netFormulary

Lancashire and South Cumbria
Formulary

13 Skin

Dermatology prescribing may require use of expensive unlicensed
creams and ointments (known as ‘Specials’). Please consult the revised British Association of Dermatologists (BAD) list of preferred Specials (2018) for advice on appropriate product choice.

Several medicines in the skin chapter are available for purchase over the counter and may be appropriate for self care. Please consult the local OTC policy for more details.

LSCMMG: Over The Counter (OTC) Items That Should Not Be Routinely Prescribed In Primary Care Policy

13-04 Topical corticosteroids.

In the BNF publications topical corticosteroids for the skin are categorised as ‘mild’, ‘moderately potent’, ‘potent’ or ‘very potent’; the least potent preparation which is effective should be chosen but dilution should be avoided whenever possible.

Potency of a topical corticosteroid preparation (including compound preparations) is based solely on the corticosteroid component, irrespective of the formulation and strength.

The potency of each topical corticosteroid should be included on the label with the directions for use. The label should be attached to the container (for example, the tube) rather than the outer packaging.

For guidance on quantities to prescribe see BNF:
https://bnf.nice.org.uk/treatment-summaries/topical-corticosteroids/

Hydrocortisone

Formulary

Cream 1%
Ointment 1%

Consider OTC/Self care.

Mild corticosteroid.

Hydrocortisone with clotrimazole Canesten HC^®

Formulary

Cream hydrocortisone 1%, clotrimazole 1%

Consider OTC/Self care.

Mild corticosteroid.

Hydrocortisone with fusidic acid Fucidin H^®

Formulary

Cream hydrocortisone acetate 1%, fusidic Acid 2%

Preparations containing fusidic acid should not be used in secondary care for in-patients.

Mild corticosteroid.

Hydrocortisone with benzalkonium chloride, dimeticone and nystatin Timodine^®

Formulary

Cream hydrocortisone 0.5%, nystatin 100000 unit per 1 g, benzalkonium chloride 0.2%, dimeticone '350' 10%

Mild corticosteroid.

Hydrocortisone butyrate Locoid^®

Formulary

Lipocream 0.1%

Lichen sclerosus in women when betamethasone cream is ineffective.

Moderate corticosteroid.

Clobetasone Butyrate

Formulary

Cream 0.05% (Eumovate®)
Ointment 0.05%

Moderate corticosteroid.

Clobetasone butyrate with nystatin and oxytetracycline Trimovate^®

Formulary

Cream clobetasone 0.05%, nystatin 100000 unit per 1 gram, oxytetracycline 3%

Moderate corticosteroid.

Betamethasone Valerate

Formulary

Cream 0.025%, 0.1%
Ointment 0.025%, 0.1%
Scalp application 0.1%
Foam 0.1% (Bettamousse®)

Potent corticosteroid.

Betamethasone dipropionate with salicylic acid Diprosalic^®

Formulary

Ointment betamethasone 0.05%, salicylic acid 3%
Scalp application betamethasone 0.05%, salicylic acid 2%

Potent corticosteroid.

Betamethasone valerate with fusidic acid

Formulary

Cream betamethasone 0.1%, fusidic acid 2%

Preparations containing fusidic acid should not be used in secondary care for in-patients.

Potent corticosteroid.

Betamethasone dipropionate with clotrimazole Lotriderm^®

Formulary

Cream betamethasone 0.064% , clotrimazole 1%

Potent corticosteroid.

Flucinolone Acetonide

Formulary

Gel 0.025% (Synalar®)

For scalp use only.

Potent corticosteroid.

Fludroxycortide

Formulary

Tape 4micrograms/square cm, 7.5cm

Potent corticosteroid.

Mometasone Furoate

Formulary

Cream 0.1%
Ointment 0.1%

Potent corticosteroid.

Clobetasol Propionate

Formulary

Cream 0.05%, Ointment 0.05%
Cutaneous foam 0.05% (Clarelux®)
Shampoo 0.05% (Etrivex®)

Very potent corticosteroid.

Betamethasone dipropionate Diprosone^®

Formulary

Cream 0.05%

For use post urology surgery.

Potent corticosteroid.

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