Non-hormonal ointments for dermatitis

Non-hormonal ointments for dermatitis are dermatotropic drugs for external use that do not contain glucocorticoid hormones of the adrenal cortex (GCS) or their synthetic analogues.

It is important to know what ointments used to treat dermatitis contain, since this disease is chronic (and atopic dermatitis is also genetically determined), requiring long-term therapy, and the use of hormonal ointments is limited in time due to the risk of severe side effects, including systemic ones.

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Indications non-hormonal ointments for dermatitis.

Indications for the use of ointments for dermatitis that do not contain GCS include the presence of symptoms of this type of skin inflammation: hyperemia, urticaria, swelling, itching (leading to scratching and possible infection), formation of keratinized crusts (scabs), cracking, exudative soaking of rashes (weeping), hyperkeratosis, increased dryness of the skin.

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Release form

This review includes the following names of non-hormonal ointments for dermatitis: Dermadrin (synonym Psilo-balm), Carboderm (Uroderm), Keratolan, Zinc ointment, Dexpanthenol (D-Panthenol, Pantoderm, Bepanten), Dermalex, Losterin, Protopic (Tacropic).

We would like to draw your attention to such non-hormonal ointments for atopic dermatitis as Dermadrin, Dermalex, Losterin and Protopic, recommended by specialists.

Almost all of the above-mentioned drugs (including Protopic ointment) can be used as non-hormonal ointments for dermatitis on the face.

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Pharmacodynamics

Dermadrin ointment contains the antihistamine diphenhydramine, i.e. diphenhydramine, which selectively inactivates the H1 receptors of histamine, a neurotransmitter of allergic reactions secreted by immune cells. As a result of diphenhydramine, allergic rashes and skin itching are reduced.

Non-hormonal ointments for dermatitis Carboderm and Keratolan contain urea, which promotes hydration and softening of the skin, freeing the skin from keratinized cells and reducing the intensity of itching. And in the composition of the Keratolan ointment, in addition to urea, there is 2-hydroxypropanoic (lactic) acid, which has bactericidal, exfoliative and pH-regulating properties, as well as betaine monohydrate, which moisturizes the epidermis well.

Thanks to zinc oxide, non-hormonal Zinc Ointment is known for its disinfecting and drying effects, which are beneficial for the skin condition in exudative dermatitis.

Dexpanthenol, which is contained in the regenerating ointment Dexpanthenol, is converted into vitamin B5 – pantothenic acid in the epidermis, which improves metabolism and water balance in skin cells and the intercellular matrix.

The drug Dermalex also relieves inflammation, moisturizes and restores damaged epidermis, but due to the presence of modified aluminosilicates and alkaline anions of calcium and magnesium, which prevent the loss of fluid by inflamed cells.

Non-hormonal ointments for atopic dermatitis Losterin and Protopic (Tacropic) also have different mechanisms of pharmacological action. If Losterin prevents dry skin and exfoliates excess keratin and restores epidermal cells with the help of urea, dexpanthenol, naphthalene and castor oils and glycosides of the medicinal plant Sophora japonica, then the drug Protopic has one active component - the natural macrolide tacrolimus.

This substance is a calcineurin inhibitor (calcium-dependent phosphatase) and acts on the nuclei of T-lymphocytes, which are known to be activated during the immune response. Protopic ointment neutralizes the activity of calcineurin in dephosphorylating the cytoplasmic factor of T-lymphocytes and reduces not only the production of inflammatory cytokines, but also their release from mast cells.

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Pharmacokinetics

As a rule, the pharmacokinetics of drugs in the form of ointments are not studied by manufacturers and are not described in the instructions. So there is no information regarding the "movement of the drug" Carboderm, Keratolan, Dermalex, Losterin.

According to the instructions for the drug Dermadrin, diphenhydramine, which is part of it, does not have a systemic effect. Dexpanthenol enters the bloodstream in very small quantities and is excreted in the urine as pantothenic acid.

Tacrolimus ointment Protopic enters the blood, is transformed by liver enzymes and is excreted from the body through the kidneys.

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Dosing and administration

All ointments should be applied to clean, dry areas of the skin in the thinnest possible layer:

• Dermadrin, Dexpanthenol – up to five times a day (after applying Dermadrin ointment, do not go out in the sun);
• Carboderm – no more than twice a day, the course of treatment is no longer than two weeks;
• Keratolan, Zinc ointment, Dermalex, Losterin – two to three times a day.

Non-hormonal ointment for atopic dermatitis Protopic is used as follows: 0.03% ointment for patients aged 2-16 years – twice a day for 21 days, and then once – until symptoms are completely relieved; 0.1% ointment (for adult patients) – twice a day with a gradual transition to using a lower concentration of the drug (0.03%).

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Use non-hormonal ointments for dermatitis. during pregnancy

Zinc ointment and Dexpanthenol can be used during pregnancy; Carboderm and Keratolan ointments can only be prescribed to pregnant women by a doctor.

Dermadrin ointment is prohibited for use in the first trimester, and Protopic - throughout pregnancy.

The possibility of using non-hormonal ointments for dermatitis Dermaleks and Losterin in the treatment of dermatitis in pregnant women has not been studied.

Contraindications

Contraindications to the use of non-hormonal ointments for dermatitis are as follows:

• Dermadrin - intolerance to diphenhydramine, vesicular rashes, presence of open wounds or scratches, rashes with measles and rubella, children under two years of age;
• Keratolan and Zinc ointment - hypersensitivity to drugs;
• Carboderm – exudative dermatitis, age up to 15 years;
• Dermalex - skin infections;
• Protopic - tacrolimus intolerance, autoimmune ichthyosiform erythroderma; 0.03% ointment is not used in children under two years of age, and 0.1% ointment is not used in patients under 16 years of age.

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Side effects non-hormonal ointments for dermatitis.

The non-hormonal ointments for dermatitis presented in the review have the following side effects:

• Dermadrin – itching and flaking of the skin, dry mouth;
• Carboderm, Keratolan and Dermalex – redness of the skin, burning, itching;
• Protopic - urticaria, sensation of heat and loss of sensitivity at the site of application of the ointment, addition of a bacterial or viral infection (folliculitis, acne, rosacea, herpes); isolated cases of lymphoma and skin cancer were observed.

The instructions for such products as Zinc Ointment, Dexpanthenol and Losterin indicate a possible side effect in the form of hives, but they claim that this is extremely rare.

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Overdose

According to the manufacturers of the described drugs, overdoses have not been observed.

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Interactions with other drugs

Carboderm, Keratolan, Zinc Ointment, Dexpanthenol, Losterin ointments should not be used simultaneously with other external agents.

Dermaleks ointment can be combined with hormonal ointments for dermatitis.

Due to the diphenhydramine content, the drug Dermadrin is incompatible with drugs for lowering blood pressure, sleeping pills and antidepressants.

Manufacturers of Protopic ointment warn that in the presence of large areas of skin lesions, tacrolimus may interact with erythromycin group drugs and antifungal agents – imidazole derivatives.

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Storage conditions

Non-hormonal ointments for dermatitis Dermadrin, Carboderm, Keratolan, Dexpanthenol, Dermaleks, Losterin, Protopic should be stored at a temperature of +15-25°C; Zinc ointment – at a temperature of +10-15°C (in a dark place).

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Shelf life

Shelf life: Dermadrin and Zinc ointments are 5 years; Keratolan and Protopic are 3 years; Carboderm, Dexpanthenol and Dermalex ointments are 2 years.

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