balm can 10ml be applied once or twice daily as prescribied. It Price combines 25% urea with ceramide rich Oat Lipd Oil £2.07 and can treat callus and anhidrosis anywhere on the body. Free of parabens. Occlusal Indications Alliance Pharmaceuticals Ltd For the removal of callus, hyperkeratosis and plaque Description on the body. Occlusal contains salicylic acid, which has Sizes bacteriostatic and fungicidal actions, but its 75ml, 200ml keratolytic properties are important for this Price product. When applied externally, it produces slow £3.80; £9.40 and painless destruction of the epithelium. Indications www.dermatologyhandbook.co.uk For the treatment and removal of common and plantar warts (verrucae).

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Sizes availability of salicylic acid from the dried collodion. 10ml Indications Price For the topical treatment of warts, verrucas, corns £3.56 (DT) and calluses. Sizes Salactol 8g Dermal Laboratories Ltd Price Description £2.98 Salactol is a combination of salicylic acid and lactic acid in flexible collodion. Salicylic acid has Verrugon bacteriostatic and fungicidal actions, as well as Optima Consumer Health keratolytic properties. Its effectiveness as a topical Description treatment for hyperkeratotic skin lesions is based Verrugon contains the active ingredient salicylic on its mild keratolytic action, which slowly and acid, which is a keratolytic. Salicylic acid works by painlessly destroys the epithelium. In the treatment breaking down keratin, a protein that forms part of of warts, a mild irritant reaction, which may render the skin structure. This results in the shedding of the virus more prone to immunologic stimulation skin cells from the affected area. In the treatment of or response, may add to the mechanical removal verrucas, the effect of salicylic acid is to remove the of infected cells. In addition to its antiseptic affected skin over a period of time. If successful, the and caustic properties, lactic acid enhances the new skin that grows underneath will be healthy. availability of salicylic acid from the dried collodion. Indications Indications For the treatment of verrucas. For the topical treatment of warts, verrucas, corns Sizes and calluses. 6g Sizes Price 10ml £3.61 (trade price) Price £1.71 Salatac Gel Dermal Laboratories Ltd Description Salatac Gel is a combination of salicylic acid and lactic acid, which are routinely used in the treatment of verrucas, warts, corns and calluses for their keratolytic properties. When applied topically and in high enough concentrations, salicylic acid acts by achieving a slow, painless destruction of the thickened stratum corneum. It softens and destroys the stratum corneum of the affected tissue by reducing the adhesiveness of the corneocytes while causing the cornified epithelium to swell, soften, macerate and finally desquamate. In the treatment of warts, a mild irritant reaction, which may render the virus more prone to immunologic stimulation or response, may add to the mechanical removal of infected cells. In addition to its antiseptic and caustic properties, lactic acid enhances the

160 Dermatology Handbook 2021–2022 Topical treatments online

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| £3.99 20 July-16 August 2015 www.independentnurse.co.uk

IN THIS ISSUE For primary care and community nurses News Dementia strategy | £3.99 A new scheme in Kingston 15 June-19 July 2015 www.independentnurse.co.uk seeks to improve p4 dementia diagnosis For primary care and community nurses News IN THIS ISSUE Safe staffing | £3.99 NICE will continue to work News 7 September-20 September 2015 on evidence for safe www.independentnurse.co.uk p4 Safe staffing staffing levels guidelines halted News NICE asked to stop before RCN Congress work on community p5 IN THIS ISSUE staffing levels finished For primary care and community nurses Everything you need to Exclusive know from RCN Congress News Practice nurses | £3.99 2015 p8 18 May-31 May 2015 Budget cuts hit vital for future www.independentnurse.co.uk Opinion public health The Roland Commission Ageing population Cutting local authority report highlighted the p5 Care providers must adaptp18 funding will impact on profession’s role IN THIS ISSUE as patients live longer primary care p5 Exclusive News Opinion News Concern over New network for Not invisible, just Welfare charity training chances overlooked practice nurses challenge State school nurses have The NHS Alliance has Advanced nurse p5 Team to climb Mount Edith difficulty accessing CPD launched a new GPN practitioners must push Cavell to raise money for p5 p7 Opinion network for regulation and role nurses’ welfare charity clarity p18 Uncovering the dangers of Exercising for News News better health Public don’t want Journals Test for genetic Osteoporosis p35 It is time for a nationalp17 to be nurses research sun exposure heart condition strategy on inactivity 78% said they would not Patients often expose themselves to excessive amounts of sunlight at homeRollout and funded abroad, by which British can Recent studies improve p7 Clinical consider a career in severely damage future skin health. 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Dermatologywww.independentnurse.co.uk Handbook 2021–2022 161 Dermatology Handbook Company details

3M United Kingdom Almirall Ltd 1 Morley Street Harman House Loughborough 1 George St LE11 1EP Uxbridge 01509 611611 Middlesex www.3m.co.uk/cavilon UK 020 7160 2500 A www.almirall.com AbbVie AbbVie House Amdipharm Mercury Company Ltd Vanwall Road Capital House Maidenhead 85 King William Street Berkshire London UK EC4N 7BL SL6 4UB 020 8588 9100 01628 561090 www.amcolimited.com www.abbvie.com Ascot Laboratories Ltd Advancis Medical Unit 1 Lowmoor Business Park Olds Approach Kirkby-in-Ashfield Tolpits Lane Nottingham Watford UK UK NG17 7JZ WD18 9TD 01623 751 500 01923 711 971 www.advancis.co.uk/ www.ascotpharma.com

AesthetiCare Aspen Medical Europe Unit 740 Clinitron House Thorp Arch Estate Ashby Park Wetherby Ashby de la Zouch West Yorkshire Leicestershire UK UK LS23 7FX LE65 1JG www.aestheticare.co.uk/ +44 (0)1530 411000 www.aspenmedicaleurope.com Alliance Pharmaceuticals Ltd Avonbridge House Aspire Pharma Bath Road 4 Rotherbrook Court, Chippenham Bedford Road, SN15 2BB Petersfield, 01249 466 966 Hampshire, www.alliancepharma.co.uk United Kingdom GU32 3QG

162 Dermatology Handbook 2021–2022 Company details

01730 231148 Beiersdorf UK Ltd www.aspirepharma.co.uk Trinity Central, Trinity Park, Astellas Pharma Ltd Bickenhill Lane, 2000 Hillswood Drive Birmingham, Chertsey B37 7ES KT16 0PS wwww.eucerin.co.uk 0203 379 8721 www.astellas.co.uk/ Bell’s Healthcare Cheshire House Auden Mckenzie Pharma Division Gorsey Lane McKenzie House Widnes Bury Street Cheshire Ruislip UK UK WA8 0RP HA4 7TL +44 (0) 151 422 1200 01895 627420 www.bells-healthcare.com/ www.audenmckenzie.com Bellava Ltd Avanor Healthcare Ltd The Joiners Shop 1a Wendover Road Historic Dockyard Rackheath Industrial Estate Chatham Norwich Kent UK UK NR13 6LH ME4 4TZ 0845 643 9545 01634 893891 www.avanor.co.uk www.keromask.com

Ayrton Saunders Ltd Biogen Idec 9 Arkwright Road Innovation House Astmoor Industrial Estate 70 Norden Road Commerce Way Maidenhead Runcorn Berkshire WA7 1NU UK 01928 502200 SL6 4AY www.ayrtons.com +44 1628 501 000 www.biogen.uk.com B Bayer PLC Boots UK 400 South Oak Way Nottingham Green Park UK Reading NG2 3AA Berkshire 0345 070 8090 RG2 6AD www.boots-uk.com/ +44 118 206 3000 www.bayer.co.uk Boston Healthcare Ltd 6 Navigation Court Beiersdorf UK Ltd Calder Park

