Greater Knox Pharmacy
Monday | 8am - 7pm |
Tuesday | 8am - 7pm |
Wednesday | 8am - 7pm |
Thursday | 8am - 7pm |
Friday | 8am - 7pm |
Saturday | 8am - 2pm |
Sunday | Closed |
Dry skin by itself isn't a medical worry, although serious cases can result in cracks and fissures that invite infection and inflammation. The real issue is discomfort — dry skin can be sore, tender to the touch, and often itchy.
The fact is that despite the long lists of obscure ingredients and the pseudoscientific hokum, all moisturisers help with dry skin for a pretty simple reason: they supply a little bit of water to the skin and contain a greasy substance that holds it in.
Emollients and moisturisers are most effective when applied immediately after bathing but can also be applied at other times.
The brand of moisturiser rarely makes a difference.
Factors that are important are:
Advantages | Disadvantages | |||
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Least greasy ↓ Most greasy |
Face or mildly dry skin | Lotion💧 |
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Aqueous cream💧💧 |
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Body and moderate to very dry | Creams💧💧💧 |
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Ointments💧💧💧💧 |
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Eczema and Dermatitis are often used interchangeably by medical professionals. Eczema has also been used to refer to Atopic Dermatitis. Other common types of Dermatitis include: Contact Dermatitis, Hand/Foot Dermatitis, Seborrheic Dermatitis, Cradle Cap and some types of Nappy Rash.
Dermatitis is characterised by skin inflammation and itching. They can present as a red rash that is usually itchy, dry, and sometimes scaly.
Dermatitis is NOT contagious.
Why some people develop eczema or dermatitis is not well understood. It is common for people with dermatitis to have other allergies. This suggests that inherited (genetic) factors increase the tendency to develop dermatitis.
In people with dermatitis the skin does not retain moisture very well, which causes it to dry out easily. This makes the skin more open to allergens and irritants. These can trigger the skin to release chemicals that make the skin itchy. Scratching itchy skin causes more chemicals to be released, making the skin feel itchier. This scratch and itch cycle can cause discomfort, disrupt sleep and affect quality of life.
Atopic Dermatitis (Eczema) usually starts before the age of 1, but can present for the first time in adults as well.
Eczema is characterised by itch, and is most commonly found in the creases of elbows, wrists, neck and behind the knees.
Many people with dermatitis may already have other allergies, or can develop other allergies, such as allergic rhinitis (hay fever), asthma, food allergy, or dust mite allergy. Studies have shown that up to 30% of infants with eczema, with a family history of allergy, will develop food allergy, and up to 40% develop asthma and/or allergic rhinitis (hay fever).
Principles of management are generally the same for all types of Dermatitis, and the rash can often be treated successfully.
Eczema responds well to topical corticosteroids.
Daily bathing is not harmful if soap and bubble bath are avoided and emollient is liberally applied immediately afterwards.
Frequent use of emollients (moisturisers) to improve skin condition is essential :
Some factors that aggravate atopic dermatitis are unavoidable, including weather changes, dry weather, concurrent upper respiratory tract infection and stress.
Aggravating factors that can be avoided or managed include overheating, skin irritants, allergens and infections.
Minimise contact with irritants such as:
Choose according to site and severity of the dermatitis:
Face | |||
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Agent | Dose / Duration | Notes | |
Mild | Hydrocortisone 1% | Use once daily until the skin is completely clear. | If not responding after 7 days, use a stronger topical corticosteroid for a limited time |
Severe | Methylprednisolone Aceponate 0.1% | Use once daily for 7 - 14 days | When the skin clears, continue to use moisturiser, otherwise send for specialist advice |
Trunk and Limbs | |||
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Agent | Dose / Duration | Notes | |
Mild | Triamcinolone Acetonide 0.02% | Use once daily until the skin is completely clear | When the skin clears, continue to use moisturiser |
Severe | Methylprednisolone Aceponate 0.1% OR Mometasone Furoate 0.1% |
Use once daily until the skin is completely clear | If response is slow, consider modified dressings before sending for specialist advice |
Fingers, Wrists, Ankles, Feet | |||
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Agent | Dose / Duration | Notes | |
Mild | Betamethasone Dipropionate 0.05% OR Betamethasone Valerate 0.1%OR Mometasone Furoate 0.1% |
Use once daily until the skin is completely clear | When the skin clears, continue to use moisturiser |
Severe | Betamethasone Dipropionate 0.05% OR Betamethasone Valerate 0.1%OR Mometasone Furoate 0.1%PLUS modified dressings |
Use once daily until the skin is completely clear | When the skin clears, continue to use moisturiser, otherwise send for specialist advice |
Scalp (Adult) | |||
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Agent | Dose / Duration | Notes | |
Mild | Betamethasone Dipropionate 0.05% lotion OR Methylprednisolone Aceponate 0.1% lotionOR Mometasone Furoate 0.1% lotion or hydrogel |
Use once daily until the skin is completely clear | If there is no response, seek specialist advice |
Severe | Betamethasone Dipropionate 0.05% lotion OR Methylprednisolone Aceponate 0.1% lotionOR Mometasone Furoate 0.1% lotion or hydrogel |
Use once daily until the skin is completely clear | If there is no response, seek specialist advice |
Scalp (Child) | |||
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Agent | Dose / Duration | Notes | |
Mild | Desonide 0.05% lotion | Use once or twice daily until the skin is completely clear | If there is no response, seek specialist advice |
Moderate | Methylprednisolone aceponate 0.1% lotion | Use once daily until the skin is completely clear | If there is no response, seek specialist advice |
Severe | Mometasone Furoate 0.1% hydrogel | Use once daily until the skin is completely clear | If there is no response, seek specialist advice |
Axillae (armpit) and groin | |||
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Agent | Dose / Duration | Notes | |
Mild | Hydrocortisone 1% OR Desonide 0.05% lotion |
Use once daily until the skin is completely clear. | If not responding after 7 days, use a stronger topical corticosteroid for a limited time |
Severe | Methylprednisolone Aceponate 0.1% | Use once daily until the skin is completely clear | If there is no response in 7 days, seek specialist advice |
A common workplace skin condition, predominantly affecting the hands.
