Therapeutic AreaFormulary ChoicesCost for 28
(unless otherwise stated)
Rationale for decision / comments
BNF Chapter 13: Dermatological preparations

NICE Clinical Guideline CG57: Atopic eczema in under 12s: diagnosis and management (2007)
SIGN National Clinical Guideline 125: Management of atopic eczema in primary care (2011)
NICE Quality Standard QS44: Atopic eczema in under 12s (2013)
NICE Clinical Guideline CG153: Psoriasis: assessment and management (2012)
NICE Quality Standard QS40: Psoriasis (2013)
Green cross Products suitable for self care:
• Antiperspirants
• Treatments for minor facial spots
• Creams, gels, and bandages for minor sprains and minor sports injuries
• Creams for bruising, tattoos, and varicose veins
• Nappy rash barrier creams (continuous use may indicate additional advice required)
• Hair removing creams all but exceptional cases are regarded as cosmetic for self care. Funding for laser treatment is considered by the IFR panel
• Head lice lotions and shampoos (wet combing is recommended)
• Athletes’ foot creams and powders
• Topical treatments for vaginal thrush
• Treatments for fungal nail infection
• Moisturisers and bath additives for minor dry skin conditions
• Sun creams (except where clinically indicated)
13.2 Emollient and barrier preparations
• Always ensure that sufficient quantities are prescribed: liberal twice daily application to the whole adult body will use at least 500g per week. Total quantity of emollient per week (based on “bd” application) for an adult: Face: 15-30g, Trunk: 400g, Both arms / legs: 100-200g, Both hands: 25-50g, Groins and genitalia: 15-25g, Scalp: 50-100g
• The more greasy an emollient the more effective it is but this needs to be balanced against cosmetic acceptability and compliance
• Emollient creams and emulsifying ointment can be used as soap substitutes as well as moisturisers
• Pump dispensers minimise the risk of bacterial contamination. Try small quantities first on an acute prescription, until an acceptable emollient is found.
• Emollients should be applied by smoothing onto the skin in direction of any hairs (not by rubbing)
• Regular re-application, especially after washing, with drying by patting not rubbing, will increase the effectiveness of all emollient therapy
Emollient bath additives A trial found no clinical benefit from including emollient bath additives in the standard management of childhood eczema.