Dermatology Handbook 2021–2022 163 Dermatology Handbook

Wakefield UK Ceuta Healthcare Group WF2 7BJ 41 Richmond Hill 01924 229370 Bournemouth www.bostonhealthcare.co.uk UK BH2 6HS Brymill Cryogenic Systems (UK) Ltd 0344 243 6661 26 Hayes View Drive www.ceutahealthcare.com/ Cheslyn Hay Walsall Chattem WS6 7EX Ringway Centre +44 (0)1256 841045 Edison Road www.brymilluk.com Basingstoke RG21 6YH C 01256 844 144 Cambridge Healthcare Supplies Ltd www.chattem.com Unit 1 Chestnut Drive Wymondham Clifden Healthcare Ltd Norfolk Madley NR18 9SB HR2 9JF 01953 607856 01981 251 214 www.cambridge-healthcare.co.uk www.saalmann.net

CD Medical Clinique Laboratories Allenby Laboratories One Fitzroy Wigan Road 6 Mortimer Street Bolton UK BL5 2AL W1T 3JJ 01942 816184 www.clinique.co.uk/ www.cdmedical.co.uk Clinisupplies Celgene Limited 100 Elmgrove Road 1 Longwalk Road Harrow Stockley Park Middlesex Uxbridge HA1 2RW UK 020 8426 0768 UB11 1DB www.clinisupplies.co.uk. +44 (0) 208 831 8300 www.celgene.co.uk Concordia International Capital House Celltrion Healthcare UK Limited 85 King William Street The Switch, 1-7 UK The Grove EC4N 7BL Slough +44 (0) 208 588 9441 Berkshire www.concordiarxinternational.com SL1 1QP 01753 983 500 ConvaTec www.celltrionhealthcare.com First Avenue

164 Dermatology Handbook 2021–2022 Company details

Deeside Industrial Park UK Deeside SW1V 2SA UK 0203 598 9603 CH5 2NU www.dermalex.co.uk 01244 584300 www.convatec.co.uk Dermasweat Crofters Barn Ego Pharmaceuticals Min Street Royal George Offices Kniveton 2 Regent Street Ashbourne Knutsford Derbyshire Cheshire DE6 1JH WA16 6GR UK www.egopharm.com/gb/en.html 07579 003279

Dermatonics D Bramley Road Diomed Developments St Ives Tatmore Place PE27 3WS Gosmore 01480 462 910 Hitchin www.dermatonics.co.uk Hertfordshire SG4 7QR Diagenics www.diomedgroup.co.uk South House 1 Bond Avenue Derma UK Bletchley Toffee Factory Milton Keynes Lower Steenbergs Yard UK Quayside MK1 1SW Ouseburn 01908 376376 UK www.diagenics.co.uk NE1 2DF 0191 375 9020 Diomed Developments www.dermauk.co.uk Tatmore Place Gosmore Dermal Laboratories Ltd Hitchin Tatmore Place Hertfordshire Preston Road UK Hitchin SG4 7QR SG4 7QR +44 (0) 1462 458866 01462 458 866 www.diomed.co.uk www.dermal.co.uk DreamSkin Health Dermalex 4 Carters Road 1st Floor, 32 Vauxhall Bridge Road (Omega Hatfield Pharma) AL9 5NB Vauxhall 01707 260 505 London www.dreamskinhealth.co.uk

Dermatology Handbook 2021–2022 165 Dermatology Handbook

07554133321 E www.pastebandagesevolan.com Easigrip Unit 13 F Scar Bank Fenton Pharmaceuticals Miller’s Road Fenton House Warwick 4 Hampstread Gate CV34 5DB 1a Frognal 01926 497108 London www.easigrip.co.uk NW3 6AL 020 7433 8595 Eli Lilly and Company www.fentonpharmaceuticals.com Indianapolis Indiana Ferndale Pharmaceuticals United States Unit 740 46285 Thorp Arch Estate +1-317-276-2000 Wetherby www.lilly.com LS23 7FX 01937 541 122 Ennogen Pharma Ltd www.ferndalepharma.co.uk Unit G4 Riverside Industrial Estate Fontus Health Riverside Way 60 Lichfield Street Dartford Walsall UK WS4 2BX DA1 5BS 0121 661 4615 www.ennogen.com www.aproderm.com/healthcare-professionals/

Espère Healthcare Forest Laboratories UK Ltd Shefford House Riverbridge House 15 Hugh Street Crossways Business Park Shefford Anchor Boulevard SG17 5DD Dartford 01462 346100 DA2 6SL www.esperehealth.co.uk 01322 421 800 www.frxeurope.eu Essential Healthcare 249 – Ongar Road G Brentwood Galderma (UK) Essex Meriden House UK 67-71 Clarendon Road CM15 9DZ Watford www.essential-healthcare.co.uk/ WD17 1DS 01923 208 950 Evolan Pharma www.galderma.co.uk Svardvagen 19 SE-182 33 Danderyd Genus Pharmaceuticals Sweden Newbury

166 Dermatology Handbook 2021–2022 Company details

RG14 1JN Heywood Distribution Park 01635 568 400 Pilsworth Road www.genuspharma.com Heywood Lancashire GlaxoSmithKline Consumer Healthcare OL10 2TT 980 Great West Road 01706 363200 Brentford www.hartmann.co.uk Middlesex UK Hospira UK TW8 9GS Huxley Europe 0800 783 8881 26 Whitaker Lane Prestwich GlaxoSmithKline UK Manchester 980 Great West Road M25 1FX Brentford 0161 773 0485 Middlesex www.huxley-europe.co.uk UK TW8 9GS I 0800 221 441 Impectron Ltd www.gsk.co.uk Unit 411 Centennial Park Glenmark Pharmaceuticals Europe Elstree Glenmark House, B. D. Sawant Marg Hertfordshire Chakala, Off Western Express Highway UK Andheri (E), Mumbai - 400 099 WD6 3TN India 0844 272 8888 +91 22 4018 9999 www.impectron.com www.glenmarkpharma.com Integra Life Sciences GlucoRx Suite 2 GlucoRx Ltd 1 A Park Street Unit 1C Maidenhead Henley Business Park SL6 1QS Pirbright Road 01628 779 461 Guildford, Surrey www.integralife.com/ GU3 2DX www.allpresan.uk.com Intrapharm Laboratories The Granary H The Courtyard Barns Harpar Grace International Choke Lane Highland House Cookham Dean Mayflower Close SL6 6PT Chandlers Ford 01628 771800 Hampshire www.intrapharmlabs.com SO53 4AR www.isclinical.co.uk/ Ipsen 190 Bath Road Hartmann Slough

Dermatology Handbook 2021–2022 167 Dermatology Handbook

Berkshire 08450 606707 SL1 3XE www.lohmann-rauscher.co.uk www.ipsen.co.uk La Roche Posay J 255 Hammersmith Road Janssen-Cilag Ltd London 50–100 Holmers Farm Way UK High Wycombe W6 8AZ HP12 4EG www.laroche-posay.co.uk/ 01494 567 444 www.janssen.co.uk LEO Pharma Horizon Jobskin Ltd Honey Lane Unit 13a Harrington Mill Hurley Leopold Street Berkshire Long-Eaton United Kingdom Nottingham SL6 6RJ UK 01844 347 333 NG10 4QG www.leo-pharma.co.uk 01159 734300 www.jobskin.co.uk/ L’Oréal Active Cosmetics Division 255 Hammersmith Road Johnson & Johnson Ltd London Foundation Park W6 8AZ Roxborough Way 0800 055 6822 (UK) / 1800 818 651 (ROI) Maidenhead www.loreal-paris.co.uk UK SL6 3UG Lornamead UK 01628 822222 Basepoint www.aveenoprofessional.co.uk London Road Camberley K GU15 3HL Kryolan UK 01276 415741 22, Tavistock Street www.keromask.com Covent Garden United Kingdom LPC Pharmaceuticals WC2E 7PY 30 Chaul End Lane 0207240 3111 Luton www.uk.kryolan.com/product-lines/dermacolor LU4 8EZ 01582 560 393 L L&R Medical UK Ltd M 1 Wellington Court M&A Pharmachem Ltd Lancaster Park Elland Close Needwood, Burton upon Trent Westhoughton Staffordshire Bolton UK BL5 3XE DE13 9PS 01942 816 184

