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 Formulary Chapter 13: Skin - Full Chapter
Notes:

Dermatology clinics at George Eliot Hospital are run by UHCW.

Therefore all dermatology outpatient prescriptions need to be in line with the UHCW formulary which consultants should be familiar with.

We will only issue prescriptions from our outpatient department if the prescription is for a specialist drug (SO,SI or SC) and those prescriptions that are deemed urgent for the patient to start immediately (ie the patients condition will deteriorate if they wait for a supply from the GP).

For any prescribers wishing to start an inpatient or an outpatient on an emollient please refer to the formulary below which has been taken from both the APC and UHCW Preferred Prescribing List (PPL).

 Details...
13.02.01  Expand sub section  Emollients
 note 

Emollients soothe, smooth and hydrate the skin and are indicated for all dry or scaling disorders. Effects are short lived and thus frequent application is advised. Emollients should be applied immediately after washing or bathing to maximise the effect of skin hydration. They are useful in dry and eczematous disorders, and to a lesser extent in psoriasis. The choice of an appropriate emollient will depend on the severity of the condtion, patient preference and the site of application. The least expensive emollient that is effective, cosmetically acceptable and that the patient is prepared to use regularly should be prescribed.
Generally, 'greasy' preparations provide the best emollient effect, however, for cosmetic reasons, patients may prefer a less oily preparation for daytime use or for use on an exposed area such as the face.
Emollients should be applied liberally and as frequently as possible, intensive use may reduce the need for topical steroids.
Careful explanation of how to use emollients, as well as how much to use may encourage compliance.

Fire hazard with paraffin-based emollients: Emulsifying ointment or 50% Liquid Paraffin and 50% White Soft Paraffin Ointment in contact with dressings and clothing is easily ignited by a naked flame. The risk is greater when these preparations are applied to large areas of the body, and clothing or dressings become soaked with the ointment. Patients should be told to keep away from fire or flames, and not to smoke when using these preparations. The risk of fire should be considered when using large quantities of any parafin based emollient.
Rapid Response Report - Fire hazard with paraffin-based skin products.

 

DO NOT supply 500g pots to the wards routinely where a smaller pot is available, check area to be treated.

Aquamax Cream
(White soft paraffin 20%, liquid paraffin 8%)
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Formulary
  • £/500g
  • Alternative to aqueous cream, can be used as a wash
 
   
Aveeno Cream
(Colloidal oatmeal)
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Formulary
  • £/100mL & ££/500mL
  • For dermatology outpatients only as per ACBS criteria
 
   
Balneum Cream
(Urea 5%)
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Formulary
  • ££/500g
  • Contains urea
  • Dermatology only
 
   
Balneum Plus Cream
(Lauromacrogols 3%, urea 5%)
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Formulary
  • £/100g & ££/500g
  • Contains urea
  • Dermatology only
 
   
Cetraben Cream
(13.2% white soft paraffin, 10.5% light liquid paraffin & 4.5% glycerin)
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Formulary
  • ££/500g
  • Dermatology advised only
 
   
Cetraben Lotion
(5% white soft paraffin, 4% light liquid paraffin & 3% glycerin)
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Formulary
  • £/500mL
  • May be used as an alternative to Aveeno Cream and Lotion
 
   
Cetraben Ointment
(35% white soft paraffin, 45% light liquid paraffin)
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Formulary
  • £/450g
  • Dermatology advised only
 
   
Dermol 500 Lotion
(liquid paraffin 2.5%, isopropyl myristate 2.5%, benzalkonium chlor. 0.1%, chlorhexidine hydrochlor. 0.1%)
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Formulary
  • ££/500mL
  • Contains antimicrobial, should only be used short term for infected/active eczema
  • Can be used as a wash (use Aquamax where long term wash required)
  • Dermatology only
 
   
Dermol Cream
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Formulary
  • £/100g & ££/500g
  • Contains antimicrobial, should only be used short term for infected/active eczema
  • Dermatology only
 
   
Doublebase gel
(isopropyl myristate 15%, liquid paraffin 15% (low paraffin content))
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Formulary
  • £/100g & ££/500g
  • Dermatology only
 
   
E45 Cream
(white soft paraffin 14.5%, hypoallergenic anhydrous lanolin 1%, light liquid paraffin 12.6%)
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Formulary
  • £/100g & ££/500g
 
