Ointments for eczema

Among dermatotropic drugs used to treat skin inflammatory diseases, which include eczema (or atopic dermatitis), most often prescribed ointment from eczema - a local symptomatic.

Indications for the use of a variety of ointments are a diagnosis of eczema established by a dermatologist in the presence of its symptoms in the form of severe hyperemia and swelling of the affected skin, causing itching of the rash (vesicles and serous papules), moccasins, cracks, keratinized peels and peeling.

[1], [2]

Release form

It is difficult to clear all the names of ointments from eczema in one article, so let's focus on those that dermatologists often recommend to use for their patients.

If there is no severe inflammation, such non-hormonal eczema ointments as zinc ointment (Tsindol, Desitin), ichthyol ointment, naftalan ointment (Naftaderm), 2-5% sulfuric ointment (with seborrheic eczema), 2% salicylic ointment, Dermalex.

Possessing antiseptic properties, ichthyol ointment, can remove inflammation, see more in our Medicines Handbook - Ichthyol Ointment. And how it works and how correctly salicylic ointment is used, read the article - Salicylic ointment

However, in many cases, only corticosteroid or hormonal ointments can help with eczema, for example: Hydrocortisone ointment, Flucinar (other trade names - Flukort, Sinaflund, Sinoderm), Trimistin, Diprosalik (Betasalik), etc.

As a rule, preparations containing corticosteroids (synthetic hormones of the adrenal cortex), are used as an ointment for eczema and dermatitis.

Assign an ointment for eczema for a child - depending on his age and severity of the disease - should the doctor, since many drugs have age-related contraindications. Thus, ointments with corticosteroids are not used in children up to two years due to higher than in adults systemic absorption of corticosteroids. Decisive in the treatment of eczema in the child has a moisturizing of the skin, and doctors recommend that, in the absence of exudation of the rashes, use ointment-emollients, for example, D-Panthenol (Dexpanthenol, Bepanten). But, perhaps, the baby is more suitable dermatological cream Dermaleks Repair Eczema Babies (according to the manufacturer, safe for children from two months) or cosmetic products with extracts of chamomile, calendula or aloe vera (based on lanolin or medical Vaseline).

Treatment of microbial eczema with ointments is recommended to be carried out with the help of such drugs as Prefuzin (Fusiderm), Triderm, Argosulfan. Also strong ointments with eczema - Trimistin and Flucinar.

Ointment from dry eczema, which is characterized by increased peeling of the epidermis: 3% ichthyol ointment, naftalan ointment (5-15%), diprosalic (Betasalik), prednikarb, Dermalex. Also, with dry dermatoses, homeopathic ointment from eczema can be used - Psoriaten.

If you need ointment from wet eczema, then it is better to use zinc ointment or Delaskin. Outside the stage of exacerbation of the disease, retinol ointments can be prescribed to accelerate skin regeneration with eczema, for example, Videstim. And for those who prefer traditional oriental medicine, Chinese ointments are offered from eczema and dermatitis - Shi Zhen Gao (Blue Poppy Herbs brand), Qumixin Rugao, and others.

As for the prices of these drugs, the cheapest ointment for eczema is zinc, ichthyol, salicylic, hydrocortisone, diprosalik, Sinaflan ointment.

On the question, what are the most effective ointments for eczema, even for dermatologists it is difficult to answer, since different preparations are used at different stages of different forms of this disease, and, in addition, the sensitivity of each patient is individual.

[3], [4], [5], [6], [7]

Pharmacodynamics

The antiseptic and adsorbing action of the zinc ointment is provided by zinc oxide, which changes the structure of the proteins of the inflammatory exudate formed in the papules, absorbs the discharge in the case of mucous eruptions and reduces inflammation and irritation of the skin.

Pharmacodynamics antiseptic ointment naphthalan (Naftaderm) is due to the properties of thick naphthalane oil (naphthalan). Naftalan is half composed of polymethylene hydrocarbons (cycloparaffins), possessing keratolytic and hydrophilic qualities, and 15% of the substances of this oil are aromatic hydrocarbons having bacteriostatic and anti-inflammatory qualities.

Sulfur ointment, effective for seborrheic eczema, also acts as an antiseptic due to the production of polysulphandisulfonic acids by the interaction of sulfur with the skin secretion.

Ointment from eczema and dermatitis Dermalex as an active ingredient contains modified aluminosilicates (with anions of aluminum and silicon), alkaline minerals and magnesium chloride hexahydrate, which in the complex act as a moisturizing, anti-inflammatory, regenerating and skin protective agent.

The antimicrobial and healing effect of Argosulfan ointment is based on bactericidal sulfanilamide sulfatiazole and silver ions.

Ointment from dying eczema Delaskin contains a sulfonated polycondensate phenol-methanal-urea - a synthetic substance that exerts astringent and tanning action on epidermal cells, as well as skin moisturizing stearyl alcohol and moisture-preventing liquid silicone (dimethicone).