168 Dermatology Handbook 2021–2022 Company details

www.mapharmachem.co.uk Medicareplus International Marlborough Pharmaceuticals Ltd Chemilines House Sovereign House Alperton Lane Miles Gray Road Wembley Basildon UK Essex SS14 3FR HA0 1DX UK 020 8810 8811 01268 594777 www.medicareplus.co.uk

McBride Medik8 Middleton Way 730 Centennial Park Manchester Elstree M24 4DP Herts 0345 604 6456 UK www.surcare.co.uk WD6 3SZ www.medik8.com McNeil Products Foundation Park Medline Industries Roxborough Way 3rd Floor Maidenhead Quayside Wilderspool Business Park SL6 3UG Greenalls Avenue 01344 864 042 Warrington www.mcneilproducts.co.uk UK WA46HL Meda Pharmaceuticals 0844 334 5237 Skyway House uk.medline.com/ Parsonage Road Takeley Merck Sharp & Dohme Ltd CM22 6PU Hoddeson 0845 460 0000 EN11 9BU www.medapharma.co.uk 01992 467 272 www.msd-uk.co.uk medi UK Plough Lane Mölnlycke Health Care Hereford Unity House HR4 0EL Medlock Street 01432 373500 Oldham www.mediuk.co.uk OL1 3HS 0161 621 3900 Medical Aesthetic Group www.molnlycke.co.uk Unit 3 Compass Point Ensign Way Mylan Hamble Building 4 Southampton Trident place UK Mosquito Way SO31 4RA Hatfield 02380 676 733 AL10 9UL

Dermatology Handbook 2021–2022 169 Dermatology Handbook

UK 01707 853000 O www.mylan.co.uk Omega Pharma 32 Vauxhall Bridge Road N London Nagor SW1V 2SA 129 Deerdykes View 0203 598 9601 Westfield Industrial Estate www.omegapharma.co.uk Cumbernauld Glasgow Optima Consumer Health UK 27 Victoria Mews G68 9HN Cottingley Business Park 01236 780780 Cottingley www.gcaesthetics.com/ Bingley UK Napp Pharmaceuticals BD16 1PY Cambridge Science Park 01274 526360 Milton Road www.optimah.com Cambridge UK Opus Healthcare CB4 0AB Avonbridge House +44 (0)1223 424444 Bath Road www.napp.co.uk Chippenham Wiltshire Neostrata SN15 2BB 307 College Road East 01249 466966 Princeton, NJ 08540 www.opus-healthcare.co.uk United States 1-800-628-9904 Organon Pharma (UK) Limited www.neostrata.com Hertford Road Hoddesdon Neubourg Pharma UK Hertfordshire Headley House EN11 9BU Parklands 0208 159 3593 Queen Elizabeth Park www.msd-uk.com Railton Rd UK Oswell Penda Pharmaceutical GU2 9JX 106 Holme Lane 01483 238 209 Hillsborough allpresan.uk.com Sheffield S6 4JW Novartis Pharmaceuticals UK Ltd 01691 674046 Frimley Business Park www.opp-uk.com Frimley Camberley Ovelle Pharmaceuticals GU16 7SR Coes Road West 01276 698 370 Dundalk www.novartis.co.uk County Louth

170 Dermatology Handbook 2021–2022 Company details

Ireland R 00 353 42 933 2305 R & D Healthcare www.elaveskincare.com 6 Station Road Harpenden P Hertfordshire Penlan Healthcare UK Abbey House AL5 4SE Wellington Way 01582 712708 Weybridge UK Reckitt Benckiser Healthcare UK KT13 0TT Wellcroft House 0345 241 4330 Wellcroft Road www.penlanhealthcare.com Slough SL1 4AQ Pern Consumer Products Ltd 01753 217800 Quantum House www.rb.com Hobson Industrial Estate Burnopfield Reig Jofre UK Ltd County Durham 9 (a) Business Support Centre NE16 6EA Caddsdown Business Park 0800 599 9022 Bideford www.dermacool.co.uk EX39 3DX 01237 471296 Pfizer Ltd www.reigjofre.com Walton Oaks Dorking Road Roche Products Ltd Tadworth Hexagon Place KT20 7NS 6 Falcon Way 01304 616 161 Shire Park www.pfizer.co.uk Welwyn Garden City AL7 1TW Pierre Fabre 01707 366 000 Hyde Abbey House www.roche.co.uk 23 Hyde Street Winchester RPH Pharmaceuticals AB Hampshire Pure Offices, Suite 71 SO23 7DR Brooks Drive 01962 874 400 Cheadle Royal Business Park www.pierre-fabre.com Cheadle UK Pilva Pharma +44 (0) 845 023 0467 Prilaz Baruna Filipovića 25 www.recipharm.com 10000 Zagreb Croatia S + 385 1 37 20 000 Sandoz www.pliva.com Frimley Business Park Frimley, Camberley GU16 7SR

Dermatology Handbook 2021–2022 171 Dermatology Handbook

01420 478 301 Hagley www.sandoz.com West Midlands DY9 9LQ Sanofi UK 01562 546123 One Onslow Street www.skinniesuk.com Guildford GU1 4YS Smith & Nephew Healthcare 0845 372 7101 Croxley Business Park www.sanofi.co.uk Building 5 Hatters Lane Schuco International (London) Hertfordshire Hercules Way UK Leavesden Park WD18 8YE Hertfordshire www.smith-nephew.com WD25 7GS UK Spirit Healthcare Ltd 01923 234 600 Spirit House www.schuco.co.uk Saffron Way Leicester Sesderma LE2 6UP 42A Station Road East Oxted Stiefel, a GSK Company Surrey Stockley Park West UK Uxbridge RH8 0PG UK 01883 717485 UB11 1BT www.sesderma.co.uk/ 0800 221 441 www.stiefel.co.uk SilDerm Dane Mill Business Centre T Broadhurst Lane Teva UK Congleton Field House CW12 1 LA Station Approach 01260 271 666 Harlow www.silderm.com CM20 2FB 0207 540 7117 Sinclair IS Pharma PLC www.tevauk.com 1st Floor Whitfield Court 30-32 Therapy World (MGC) Whitfield Street 8 Sovereign Centre London Farthing Road UK Ipswich WIT 2RQ IP1 5AP 020 7467 6920 01473 466300 www.sinclairpharma.com www.therapyworld.org.uk

Skinnies Thomas Blake Cosmetic Creams UNit 5 Hagley Mews Quantum House

172 Dermatology Handbook 2021–2022 Company details

Hobson Industrial Estate www.vernacare.com Burnopfield Northern Ireland W NE16 6EA Water-Jel Systems Europe 01207 272311 201-507-8300 www.veilcovercream.com www.waterjel.com

Thornton & Ross Z Linthwaite Labs Zeon Linthwaite Landscape Close Huddersfield Weston-on-the-Green HD7 5QH OX25 3SX 01484 842 217 01869 343990 www.thortonandross.co.uk www.clearzal.co.uk

