Non-hormonal ointments from dermatitis

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

It is important to know that they contain ointments used for the treatment of dermatitis, since this disease is chronic (and atopic dermatitis is also genetically determined), requiring prolonged therapy, and the use of hormonal ointments is limited in time because of the risk of serious side effects, including system.

[1],

Indications of the non-hormonal ointments from dermatitis

Indications for the use of dermatitis ointments that do not contain GCS include the presence of symptoms of this type of skin inflammation: hyperemia, urticaria, swelling, itching (leading to combs and possible attachment of infections), the formation of keratinized crusts (splints), cracking, exudative razmakanie rashes wetness), hyperkeratosis, increased dryness of the skin.

[2], [3], [4]

Release form

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

We draw your attention to such recommended non-hormonal ointments from atopic dermatitis as Dermadrin, Dermalex, Losterin and Protopic.

Virtually all of these drugs (including ointment Protopik) can be used as non-hormonal ointments from dermatitis on the face.

[5], [6]

Pharmacodynamics

Dermadrin ointment contains an antihistamine drug, diphenhydramine, that is, dimedrol, which selectively inactivates the H1 receptors of histamine, which is secreted by the immune cells of the neurotransmitter of allergic reactions. As a result of the action of diphenhydramine, allergic rashes and itching of the skin decrease.

Non-hormonal ointments from dermatitis Carboderm and Keratolan contain urea, which promotes hydration and softening of the skin, releasing the skin from keratinized cells and reducing the intensity of itching. And in the Keratolan ointment, besides urea, there is a 2-hydroxy-propanoic (lactic) acid, which has bactericidal, exfoliative and pH-controlling properties of the skin, as well as betaine monohydrate, which moisturizes the epidermis well.

Due to zinc oxide, non-hormonal zinc ointment is known for its disinfecting and drying effects, which are favorable for the skin condition with exudative dermatitis.

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

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

Various mechanisms of pharmacological action have nonhormonal ointments from atopic dermatitis Losterin and Protopic (Tacropic). If Losterin prevents skin dryness and exfoliates excess keratin and restores the epidermal cells with urea, dexpanthenol, naphthalanic and castor oils, and medicinal plant glycosides, Japanese Sophora, then the Protopic preparation has one active ingredient, the natural macrolide tacrolimus.

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

[7], [8], [9],

Pharmacokinetics

As a rule, manufacturers do not study the pharmacokinetics of preparations in the form of an ointment and are not described in the instructions. So information about the "movement of the drug" Carboderm, Keratolan, Dermalex, Losterin is absent.

According to the instructions to the drug Dermadrin, its constituent dimedrol (diphenhydramine) does not have a systemic effect. Dexpanthenol enters the bloodstream in a very small volume and is excreted in the urine in the form of pantothenic acid.

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

[10], [11], [12]

Dosing and administration

All ointments should be applied to clean dry areas of the skin as thin as possible:

• Dermadrin, Dexpanthenol - up to five times a day (after applying Dermadrin ointment should 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 or three times during the day.

Non-hormonal ointment from atopic dermatitis Protopik is used as follows: 0.03% ointment for patients 2-16 years - twice a day for 21 days, and then once - until complete relief of symptoms; 0.1% ointment (adult patients) - twice a day with a gradual transition to the use of a drug of lower concentration (0.03%).

[18], [19], [20], [21]

Use of the non-hormonal ointments from dermatitis during pregnancy

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

Ointment Dermadrin is forbidden to use in the first trimester, and Protopic - during the entire pregnancy.

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

Contraindications

Contraindications to the use of non-hormonal ointments from dermatitis are the following:

• Dermadrin - intolerance of diphenhydramine, vesicular rashes, the presence of open wounds or scratching, rash with rubella, a child of up to two years;
• Keratolan and Zinc Ointment - hypersensitivity to drugs;
• Carboderm - exudative dermatitis, age up to 15 children;
• Dermalex - skin infections;
• Protopic - intolerance to tacrolimus, autoimmune ichthyosiform erythroderma; 0.03% ointment is not used for children under two years, and ointment 0.1% concentration - for patients under 16 years old.

[13], [14],

Side effects of the non-hormonal ointments from dermatitis

Presented in the review of non-hormonal ointments from dermatitis have the following side effects:

• Dermatrin - itching and flaky skin, dry mouth;
• Carboderm, Keratolan and Dermalex - redness of the skin, burning, itching;
• Protopic - urticaria, sensation of heat and loss of sensitivity in the place of application of ointment, attachment of bacterial or viral infection (folliculitis, acne, rosacea, herpes); there were isolated cases of development of lymphomas and skin cancers.

In instructions for such drugs as Zinc ointment, dexpanthenol and losterin, a possible side effect in the form of urticaria is indicated, but it is said that this is extremely rare.

[15], [16], [17]

Overdose

According to the manufacturers of the described drugs, their overdose was not noted.

[22], [23], [24]

Interactions with other drugs

Ointments Carboderm, Keratolan, Zinc ointment, Dexpanthenol, Losterin should not be used concomitantly with other external agents.

Ointment Dermalex can be combined with hormonal ointments from dermatitis.

The drug Dermadrin because of the content of diphenhydramine is incompatible with drugs to reduce blood pressure, hypnotics and antidepressants.

Producers of ointment Protopik warn that in the presence of large areas of skin lesions, tacrolimus can interact with preparations of the erythromycin group and antifungal agents - imidazole derivatives.

[25], [26]

Storage conditions

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

[27], [28], [29], [30]

Shelf life

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

[31], [32], [33], [34]