Principles of Topical Treatments in Dermatology

enables the enhancement of systemic treatment measures
An extensive region for

the application and absorption of topical medications
The active ingredients penetrate the skin either via transepidermal or transfollicular pathways

drug administration
Age of patient
Area of the body
Pathologic changes in the

skin
Hydration of stratum corneum and skin temperature
Vascular supply
Role of vehicle

skin disorder covering < 30% of body, the topical

medication may be considered.

are:

Patient’s skin type
Degree of acuity of the disease
Nature of the lesions

skin or seborrhea. They do better with creams, lotions, or

shake lotions while the ones with dry skin do better with ointments or pastes.
Degree of acuity: Acute inflammatory processes are best treted with creams or lotions. If the lesions are weeping, shake lotions are fine.

Recommended

Avoided
Acute erythema shake lotion, Ointment,
lotion, cream paste
Vesicles shake lotion, Paste,
gel, lotion ointment
Blisters Wet dressings, Paste,
shake lotions ointment,
powder
Erosions Wet dressings, powder,
ointment shake lotion
Crusts Ointment, wet dr. Powder, gel
Ch. inflammation Ointment

products
Tacrolimus, pimecrolimus
Nonsteroidal antiinflammatory agents
Sunscreens

III: Betamethasone 17-valerate
Class IV (strongest): Clobetasol 17-propionate

Atrophy, striae
Pigmentation: Hypopigmentation
Vessels: Erythema, telangiectases

and small papules on the cheeks
An infant having severe erythema

and mild scaling involving the convexities of the buttocks
A female adult having mild erythema, scales and fissures on the fingertips and volar aspect of her hands

the wrist, with erythema and blisters
A clinical picture with vesicles,

yellow ccrusts and oozing erosions
Hyperkeratotic plaque with scales, prominent skin markings and severe pruritus