Transdermal Merlin House Brunel Road Theale Reading RG7 4AB 0118 902 6770 www.transdermal.co.uk

Typharm 14D Wendover Road Rackheath Industrial Estate Norwich NR13 6LH 01603 722480 www.typharm.com U UCB Pharma 208 Bath Road Slough SL1 3WE 01753 534 655 www.ucbpharma.co.uk V Vernacare Ltd 1 Western Avenue Matrix Park Chorley PR7 7NB 01772 299900

Dermatology Handbook 2021–2022 173 Dermatology Handbook Products by company

3M United Kingdom Cavilon Continence Care Wipes Ascot Laboratories Ltd Cavilon Durable Barrier Cream Exmaben Cream Cavilon No Sting Barrier Film Exmalatum Cream ExmaQS Cream AbbVie Humira Aspen Medical Europe Sorbaderm Barrier Cream Advancis Medical Sorbaderm No-Sting Barrier Film Advasil Conform Aspire Pharma AesthetiCare Epimax ExCetra Cream AesthetiCare Control Tactics Redness-Control Gel Epimax Isomol Gel Epimax Moisturising Cream Alliance Pharmaceuticals Ltd Epimax Oatmeal Cream Aquadrate 10% w/w Cream Epimax Ointment Hydromol Bath & Shower Emollient Epimax Original Cream Hydromol Cream Epimax Paraffin-free Ointment Hydromol Intensive Hydromol Ointment Astellas Pharma Ltd Kelo-Cote Conotrane MolluDab Lipobase Cream Occlusal Locoid Quinoderm Cream / Quinoderm Cream 5 Mildison Lipocream Timodine Protopic Zineryt Almirall Ltd Actikerall Avanor Healthcare Ltd Aknemycin Plus Hidrex ClassicION Iontophoresis Machine Balneum Bath Oil Hidrex ConnectION Iontophoresis Machine Balneum Cream Idromed 5GS Balneum Plus Bath Oil Idromed 5PS Balneum Plus Cream Perspi-Guard Maximum Strength Antiperspirant Curatoderm Lotion Perspi-Guard Odour Control Bodywash Curatoderm Ointment Skilarence Ayrton Saunders Ltd Solaraze Betadine Dry Powder Spray Unguentum M Cream Sprilon Vaniqa Bayer PLC Amdipharm Mercury Company Canesten Ltd Canesten HC Erythrocin/Erythroped Canesten Hydrocortisone Robinul Dianette

174 Dermatology Handbook 2021–2022 Products by company

Diprobase Boston Healthcare Ltd Finacea Cepton Medicated Skin Wash Skinoren Uvistat Beiersdorf UK Ltd Brymill Cryogenic Systems Aquaphor (UK) Ltd Eucerin Actinic Control MD SPF100 Heine Headlight & Loupes Eucerin Anti-Pigment Bovie A940 Eucerin Anti Redness Concealing Day Cream SPF Bovie A950 25 + UVA Bovie Derm 102 Eucerin Anti Redness Soothing Care Closed Probes Eucerin AtoControl Acute Care Cream Cry-Ac Eucerin Dermo Capillaire Calming Shampoo with Cryo Tweezers 5% urea Heine Delta 20T Eucerin Dermo Capillaire Scalp Treatment with 5% Liquid Nitrogen Storage & Withdrawal urea Open Sprays Eucerin DermoPurifyer Oil Control Adjunctive Opticlar D-Scope Soothing Cream Eucerin Oil Control Sun Cambridge Healthcare Eucerin Pigment Control Sun Supplies Ltd Eucerin Replenishing Face Cream Anabact Eucerin Sun Allergy Protect Xepin Eucerin Urea Repair 5% Urea Original Cream Eucerin Urea Repair Plus 10% Urea Foot Cream CD Medical Eucerin Urea Repair Plus 5% Urea Hand Cream Clinifilm Eucerin Urea Repair Plus 5% Urea Replenishing Emollin Spray Body Wash Peel-Easy Eucerin Urea Repair Plus 10% Urea Lotion Celltrion Healthcare UK Bell's Healthcare Limited Bell's Emollient Remsima Bellava Ltd Celgene Limited Keromask Otezla Bio Oil Ceuta Healthcare Group Bio-Oil Infaderm Therapeutic Oil Vamousse Biofrontera Ameluz Chattem Selsun Biogen Idec Benepali Clinique Laboratories Flixabi Anti-Blemish Solutions 3-step System Emergency gel lotion Boots UK Even Better Boots Derma Care Itch Relief Even Better Dark Spot Defense SPF 50 Redness Solutions Daily Protective Base SPF 15

Dermatology Handbook 2021–2022 175 Dermatology Handbook

Redness Solutions Daily Relief Cream Psoriderm Cream Redness Solutions Soothing Cleanser Psoriderm Scalp Lotion Salactol Clinisupplies Salatac Gel CliniFast CliniFast Garments Dermalex imuDERM emollient Dermalex Repair Concordia International Dermasweat Zyomet Idromed 5 GS (rental or hire purchase) ConvaTec Dermatonics Niltac Sting Free Medical Adhesive Remover Dermatonics Dry Skin Balm Sensi-Care Sting Free Adhesive Releaser Dermatonics Once Callus Removing Balm Sensi-Care Sting Free Protective Skin Barrier Dermatonics Once Heel Balm Silesse Sting Free Skin Barrier Wipes Ultraveen Itch Relief Cream Diomed Developments Diagenics Freederm Treatment Allergopharma Skin Prick Test Solutions True Test Derma UK Cetavlex Cream Diomed Developments Covermark Bazuka Extra Strength Menthoderm Sebco DreamSkin Health Siopel DreamSkin Ultrabase Easigrip Dermal Laboratories Ltd Easifast Adex Gel Anhydrol Forte Ego Pharmaceuticals Betacap Scalp Application QV Bath Oil Capasal Therapeutic Shampoo QV Cream Dermalo Bath Emollient QV Gentle Wash Dermax Therapeutic Shampoo QV Intensive Ointment Dermol 200 Shower Emollient QV Skin Lotion Dermol 500 Lotion SunSense Daily Face Dermol 600 Bath Emollient SunSense Kids Dermol Cream SunSense Lip Balm Dermol Wash SunSense Sensitive Doublebase Dayleve Gel SunSense Ultra Doublebase Emollient Bath Additive Doublebase Emollient Shower Gel and Doublebase Eli Lilly and Company Emollient Wash Gel Talz Doublebase Gel Emulsiderm Bath Additive Ennogen Pharma Ltd Glutarol Aquasoothe Nicam Gel Cala Soothe

176 Dermatology Handbook 2021–2022 Products by company

Enopen Cetaphil Restoraderm Skin Restoring Body Fifty-50 Moisturiser Ovelle Emulsifying Ointment Cetaphil Restoraderm Skin Restoring Body Wash Thirty-30 Differin Trimovate Efracea Epiduo Gel Espère Healthcare Etrivex Alhydran Loceryl BAP Scar Care Gel Metrogel BAP Scar Care S Metvix Cream BAP Scar Care T Mirvaso DermaSilk Therapeutic Clothing Nutraplus Microair Barrier Socks and Gloves Rozex Molutrex Silkis Viticolor Gel Soolantra Tetralysal 300 Essential Healthcare KreaMoint 50:50 Ointment Galen Limited Dermipar Ointment Evolan Pharma ExoCream Ichthopaste Bandage Miclaro Oat Cream & Lotion Viscopaste PB7 Bandage Myribase Emollient Shower Gel Zipzoc MyriBase Gel Fenton Pharmaceuticals GlaxoSmithKline Consumer Delph Healthcare Driclor Ferndale Pharmaceuticals Lamisil AT 1% Gel Acea Lamisil AT 1% Spray Lamisil Once cutaneous solution Fontus Health Piriton AproDerm Barrier Cream Tavegil AproDerm Colloidal Oat Cream AproDerm Emollient Cream GlaxoSmithKline UK AproDerm Gel Bactroban AproDerm Ointment Betnovate Betnovate Scalp Application FranceMed Pharma Betnovate RD Magicool Plus Cutivate Dermovate Galderma (UK) Dermovate Scalp Application Acnecide Eumovate Aktilite CL128 Lamp Valtrex Calmurid Cream Zovirax Cetaphil Gentle Skin Cleanser Zovirax Oral Cetaphil Moisturising Cream Cetaphil Moisturising Lotion