The active substance, which contains retinol ointment with eczema Videstim - retinol palmitate - has a stimulating effect on the skin receptors of retinol and thereby slows keratinization and promotes the regeneration of normal skin cells.

Homeopathic ointment from eczema Psoriaten reduces inflammation and reddening of the skin, and also reduces itching and squamous formations due to the action of alkaloids of the evergreen cactus of Mahonia aquifolium (Mahonia aquifolium).

It is worthwhile to figure out what the Chinese ointments from eczema Shi Zhen Gao and Qumixin Rugao consist of. The composition of Shi Zhen Gao includes vegetable oil, beeswax and alum, as well as Huang Bai (Chinese velvet bark), Kang Zhu (rhizome of atractylodes), Chuang Tzu (root-plant root seeds), Bai Zhi (root of the Daurian dudnik), Tien Hua Feng (the root of the trichotent or Chinese snake pumpkin).

And the manufacturers of Qumixin Rugao do not indicate its active substance, although - judging by the listed side effects, first of all, skin atrophy and hypercorticism - it can be concluded that this drug belongs to glucocorticosteroids (GCS).

Pharmacodynamics of hormonal ointments from eczema

Hydrocortisone ointment and all preparations with topical SCS are effective agents for removing all the symptoms of eczema and other dermatoses.

Hydrocortisone (hydrocortisone ointment), prednisolone (in Prefusin and Predninarb ointments), fluocinolone acetonide (in Flucinar and Sinaphlan ointments), triamcinolone acetonide (Trimistin ointment), betamethasone dipropionate (Tridentum and Diprosalik ointment) work in the same way. By acting on the cytoplasmic receptors of GCS, the preparations of this pharmacological group block the enzyme phospholipase A2, which leads to the termination of the synthesis of arachidonic acid necessary for the formation of protein mediators of the inflammatory reaction. Also, the release of histamine from mast cells is blocked, the activity of T-lymphocytes and macrophages is suppressed, the permeability of the vessel walls is reduced and their lumen is narrowed (providing anti-edematous effect).

In addition to GCS, the combination drugs, with which the treatment of microbial eczema with ointments, contain:

• Triderm - antibiotic gentamicin and antifungal imidazole derivative clotrimazole;
• Prefuzin - an antimicrobial agent in the form of fusidic acid (active against staphylococci, corynebacteria, clostridia, etc.);
• Trimistin is an antimicrobial and fungicidal drug of miramistin, which helps to restore damaged skin cells.

Ointment from dry eczema Diprosalik (Betasalik) contains salicylic acid, which has antimicrobial properties. And in the Predniacb salve there is urea, which not only contributes to the retention of moisture in the skin, but also easily softens the keratinized crusts formed after the drying of the wetting rash.

[8]

Pharmacokinetics

In the instructions of such drugs as zinc ointment, ointment naftalan, Dermalex, Triderm,

Delaskin, Trimistin, retinol ointment with eczema Widestim, there is no information on pharmacokinetics.

As the manufacturers assure, the active substances of the Trimistin ointment, as well as the homeopathic ointment from psoriasis eczema, are not absorbed into the systemic bloodstream; sulfur and petrolatum sulfuric ointment - also practically do not get into the blood.

Hydrocortisone and prednisolone enter the bloodstream and bind to proteins, but are broken down by liver enzymes and excreted by the kidneys with urine.

Flucinar ointment and Sinaphlan ointment, that is, their active component fluocinolone acetonide, penetrates the dermis and accumulates (showing pharmacological activity for two weeks); the degree of systemic absorption is low, but can increase with prolonged use (more than seven days) and application to the damaged skin.

In the instructions to the Prefuzin ointment, information on its pharmacokinetics is not available, but it is known that fusidic acid is able to penetrate deep layers of the skin and remain in the intercellular fluid for up to 12 hours and can enter the bloodstream; undergoes a transformation in the liver and is excreted with feces.

[9], [10], [11], [12], [13], [14], [15],

Dosing and administration

Any ointment from eczema and dermatitis is applied very thinly and only on dry skin. Zinc ointment is applied 4-5 times a day; sulfuric ointment, Dermalex, hydrocortisone ointment, prednikarb, delaskin, argosulfan - no more than three times a day.

Naphthalan ointment should be applied twice a day (it can not be rubbed).

Ointment from dry eczema Diprosalik (Betasalik) is recommended to be used twice during the day; hormonal ointments Flucin (Sinaphlan) and the combined remedy Trimistin - once or twice a day (children after two years - only once); Prefuzin - no more than twice a day; Triderm - three times a day (the ointment can easily be rubbed into the skin).

Hormonal ointments with eczema and any dermatological diseases are recommended to be applied as neatly as possible, without affecting the healthy skin; In this case it is necessary to take into account that the maximum allowable area of skin covered with these preparations should not exceed 20% of the entire surface of the body.

Retinol ointment Widestim should be applied to the skin, treated with some non-alcoholic antiseptic, twice a day - in the morning and in the evening.

