Dermatological Drugs

DERMATOLOGICAL DRUGS.
DRUGS USED FOR ECZEMA.
Eczema/ dermatitis refers to a variety of skin disorders characterized by superficial skin

inflammation and itching.
Drugs used in treatment of eczema include;
 Emollients
 Oral antihistamines
 Topical corticosteroids
 Antibiotics
Emollients
Emollients are hydrophobic agents that seal the surface of the skin and reduce water loss. Apply
them twice daily preferably after bathing when water content of the skin is at its greatest.
Examples include; E45 cream, aqueous cream and sudocream.
Antihistamines.
They relieve the itching associated with dermatitis. Sedating antihistamines are preferred to non
sedating antihistamines. Examples are; hydroxyzine, chlopheniramine, promethazine and
Cetrizine.
Antibiotics
Systemic antibiotics such as macrolides (erythromycin, Azithromycin), penicillins (cloxacillin,

flucloxacillin, ampiclox) are recommended in the treatment of secondary bacterial infection
associated with atopic dermatitis. Topical antibiotics are rarely used because of their potential to
cause hypersensitivity.
Topical Corticosteriods.
They are used where emollients don’t provide adequate relief. The patient’s age, severity of the
disease and site of involvement determine the type and strength of topical corticosteroids to be
used. Examples are; hydrocortisone, clobetasol, fluocinolone, triamcininolone acetonide,
betamethasone, beclomethasone etc.
HYDROCORTISONE.
Available preparations; cream 1% and ointment 1%.

Indications.
 Dermatitis.
Contraindications
 Acne vulgaris
 broken skin
 untreated bacterial, fungal or viral skin infections.
Dose; Apply film layer twice daily until improvement occurs, then less frequently once a day.
Side effects.
 Worsening of untreated infections

 Burning sensation or irritation of the skin
 pimples
 skin rash
 discoloration.
BETAMETHASONE
Available preparations; 0.1%, 0.5% and ointment 0.1%, 0.5%.
Indications
 dermatitis
 insect bite reaction
 psoriasis.
Contraindications
 untreated skin infections

 herpes simplex virus
 chicken pox infection
 broken skin
 acne
Dose; apply 1-2 times daily until improvement occurs, mantainance apply once daily or less
often.
Side effects
 exacerbation of local infection

 skin irritation
 hypopigmentation
 acne at site of application.
DRUGS FOR PSORIASIS.
Psoriasis is a chronic, non infectious inflammatory skin disease characterized by enhanced

epidermal proliferation leading to redness of the skin, scaling and thickening of the skin.
Drugs used in treatment of psoriasis include;
 Moisturilisers
 Vitamin D analogues
 Topical corticosteroids
 Keratolytics
 Retinoids.
 systemic methotrexate
 Systemic retinoids.
Emollients
Emollients are frequently used to help soften and soothe the skin thereby reducing scaling,
cracking and dryness. They are useful in conditions characterized by dryness, scaling and
cracking of the skin such as psoriasis and eczema.
Keratolytics
Keratolytics such as saliclylic acid ointment 2%, 5%, 10% and 20% are used to break down
keratin and soften skin which improves penetration of other drugs like corticosteroids.
Vitamin D analogues.
This class of drugs include calcipotriol, they are used in mild to moderate chronic plague
psoriasis. They regulate epidermal proliferations and differentiation and also have
immunosuppressant properties. Patient acceptance is good since they don’t smell and they don’t
have the risk of skin atrophy seen with topical steroids.
DRUGS FOR ACNE.
Acne is a common condition caused by excessive production of the skin’s natural oil (sebum)
leading to blockage of hair follicles. It commonly affects adolescents but may occur at any age.
Acne primarily affects the face, neck, back.
Drugs used in treatment of acne are;

Topical preparations
 Peroxides
 Retinoids
 Antibacterials
Systemic preparations
 Oral antibacterials
 Retinoids.
PEROXIDES.
BENZOYL PEROXIDE.
Benzoyl peroxide may be used with topical or oral antibacterial drugs.
Available preparations; creams 5%, 10%, gel 5%.
Indications
 acne vulgaris
Contraindications
 hypersensitivity to benzoyl peroxide.
Dose; Apply to clean skin twice daily starting with a lower strength of 5% then gradually
increase to 10%. Improvement occurs after 4weeks.
Side effects
 skin dryness or peeling

 skin rash
 mild bleaching
 local dermatitis
 redness of the skin
 allergic dermatis.
Nursing considerations
 wash affected area with soap and warm water prior to application
 Stop the medication if severe irritation occurs
 Avoid contact with eyes, mouth and other mucus membranes.
FUNGAL INFECTIONS.
TINEA.
Tinea is a superficial infection of the skin, hair or nails caused by dermatophytes. Classified
according to area affected ie
 Tinea pedis (foot)