Dermatology Handbook 2021–2022 177 Dermatology Handbook

Glenmark Pharmaceuticals Europe Kryolan UK Emcrem Dermacolor GlucoRx L&R Medical UK Ltd GlucoRx Allpresan Basic ActiFast Tubular Bandages GlucoRx Allpresan Intensive Debrisoft Debrisoft Lolly Harpar Grace International iS Clinical Tri Active Exfoliant La Roche Posay iS Clinical White Lightening Complex Anthelios Baby & Kids Anthelios Sun Protection Hospira UK Cicaplast Baume B5 Methotrexate Effaclar A.I. Breakout Corrector Effaclar H Huxley Europe Effaclar K+ LPL 63.4 Fragrance Free Bath Emollient Lipikar Baume AP+M Pigmentclar Impectron Ltd Rosalic AR Intense Aquaderm Cetomacrogol Cream Toleriane Ultra Aquaderm Hydrous Cream Aquaderm Liquid Paraffin and White Soft Paraffin LEO Pharma Dovobet Gel Integra Life Sciences Dovobet Ointment Medihoney Barrier Cream Enstilar Cutaneous Foam Fucibet Cream Intrapharm Laboratories Fucibet Lipid Cream Aquamax Fucidin Aquamax Wash Fucidin H Cream Terra-Cortril Ointment Kyntheum Picato Ipsen Dysport Lexon UK Pure Health Janssen-Cilag Ltd Daktacort L’Oréal Active Cosmetics Pevaryl Division Sporanox CeraVe Moisturising Cream Stelara CeraVe Moisturising Lotion Tremfya LPC Pharmaceuticals Jobskin Ltd Psorin Scar FX Marlborough Pharmaceuticals Johnson & Johnson Ltd Ltd Aveeno Cream Dermacort Aveeno Lotion Neutrogena T/Gel

178 Dermatology Handbook 2021–2022 Products by company

McBride Tubifast Garments with 2-Way Stretch Technology Surcare Sensitive Mylan McNeil Products Dermatix Benadryl Allergy Dermatix Silicone Gel Daktarin Efudix Regaine Elidel Minocin MR Meda Pharmaceuticals Treclin Aldara Zyclara Nagor Silgel medi UK UCS Debridement Neostrata Enlighten Pigment Controller Medical Aesthetic Group Exuviance Blemish Treatment Gel DCL Acne Healing System NeoCeuticals Acne Spot Treatment Gel DCL Skincare DCL Spot Therapy Novartis Pharmaceuticals UK M&M Systems Ltd Mene and Moy acne gel Cosentyx Lamisil Medicareplus International Neoral Lifteez Medical Adhesive Remover Medi Derma-Pro Foam and Spray Incontinence Omega Pharma Cleanser Alphosyl 2-in-1 Medi Derma-Pro Skin Protectant Ointment – Non- Drapolene Sting Fenistil Cold Sore Cream Medi Derma-S Total Barrier Cream – Non-sting Kamillosan Medi Derma-S Total Barrier Film – Non-sting Lyclear Medik8 Optima Consumer Health Red Alert Cleanse Pickles Redness Corrector Verrugon White Balance Click White Balance Click Oxy-R Opus Healthcare LaVera Barrier Cream Medline Industries Lift Plus Medical Adhesive Remover Non-sting Remedy Moisturising Barrier Cream SkinSafe Remedy Moisturising Cream Organon Pharma (UK) Limited Merck Sharp & Dohme Ltd Diprosalic Ointment Remicade Diprosalic Scalp Application Diprosone Mölnlycke Health Care Elocon Epaderm Cream Lotriderm Epaderm Ointment NeoClarityn Mepiform Propecia

Dermatology Handbook 2021–2022 179 Dermatology Handbook

Synalar 1 in 4 Dilution Oswell Penda Pharmaceutical Synalar C Revamil Balm Synalar N Revamil Gentle Hand Wash Revamil Hand Cream Roche Products Ltd Roaccutane Ovelle Pharmaceuticals Elave Sensitive Body Lotion RPH Pharmaceuticals AB Elave Sensitive Intensive Cream Bettamousse Elave Sensitive Ointment Cocois Elave Sensitive Sun SPF30 Salcura PCA Skin Antiac Activ PCA Skin Acne Gel PCA Skin Anti-Redness Serum Sandoz Erelzi Pern Consumer Products Ltd Permethrin 5% Cream Dermacool Sanofi UK Pfizer Ltd Dupixent Dalacin T Mizollen Diflucan Phenergan Enbrel Inflectra Schuco International (London) Trosyl Nail solution Coa-Comp M CryoPro Pierre Fabre CryoSuccess Clarelux DermLite Basic Dexeryl DermLite Carbon Rosiced DermLite DL200 HR DermLite DL200 Hybrid R & D Healthcare DermLite DL3N Chemists' Own Head Lice DermLite DL4 DermLite DL4W Reckitt Benckiser Healthcare Hyfrecator 2000 UK Surtron 120 Derbac–M E45 Bath Oil Sesderma E45 Cream Azelac RU E45 Itch Relief Cream E45 Lotion SilDerm E45 Wash Cream Lumixyl Active Preparation Full Marks Lumixyl Glycopeel Lumixyl Kit Reig Jofre UK Ltd Lumixyl Topical Brightener Crystacide Cream 1% Metosyn Sinclair IS Pharma PLC Synalar Xclair

180 Dermatology Handbook 2021–2022 Products by company

Treviolux Skin Med Akincare Thomas Blake Cosmetic Creams SkinCeuticals Veil Cover Cream Advanced Pigment Corrector Thornton & Ross Skinnies Care Aqueous Calamine Cream (SLS free) Skinnies Laundry Care Aqueous Emollient Cream (SLS Free) Skinnies Silk Care Hydrogen Peroxide Solution 3% Skinnies Viscose Garments Care Hydrogen Peroxide Solution 6% Skinnies WEB Garments Care Hydrogen Peroxide Solution 9% Care Magnesium Sulfate Paste BP Smith & Nephew Healthcare Care ViraSoothe Cica-Care Care Zinc & Castor Oil Cream Cetraben Bath Additive Spirit Healthcare Ltd Cetraben Cream Ambulight PDT Multi Cetraben Lotion Cetraben Ointment Stiefel, a GSK Company Duofilm Duac Once Daily Eczmol Isotrexin Eurax Cream Toctino Eurax HC Cream Flexitol 10% Urea Cream Stragen Pharma Flexitol 25% Urea Heel Balm Clairette Flexitol Hand Balm Flexitol Hard Skin & Callus Balm Synchroline Flexitol Skin Balm Thiospot Intensive Cream Hedrin Mycota Vernacare Ltd Nizoral Anti-dandruff Shampoo ComfiFAST Easywrap Garments Oilatum Cream ComfiFAST MultiStretch Tubular Bandage Oilatum Emollient ComfiFAST Tubular Bandages Oilatum Junior Bath Additive Oilatum Junior Cream Teva UK Oilatum Plus Antiseptic Acitretin (Neotigason) 10mg and 25mg Capsules Oilatum Shower Gel Calcipotriol/Betamethasone (Dalbecal) 50mcg/g + Tavegil 0.5mg/g Ointment ZeroAQS Emollient Cream Cyproheptadine (Periactin) 4mg Tablets Zerobase Emollient Cream Exorex Lotion 5% v/w Cutaneous Emulsion Zerocream Emollient Cream Sudocrem Antiseptic Healing Cream Zeroderm Ointment Zerodouble Emollient Gel Therapy World (MGC) Zeroguent Emollient Cream MEDLight MED-Tester Mini Zerolatum Bath Additive MEDLight N-LINE Pro Zeroneum MEDLight N-LINE t Zeroveen Cream MEDLight Psor-COMB