Before starting pharmacological treatment:
Face | |||
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Agent | Dose / Duration | Notes | |
Mild | Hydrocortisone 1% | Use once daily until the skin is completely clear. | If not responding after 7 days, use a stronger topical corticosteroid for a limited time |
Severe | Methylprednisolone Aceponate 0.1% | Use once daily for 7 - 14 days | When the skin clears, continue to use moisturiser, otherwise send for specialist advice |
Hands | |||
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Agent | Dose / Duration | Notes | |
Mild | Betamethasone Dipropionate 0.05% OR Betamethasone Valerate 0.1%OR Mometasone Furoate 0.1% |
Use once daily until the skin is completely clear | When the skin clears, continue to use moisturiser |
Severe | Betamethasone Dipropionate 0.05% OR Betamethasone Valerate 0.1%OR Mometasone Furoate 0.1%PLUS modified dressings |
Use once daily until the skin is completely clear |
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Feet | |||
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Agent | Dose / Duration | Notes | |
Mild | Betamethasone Dipropionate 0.05% | Use once daily until the skin is clear for up to four weeks | When the skin clears, continue to use moisturiser |
Severe | Betamethasone Dipropionate 0.05% in optimised vehicle | Use once daily until the skin is clear for up to four weeks |
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Genital and pubic area | |||
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Agent | Dose / Duration | Notes | |
Mild | Methylprednisolone Aceponate 0.1% | Use once daily until the skin is clear for up to one week | If there is no response, seek specialist advice |
Severe |
A chronic relapsing condition that affects mainly the scalp, but can present on the cheeks, side of the nose, eyebrows and eyelids.
Mild / First line / Dandruff | Daily shampoo use till scalp clears | Daily |
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Severe / Unresponsive to first line | Anti-fungal shampoo (e.g. Cedel, Selsun, Nizoral) | 2 - 7 times per week |
Add a steroid lotion if anti-fungal shampoo is not sufficient (e.g. Diprosone, Advantan, Elocon, Novasone, or Zatamil) | Once daily at night for 7 nights |
Initially | For red severe cases | Dose / Duration | Notes |
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Hydrocortisone 1% + Candida treatment (e.g. Nystatin, Miconazole, Clotrimazole)+ Zinc Oxide |
Methylprednisolone Aceponate 0.1% + Candida treatment+ Zinc OxideOR Triamcinolone Acetonide 0.02%+ Candida treatment+ Zinc Oxide |
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Potency | Agent | Strength | Brands | Form | Availability |
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Mild | Hydrocortisone | 0.5% | Dermaid 0.5% | cream, lotion | OTC |
1% | Sigmacort, Cortic DS, Dermaid 1%, others | cream, ointment | OTC, Prescription | ||
Moderate | Betamethasone Valerate | 0.02% | Antroquoril, Betnovate ⅕, Celestone M, Cortival ⅕ | cream | Prescription |
0.05% | Betnovate ½, Cortival ½, | cream | Prescription | ||
Triamcinolone | 0.02% | Aristocort, Tricortone | cream, ointment | Prescription | |
Potent | Betamethasone Dipropionate | 0.05% | Diprosone, Eleuphrat | cream, ointment, lotion | Prescription |
Betamethasone Valerate | 0.1% | Betnovate | cream, ointment | Prescription | |
Methylprednisolone Aceponate | 0.1% | Advantan | cream, ointment, fatty ointment, lotion | Prescription | |
Mometasone Furoate | 0.1% | Elocon, Novasone, Zatamil, others | cream, ointment, gel, lotion | OTC, Prescription | |
Very Potent | Betamethasone Dipropionate | 0.05% in optimised vehicle | Diprosone OV | ointment | Prescription |
Take a bath or shower and lightly pat skin dry. Apply topical corticosteroid to affected skin. Cover treated skin with damp (wrung-out) wet dressings. Soak dressings in water that is a comfortable temperature. For babies, use a jumpsuit as the dressing. For older children and adults, use pyjamas, elasticated tubular bandages, towels, sheets, cotton socks (for feet) or cotton gloves (for hands). Wrap up in a towel or wear dry clothes on top, to keep warm and ensure the damp layer is in close contact with the skin. Remove the wet dressings after 15 to 60 minutes. Dry the skin, then apply an emollient.
Soak in a warm bath of plain water for 20 minutes just before bedtime. Don’t dry skin after getting out of bath. Smear affected skin with large amounts of corticosteroid. Put on old pyjamas or loose clothes (still don’t dry the skin). Moisturise the skin the next morning. Do this every night for 4 to 14 nights until the skin inflammation clears.