 Tinea cruris (groin)
 Tinea corporis ( trunk)
 Tinea capitis (scalp and hair)
 Tinea unguium (nails)
 Tinea manuum (hands)
Drugs used in treatment of superficial fungal infections include;
 Clotrimazole
 Miconazole
 terbinafine
 isoconazole
 Ketoconazole
 tioconazole
 econazole
CLOTRIMAZOLE
Available preparations: cream 1%, powder and lotion.
Indications
 Skin candidiasis
 athletes foot
 fungal Otitis externa
 tinea cruris
 vaginal candidiasis
Contraindications
 hypersensitivity to Clotrimazole
Dose; apply a thin layer 2-3 times daily for 4-8weeks.
Side effects;
 Is well tolerated when applied topically but mild burning sensation and itching may
occur.
Nursing consideration;
 For inflammation due to fungal infection, use combination of Clotrimazole with steroid
until inflammation subsides then continues Clotrimazole alone.
KETOCONAZOLE.
Available preparations: cream 2% and shampoo 2%.
Indications.
 Athlete’s foot
 ring worms
 Tinea cruris
 skin candidiasis
 dandruff(shampoo)
Contraindications.
 hypersensitivity to Ketoconazole
 avoid using shampoo on broken skin.
Dose; apply 1-2 times daily for 4weeks.
Side effects.
 well tolerated but mild itching, burning and irritation may occur.
VIRAL INFECTIONS.
Common viral infections treated with topical antivirals include;
 herpes zoster
 chicken pox
 herpes simplex
 warts.
ACYCLOVIR
Available preparations; cream 5%.

Indications
 herpes zoster
 genital warts
Contraindication
 hypersensitivity to acyclovir
Dose; apply every 4 hours for 10days.
Side effects
 dry skin
 burning skin
 itching
 redness of the skin.
Nursing consideration
 advise patient to avoid contact with eyes and inside mouth

 treatment should be started immediately at the first sign of the lesion.
ANTIPRURITIC DRUGS.
Pruritis may be caused by systemic diseases such as jaundice or skin diseases such as scabies,
insect bites and stings, eczema etc.
CALAMINE.
It is used in the treatment of pruritis because of its soothing, antinflammatory and antipuritic
action.
Available preparation. lotion 15%
Indications
 pruritis due to scabies, insect bites and stings and chicken pox.
Dose; apply to the infected area 3times a day.
Nursing consideration.
 Advise the patients to avoid contact with eyes, mucous membranes of the nose, mouth
and genital area.
 Treatment should be discontinued in case of allergic skin reactions.
 Considered safe in pregnancy.

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DERMATOLOGICAL DRUGS.

DRUGS USED FOR ECZEMA.

Eczema/ dermatitis refers to a variety of skin disorders characterized by superficial skin

Drugs used in treatment of eczema include;

Systemic antibiotics such as macrolides (erythromycin, Azithromycin), penicillins (cloxacillin,

Available preparations; cream 1% and ointment 1%.

 Worsening of untreated infections

Available preparations; 0.1%, 0.5% and ointment 0.1%, 0.5%.

 untreated skin infections

 exacerbation of local infection

DRUGS FOR PSORIASIS.

Psoriasis is a chronic, non infectious inflammatory skin disease characterized by enhanced

Drugs used in treatment of psoriasis include;

DRUGS FOR ACNE.

Drugs used in treatment of acne are;

Benzoyl peroxide may be used with topical or oral antibacterial drugs.

Available preparations; creams 5%, 10%, gel 5%.

 hypersensitivity to benzoyl peroxide.

 skin dryness or peeling

 Tinea pedis (foot)

Drugs used in treatment of superficial fungal infections include;

Available preparations: cream 1%, powder and lotion.

Dose; apply a thin layer 2-3 times daily for 4-8weeks.

Available preparations: cream 2% and shampoo 2%.

Dose; apply 1-2 times daily for 4weeks.

Common viral infections treated with topical antivirals include;

Available preparations; cream 5%.

Dose; apply every 4 hours for 10days.

 advise patient to avoid contact with eyes and inside mouth

Available preparation. lotion 15%

Dose; apply to the infected area 3times a day.

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