Dermatology Handbook 2021–2022 181 Dermatology Handbook

Transdermal Dandrazol 2% Shampoo Dandrazol Anti-dandruff Shampoo Typharm Fludroxycortide 4micrograms/square cm tape 7.5cm Fludroxycortide Cream Nystatin Nystatin HC UCB Pharma Xyzal Zirtek Vichy Dermablend Vichy Normaderm Double Correction Daily Care Moisturiser Vitame Ltd Emelpin Ointment Soffen Cream Water-Jel Systems Europe R1 Cooling Gel and R2 Protectant Lotion Zeon ClearZal ClearZal Hard Skin Remover Ultralanum

182 Dermatology Handbook 2021–2022 Products by company EXPLORE THE COMPLETE ARCHIVE www.magonlinelibrary.com/ journal/nrec

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Guidance and best practice for the nursing home Dermatology Handbook 2021–2022 183 Dermatology Handbook Product index

A Azelac RU ...... 51 Acea ...... 153 Acitretin (Neotigason) 10mg and 25mg Capsules 121 B Acnecide ...... 127 Bactroban ...... 130 ActiFast Tubular Bandages ...... 28 Balneum Bath Oil ...... 66 Actikerall ...... 157 Balneum Cream ...... 88 Adex Gel ...... 98 Balneum Plus Bath Oil...... 70 Advanced Pigment Corrector ...... 51 Balneum Plus Cream ...... 100 Advasil Conform ...... 33 BAP Scar Care Gel ...... 33 AesthetiCare Control Tactics Redness-Control Gel 54 BAP Scar Care S ...... 33 Akincare ...... 126 BAP Scar Care T ...... 33 Aknemycin Plus ...... 128 Bazuka Extra Strength ...... 159 Aktilite CL128 Lamp ...... 108 Bell’s Emollient...... 74 Aldara ...... 157 Benadryl Allergy ...... 113 Alhydran ...... 33 Benepali ...... 116 Allergopharma Skin Prick Test Solutions ...... 62 Betacap Scalp Application ...... 136 Allpresan Diabetic Foam Cream Basic ...... 93 Betadine Dry Powder Spray ...... 131 Allpresan Diabetic Foam Cream Intensive ...... 93 Betnovate ...... 145 Alphosyl 2-in-1 ...... 155 Betnovate-RD ...... 143 Altargo ...... 130 Betnovate Scalp Application ...... 136 Ambulight PDT Multi ...... 108 Bettamousse ...... 138 Ameluz ...... 157 Bio-Oil ...... 34 Anabact ...... 130 Boots Derma Care Itch Relief ...... 20 Anhydrol Forte ...... 22 Bovie A940 ...... 105 Anthelios Baby & Kids ...... 36 Bovie A950 ...... 105 Anthelios XL ...... 36 Bovie Derm 102 ...... 105 Antiac Activ ...... 48 Anti-Blemish Solutions 3-step System ...... 48 C Apriro ...... 87 Cala Soothe ...... 21 AproDerm Barrier Cream ...... 22 Calmurid Cream ...... 88 AproDerm Colloidal Oat Cream ...... 87 Canesten ...... 132 AproDerm Emollient Cream ...... 73 Canesten HC ...... 138 AproDerm Gel ...... 73 Canesten Hydrocortisone ...... 131 AproDerm Ointment ...... 73 Capasal Therapeutic Shampoo ...... 155 Aquaderm Cetomacrogol Cream ...... 74 Care Aqueous Calamine Cream (SLS free) ...... 74 Aquaderm Hydrous Cream ...... 74 Care Aqueous Emollient Cream (SLS Free) ...... 71 Aquaderm Liquid Paraffin and White Soft Paraffin 74 Care Hydrogen Peroxide Solution 3% ...... 131 Aquadrate 10% w/w Cream ...... 88 Care Hydrogen Peroxide Solution 6% ...... 131 Aquamax ...... 74 Care Hydrogen Peroxide Solution 9% ...... 131 Aquamax Wash ...... 71 Care Magnesium Sulfate Paste BP ...... 131 Aquaphor Soothing Skin Balm ...... 88 Care ViraSoothe...... 21 Aquasoothe...... 74 Care Zinc & Castor Oil Cream ...... 23 Aveeno Cream ...... 88 Cavilon Continence Care Wipes ...... 23 Aveeno Lotion ...... 88 Cavilon Durable Barrier Cream ...... 23

184 Dermatology Handbook 2021–2022 Product index

Cavilon No Sting Barrier Film ...... 23 Dandrazol 2% Shampoo ...... 155 Cepton Medicated Skin Wash ...... 126 Dandrazol Anti-dandruff Shampoo ...... 155 CeraVe Moisturising Cream ...... 90 DCL Acne Healing System ...... 48 CeraVe Moisturising Lotion ...... 90 DCL Skincare ...... 51 Cetaphil Gentle Skin Cleanser ...... 71 DCL Spot Therapy ...... 48 Cetaphil Moisturising Cream ...... 75 Debrisoft ...... 35 Cetaphil Moisturising Lotion...... 75 Debrisoft Lolly ...... 35 Cetaphil Restoraderm Skin Restoring Body Delph ...... 36 Moisturiser ...... 90 Derbac–M ...... 148 Cetaphil Restoraderm Skin Restoring Body Wash 71 Dermablend ...... 30 Cetavlex Cream...... 132 Dermacolor ...... 30 Cetraben Bath Additive ...... 66 Dermacool ...... 76 Cetraben Cream ...... 75 Dermacort ...... 143 Cetraben Lotion ...... 75 Dermalex Repair ...... 54 Cetraben Ointment ...... 75 Dermalo Bath Emollient...... 66 Chemists’ Own Head Lice ...... 148 DermaSilk Therapeutic Clothing ...... 41 Chemotechnique Diagnostics ...... 62 Dermatix ...... 34 Cica-Care ...... 34 Dermatix Silicone Gel ...... 34 Cicaplast Baume B5 ...... 98 Dermatonics Dry Skin Balm ...... 90 Clarelux ...... 138 Dermatonics Once Callus Removing Balm ...... 159 ClearZal ...... 150 Dermatonics Once Heel Balm ...... 91 ClearZal Hard Skin Remover ...... 90 Dermax Therapeutic Shampoo ...... 156 CliniFast ...... 40 Dermipar Ointment ...... 68 CliniFast Garments ...... 40 DermLite Basic ...... 60 Clinifilm ...... 23 DermLite Carbon ...... 60 Closed Probes ...... 104 DermLite DL3N ...... 60 Coa-Comp M ...... 106 DermLite DL4 ...... 61 Cocois ...... 150 DermLite DL4W ...... 61 ComfiFAST Easywrap Garments ...... 40 DermLite DL200 HR ...... 60 ComfiFAST MultiStretch Tubular Bandage ...... 28 DermLite DL200 Hybrid ...... 60 ComfiFAST Tubular Bandages ...... 29 Dermol 200 Shower Emollient ...... 100 Conotrane ...... 24 Dermol 500 Lotion ...... 98 Cosentyx ...... 116 Dermol 600 Bath Emollient ...... 66 Covermark ...... 30 Dermol Cream ...... 98 Cry-Ac...... 104 Dermol Wash ...... 101 CryoPro ...... 104 Dermovate ...... 146 CryoSuccess...... 104 Dermovate Scalp Application ...... 138 Cryo Tweezers ...... 104 Dexeryl ...... 91 Crystacide Cream 1%...... 132 Dianette...... 112 Curatoderm Lotion ...... 152 Differin ...... 129 Curatoderm Ointment ...... 152 Diprobase...... 76 Cutivate ...... 145 Diprosalic Ointment ...... 136 Cyproheptadine (Periactin) 4mg Tablets ...... 114 Diprosalic Scalp Application ...... 138 Diprosone ...... 145 D Dithrocream ...... 150 Daktacort ...... 140 Doublebase Dayleve Gel ...... 91 Daktarin ...... 133 Doublebase Emollient Bath Additive ...... 68 Dalacin T ...... 127