   
Emulsifying Ointment BP
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Formulary
  • £/500g
 
   
Epimax Cream
(liquid paraffin 6%, white soft paraffin 15%)
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Formulary
  • £/500g
  • Alternative to diprobase and oilatum cream
 
   
Epimax Ointment
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Formulary
  • £/500g
 
   
ExCetra cream
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Formulary
  • £/500g
  • Similar to Cetraben cream but less expensive
 
   
Hydromol Intensive 10%
(urea 10%)
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Formulary
  • £/100g
  • Contains urea
  • Alternative to Calmurid
  • Dermatology only
 
   
Hydromol Ointment
(yellow soft paraffin 32%, emulsifying wax 25.5%, liquid paraffin 42.5%)
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Formulary
  • £/500g
 
   
ImuDERM Urea Emollient
(urea 5% & glycerin 5%)
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Formulary
  • ££/500g
  • Contains urea
 
   
Liquid and White Soft Paraffin Ointment
(white soft paraffin 50%, liquid paraffin 50%)
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Formulary
  • ££/500g
 
   
Menthoderm
(Menthol in aqueous cream 1%)
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Formulary
  • ££/500g
 
   
QV cream
(glycerol 10%, light liquid paraffin 10%, white soft paraffin 5%)
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Formulary
  • ££/500g
  • Dermatology advised only
 
   
QV Intensive Ointment
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Formulary
  • ££/450g
  • Dermatology advised only
 
   
Yellow soft paraffin
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Formulary
  • £/15g
 
   
13.02.01.01  Expand sub section  Emollient bath and shower preparations
 note 

In dry skin conditions soap should be avoided. Emollient bath additives should be added to bath water; hydration can be improved by soaking in the bath for 10-20 minutes. Some bath emollients can be applied to wet skin undiluted and rinsed off.
Aqueous cream used as a soap substitute may also suffice as a bath additive. It is best whisked in a jug of hot water before adding it to the bath water.
The preparations make skin and surfaces slippery - particular care is needed when bathing. The use of anti-slip bath mats/handles especially for the young and elderly should be encouraged.

 

GPs can be asked to prescribe bath additives/wash - DO NOT prescribe from outpatients unless really urgent. Patients may be asked to purchase these products in the community.

Aquamax Wash
(white soft paraffin 20%, liquid paraffin 8%)
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Formulary
  • £/250g
  • Aquamax cream can also be used as a soap substitute
  • Dermatology only
 
   
Hydromol bath and shower
(light liquid paraffin 37.8%, isopropyl myristate 13%)
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Formulary
  • £/500mL
 
   
QV Gentle Wash
(Glycerol 15%)
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Formulary
  • £/500mL
  • Dermatology only
 
   
 ....
Key
note Notes
Section Title Section Title (top level)
Section Title Section Title (sub level)
First Choice Item First Choice item
Non Formulary Item Non Formulary section
Restricted Drug
Restricted Drug
Unlicensed Drug
Unlicensed
Track Changes
Display tracking information
click to search medicines.org.uk
Link to adult BNF
click to search medicines.org.uk
Link to children's BNF
click to search medicines.org.uk
Link to SPCs
SMC
Scottish Medicines Consortium
Cytotoxic Drug
Cytotoxic Drug
CD
Controlled Drug
High Cost Medicine
High Cost Medicine
Cancer Drugs Fund
Cancer Drugs Fund
NHSE
NHS England
Homecare
Homecare
CCG
CCG

Traffic Light Status Information

Status Description

Red SO

SPECIALIST ONLY - These drugs are deemed to be not appropriate for prescribing by GPs. Specialists should not ask GPs to prescribe these drugs.   

Green SI

SPECIALIST INITIATED - These drugs must be initiated, i.e. the first dose prescribed, by the specialist and then may be continued when appropriate by the patients GP following communication from the specialist.   

Green SA

SPECIALIST ADVISED Specialists may simply advise a patients GP to initiate these drugs themselves after they have made an initial assessment.   

Amber SC

SHARED CARE - Responsibility for prescribing may be transferred from secondary to primary care with the agreement of an individual GP and when agreed shared care arrangements have been established. The specialist MUST stabilize the patient before asking for care to be transferred. Only specialists should initiate these drugs. Prescribing should be transferred to GPs according to an Shared Care Agreement [SCA]   

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