Homeopathic ointment from eczema Psoriaten is applied three times a day; Chinese ointments (Shi Zhen Gao and Qumixin Rugao) - twice.

[21], [22]

Use of the ointments from eczema during pregnancy

Without reservations, only zinc ointment and Delaskin ointment are permitted for use during pregnancy.

In the first trimester of pregnancy, no hydrocortisone ointment, no other ointment with GCS is used. And the use of these funds at a later date is possible provided that the intended benefit to the mother is much higher than the possible risk for the condition and development of the fetus. This applies to the sulfuric ointment and the homeopathic remedy Psoriaten.

It is forbidden to use pregnant women: ointment naftalan, Trimistin, Argosulfan and all without exception retinol ointments with eczema.

Contraindications

All hormonal ointments with eczema are contraindicated in bacterial,

Viral and fungal pathologies of the skin; with open wounds; malignant neoplasms of the skin; acne and rosacea; after vaccination; children under two years.

Prefuzin ointment is not used in the treatment of eczema in children; Prednjarb is contraindicated in soaking eczema.

Contraindications Argosulfan ointments include hypersensitivity to sulfonamides, children under two months of age and congenital hemolytic nesferocytic anemia.

Zinc ointment is not used in the presence of purulent inflammation; sulfuric ointment is contraindicated in children under three years of age.

Ointment naphthalan is contraindicated in anemia, problems with the work of the kidneys, adrenals and liver, with hemorrhagic diathesis, oncology, children of younger age. Dermalex is not used if there are skin infections.

Retinol ointment with eczema is contraindicated in the period of its exacerbation, as well as with an excess of vitamin A in the body.

Homeopathic ointment from eczema Psoriaten is not used in infants.

[16], [17], [18]

Side effects of the ointments from eczema

The use of zinc and sulfur ointments, Dermalex, Trimystin, homeopathic ointment Psoriaten, retinol ointments with eczema can be accompanied by side effects in the form of a skin reaction of an allergic nature (and this is the same itching rash and hyperemia of the skin at the site of application of ointments). When using naphthalanic ointment, inflammation of the hair follicles may develop.

The most likely side effects of ointments from eczema containing corticosteroids can be manifested: skin allergy, acne, persistent expansion of skin capillaries, skin and subcutaneous tissue atrophy, skin discoloration, increased blood pressure, secondary infections. And the use of topical GCS in the treatment of eczema in children can lead to oppression of the hypothalamic-pituitary-adrenal system with impaired synthesis of glucocorticoids, growth retardation and increased cerebral pressure.

Because of the presence of sulfonamide, Argosulfan can adversely affect blood composition.

[19], [20]

Overdose

According to official instructions, clinical cases of an overdose of hydrocortisone, sulfuric and zinc ointments, naftalan ointments, Widestim ointments are not described.

There was no overdose of Dermalex, Trimistin, Argosulfan.

Overdose Flucin (Cinaphlan) occurs when ointments are used for longer than 5-7 days, as prescribed by the instructions. In such cases, systemic side effects develop, and immunity sharply decreases.

[23], [24]

Interactions with other drugs

In the instructions to the described drugs, it is reported that the naftalan (Naftaderm) ointment can be combined with other local remedies, and Dermalex ointment can be used simultaneously with hormonal ointments.

While ointments based on corticosteroids should not be used together with salicylates, nonsteroidal anti-inflammatory drugs, erythromycin group antibiotics, anticoagulants and immunosuppressant drugs.

A sulfuric ointment with the simultaneous use of hydrogen peroxide or potassium permanganate can cause a chemical burn of the skin.

Treatment of microbial eczema with ointments Prefuzin and Argosulfan can not be combined with any other external means.

The interaction of Trimistin ointment with antibiotics enhances their effect. A retinol ointment with eczema (Videastim) is not used with other drugs of vitamin A and tetracycline.

[25], [26], [27]

Storage conditions

Zinc ointment, sulfuric ointment, Dermalex, hydrocortisone ointment, Flucinar (Cinaphlan), Trimystin, Prednix, Delaskin, Psoriaten should be stored at a temperature not exceeding + 25 ° C; Ointments Diprosalic and Triderm - not higher than +20 ° C.

Ointment of naphthalan and Argosulfan should be kept in a dark place, at a temperature of + 5-15 ° C; ointment Widestim - at a temperature of +2 to +8 ° C.

[28], [29], [30]

Shelf life

The shelf life of the described drugs, indicated in their instructions, is:

• Flucin (Sinaflan), Psoriaten - 5 years; hydrocortisone ointment, Diprosalic, Triderm, Prefusin - 3 years; zinc and sulfur ointment, naphthalan ointment, Trimystin, Predniacb, Argosulfan, Chinese ointments (Shi Zhen Gao, Qumixin Rugao) - 2 years;
• Retinol ointment with eczema Widestim - 12 months; Delaskin (after opening a tube) - no more than 6 months.