Dermatology Handbook 2021–2022 185 Dermatology Handbook

Doublebase Emollient Shower Gel and Doublebase Epimax Ointment ...... 80 Emollient Wash Gel ...... 71 Erelzi...... 117 Doublebase Gel ...... 76 Etrivex ...... 151 Dovobet Gel ...... 153 Eucerin Actinic Control MD SPF100 ...... 158 Dovobet Ointment ...... 153 Eucerin Anti Redness Concealing Day Cream SPF Drapolene ...... 24 25 + UVA ...... 54 DreamSkin ...... 42 Eucerin Anti Redness Soothing Care ...... 54 Driclor ...... 22 Eucerin AtoControl Acute Care Cream ...... 50 Duac Once Daily ...... 128 Eucerin Anti-Pigment ...... 51 Duofilm ...... 159 Eucerin Dermo Capillaire Calming Shampoo with Dupixent ...... 116 5% urea ...... 156 Dysport ...... 148 Eucerin Dermo Capillaire Scalp Treatment with 5% urea ...... 151 E Eucerin DermoPurifyer Oil Control Adjunctive E45 Bath Oil ...... 68 Soothing Cream ...... 80 E45 Cream ...... 76 Eucerin Intensive 10% Urea ...... 91 E45 Itch Relief Cream ...... 100 Eucerin Oil Control Sun ...... 38 E45 Lotion ...... 76 Eucerin Pigment Control Sun ...... 38 E45 Wash Cream ...... 72 Eucerin Replenishing Face Cream ...... 91 Easifast ...... 29 Eucerin Sun Allergy Protect ...... 38 Eczmol ...... 100 Eucerin Urea Repair 5% Urea Original Cream ...... 91 Effaclar A.I. Breakout Corrector...... 128 Eucerin Urea Repair Plus 5% Urea Hand Cream ...92 Effaclar H ...... 48 Eucerin Urea Repair Plus 5% Urea Replenishing Effaclar K+ ...... 49 Body Wash ...... 72 Efracea ...... 126 Eucerin Urea Repair Plus 10% Urea Foot Cream ...92 Efudix ...... 157 Eumovate ...... 143 Elave Sensitive Body Lotion ...... 77 Eurax Cream ...... 21 Elave Sensitive Intensive Cream ...... 77 Eurax HC Cream ...... 136 Elave Sensitive Ointment...... 77 Even Better ...... 52 Elave Sensitive Sun SPF 30 ...... 38 Even Better Dark Spot Defense SPF 50 ...... 52 Elidel ...... 147 Exmaben Cream ...... 80 Elocon ...... 145 Exmalatum Cream ...... 80 Emcrem ...... 77 ExmaQS Cream ...... 82 Emelpin Ointment...... 77 ExoCream ...... 82 Emergency Gel Lotion ...... 49 Exorex Lotion 5% v/w Cutaneous Emulsion ...... 153 Emollin Spray ...... 78 Emulsiderm Bath Additive ...... 66 F Enbrel ...... 117 Fenistil Cold Sore Cream ...... 135 Enlighten Pigment Controller ...... 51 Fifty-50 ...... 82 Enopen ...... 78 Finacea ...... 127 Enstilar Cutaneous Foam ...... 152 Flexitol 10% Urea Cream ...... 92 Epaderm Cream ...... 78 Flexitol 25% Urea Heel Balm ...... 92 Epaderm Ointment ...... 78 Flexitol Hand Balm ...... 93 Epiduo Gel ...... 128 Flexitol Hard Skin & Callus Balm ...... 93 Epimax Cream ...... 78 Flexitol Skin Balm ...... 93 Epimax ExCetera Cream ...... 91 Flixabi ...... 118 Epimax Moisturising Cream ...... 78 Fludroxycortide 4micrograms/square cm tape Epimax Oatmeal Cream ...... 80 7.5cm ...... 144

186 Dermatology Handbook 2021–2022 Product index

Fludroxycortide Cream and Ointment ...... 144 Lamisil AT Spray ...... 133 Freederm Treatment ...... 126 Lamisil Once cutaneous solution ...... 133 Fucibet Cream ...... 141 LaVera Barrier Cream ...... 24 Fucibet Lipid Cream ...... 142 Lifteez Adhesive Remover – Non-sting ...... 20 Fucidin ...... 132 Lift Plus Non-Sting Adhesive Remover ...... 20 Fucidin H Cream ...... 140 Lipikar Baume AP+M ...... 94 Full Marks ...... 149 Lipobase Cream ...... 84 Liquid Nitrogen Storage & Withdrawal ...... 104 G Loceryl ...... 134 Glutarol ...... 159 Locoid ...... 146 Grisol AF Spray ...... 133 Lotriderm ...... 142 LPL 63.4 Fragrance Free Bath Emollient ...... 68 H Lumixyl Active Preparation ...... 52 Hedrin ...... 149 Lumixyl Glycopeel ...... 52 Heine Delta 20T ...... 61 Lumixyl Kit ...... 52 Heine Headlight & Loupes ...... 61 Lyclear ...... 149 Hidrex GS400 Iontophoresis Machine ...... 106 Hidrex PSP1000 Iontophoresis Machine ...... 106 M Humira ...... 118 Magicool Plus ...... 21 Hydromol Bath & Shower Emollient ...... 68 Medi Derma-Pro Foam and Spray Incontinence Hydromol Cream...... 94 Cleanser – Non-sting ...... 72 Hydromol Intensive...... 94 Medi Derma-Pro Ointment – Non-sting ...... 26 Hydromol Ointment ...... 82 Medi Derma-S Total Barrier Cream – Non-sting ..24 Hyfrecator 2000 ...... 106 Medi Derma-S Total Barrier Film – Non-sting ...... 24 Medihoney Barrier Cream ...... 26 I MEDLight MED-Tester Mini ...... 107 Ichthopaste Bandage ...... 29 MEDLight N-LINE Pro ...... 107 Idromed 5GS ...... 107 MEDLight N-LINE t ...... 107 Idromed 5 PS Iontophoresis Machine ...... 107 MEDLight Psor-COMB ...... 108 imuDERM emollient ...... 94 Mene and Moy acne gel ...... 50 Infaderm Therapeutic Oil ...... 82 Menthoderm ...... 84 Inflectra ...... 118 Mepiform ...... 35 iS Clinical Tri Active Exfoliant ...... 49 Methotrexate ...... 120 iS Clinical White Lightening Complex ...... 52 Metosyn ...... 146 Isomol Gel ...... 78 Metrogel ...... 154 Isotrexin ...... 129 Metvix Cream ...... 158 Miclaro Oat Cream & Lotion ...... 94 K Microair Barrier Socks and Gloves ...... 43 Kamillosan ...... 82 Mildison Lipocream ...... 143 Kelo-cote ...... 34 Minocin MR ...... 112 Keromask ...... 32 Mirvaso ...... 154 KreaMoint 50:50 Ointment ...... 84 Mizollen ...... 114 K-Vit Anti Dark Circle Cream ...... 52 M&M Systems ...... 50 Kyntheum ...... 118 MolluDab ...... 135 Molutrex ...... 150 L Mycota ...... 134 Lamisil ...... 113 Myribase Emollient Shower Gel ...... 72 Lamisil AT Gel ...... 133 Myribase Gel ...... 84

Dermatology Handbook 2021–2022 187 Dermatology Handbook

N Q NeoCeuticals Acne Spot Treatment Gel ...... 50 Quinoderm Cream /Quinoderm Cream 5...... 126 NeoClarityn ...... 114 QV Bath Oil...... 70 Neoral ...... 120 QV Cream ...... 85 Nerisone ...... 146 QV Gentle Wash ...... 73 Neutrogena T/Gel ...... 156 QV Intensive Ointment ...... 96 Nicam Gel ...... 126 QV Skin Lotion ...... 85 Niltac Sting Free Medical Adhesive Remover ...... 20 Nizoral...... 134 R Nutraplus ...... 96 R1 Cooling Gel and R2 Protectant Lotion ...... 85 Nystatin ...... 134 Red Alert Cleanse ...... 55 Nystatin HC ...... 140 Redness Corrector ...... 55 Redness Solutions Daily Protective Base SPF 15 ....55 O Redness Solutions Daily Relief Cream...... 56 Occlusal...... 159 Redness Solutions Soothing Cleanser ...... 56 Oilatum Cream ...... 96 Regaine ...... 130 Oilatum Emollient ...... 70 Remedy Moisturising Barrier Cream...... 26 Oilatum Junior Bath Additive ...... 70 Remedy Moisturising Cream ...... 26 Oilatum Junior Cream ...... 96 Remicade ...... 118 Oilatum Plus Antiseptic ...... 66 Remsima ...... 119 Oilatum Shower Gel Fragrance-Free ...... 73 Roaccutane ...... 121 Open Sprays ...... 105 Robinul ...... 22 Opticlar D-Scope ...... 62 Rosalic AR Intense ...... 154 Otezla ...... 121 Rosiced ...... 154 Ovelle Emulsifying Ointment ...... 84 Rozex ...... 154 Oxygenetix ...... 50 S P Salactol ...... 160 PCA Skin Acne Gel ...... 50 Salatac Gel ...... 160 PCA Skin Anti-Redness Serum ...... 55 Scar FX ...... 35 Peel-Easy ...... 20 Sebco ...... 151 Periactin ...... 114 Selsun ...... 156 Permethrin 5% Cream ...... 149 Sensi-Care Sting Free Protective Skin Barrier ...... 26 Perspi-Guard Maximum Strength Antiperspirant .148 SilDerm Scar Gel ...... 35 Perspi-Guard Odour Control Bodywash ...... 148 Silesse Sting Free Skin Barrier Wipes ...... 27 Pevaryl...... 134 Silgel ...... 35 Phenergan ...... 114 Silkis ...... 152 Picato ...... 158 Simildiet Xtra lightening serum ...... 53 Pickles ...... 150 Siopel ...... 27 Pigmentclar ...... 53 Skilarence ...... 120 Piriton ...... 115 Skinnies Laundry ...... 32 Propecia ...... 113 Skinnies Silk ...... 43 Protopic ...... 147 Skinnies Viscose Garments ...... 43 Psoriderm Bath Emulsion ...... 151 Skinnies WEB Garments ...... 44 Psoriderm Cream ...... 151 Skinoren ...... 127 Psoriderm Scalp Lotion ...... 151 SkinSafe ...... 27 Psorin ...... 150 Soffen Cream ...... 85 Pure Health ...... 84 Solaraze ...... 158

188 Dermatology Handbook 2021–2022 Product index

Soolantra ...... 154 Vaniqa ...... 147 Sorbaderm Barrier Cream ...... 27 Veil Cover Cream ...... 32 Sorbaderm No-Sting Barrier Film ...... 27 Verrugon ...... 160 Sporanox ...... 113 Vichy Normaderm Double Correction Daily Care Sprilon ...... 28 Moisturiser ...... 53 Stelara ...... 119 Viscopaste PB7 Bandage ...... 30 Sudocrem ...... 28 Viticolor Gel ...... 32 SunSense Kids ...... 39 SunSense Lip Balm ...... 39 W SunSense Sensitive ...... 39 White Balance Click ...... 53 SunSense Sensitive SPF 50 ...... 39 White Balance Click Oxy-R ...... 54 SunSense Ultra ...... 38 Surcare Sensitive ...... 32 X Surtron 120 ...... 106 Xclair ...... 21 Synalar...... 146 Xepin ...... 21 Synalar 1 in 4 Dilution ...... 144 Xyzal ...... 115 Synalar C ...... 142 Synalar N ...... 142 Z ZeroAQS Emollient Cream ...... 86 T Zerobase Emollient Cream ...... 86 Talz ...... 119 Zerocream Emollient Cream ...... 87 Tavegil ...... 115 Zeroderm Ointment ...... 87 Terra-Cortril Ointment ...... 141 Zerodouble Gel ...... 87 Tetralysal 300 ...... 112 Zeroguent Emollient Cream ...... 87 Thiospot Intensive Cream ...... 53 Zerolatum Emollient Bath Additive ...... 70 Thirty-30 ...... 86 Zeroneum Emollient Bath Additive ...... 70 Timodine ...... 141 Zeroveen Cream ...... 96 Toctino ...... 122 Zindaclin...... 127 Toleriane Ultra ...... 50 Zineryt ...... 127 Treclin ...... 129 Zipzoc ...... 30 Tremfya ...... 119 Zirtek ...... 115 Treviolux ...... 108 Zovirax ...... 135 Trimovate ...... 141 Zovirax Oral ...... 116 Trosyl Nail solution ...... 134 Zyclara ...... 158 True Test ...... 62 Zyomet ...... 155 Tubifast Garments with 2-Way Stretch Technology ..45 U UCS Debridement ...... 36 Ultrabase ...... 86 Ultralanum ...... 144 Ultraveen Itch Relief Cream ...... 96 Unguentum M Cream ...... 86 Uvistat ...... 39 V Valtrex ...... 115 Vamousse ...... 149

Dermatology Handbook 2021–2022 189 Dermatology Handbook Notes

190 Dermatology Handbook 2021–2022 Notes

Dermatology Handbook 2021–2022 191 Dermatology Handbook

192 Dermatology Handbook 2021–2022 Notes

Dermatology Handbook 2021–2022 193 Dermatology Handbook

194 Dermatology Handbook 2021–2022 Notes

To advertise in the next Dermatology Handbook 2022-2023 please contact Ed Croome 020 7333 1741 [email protected]

The essential guide to product selection

Dermatology Handbook 2021–2022 195 Dermatology Handbook

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To find out more contact [email protected] Emollin® is a trademark of CD Medical Ltd, www.cdmedical.co.uk | 01942 816184 Allenby Laboratories, Wigan Road, Bolton, BL5 2AL 196 Dermatology Handbook 2021–2022