NHS Dudley Health Economy Medicines Formulary
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13.4 Topical corticosteroids

General Guidance
 

  • Topical corticosteroids are used for inflammatory skin conditions other then those caused by infection. They suppress the local anti-inflammatory response, when treatment is discontinued a rebound exacerbation often occur.
  • These agents are of no value in the treatment of urticaria, and are likely to be harmful if used in rosacea. They should not generally be used in pruritis, and are not recommended in acne vulgaris.
  • Systemic or potent topical corticosteroids should only be used by specialists in psoriasis due to the possibility of vigorous rebound symptoms on withdrawal.
  • In general the most potent topical corticosteroids should be reserved for recalcitrant conditions unresponsive to other less potent treatments they should never be first-line treatment options.
  • Only use very potent products for a short period of time.

Recommended drugs

Mild: Hydrocortisone cream/ointment 0.5% and 1%

Moderately potent: Eumovate 0.05% cream/ointment

Potent: Betamethasone valerate 0.1% cream/ointment

Very potent: Dermovate 0.05% cream/ointment 

 

With antimicrobials

Timodine cream (hydrocortisone 0.5%, nystatin 100 000 units/g, benzalkonium chloride solution 0.2%, dimeticone ‘350’ 10%)

Trimovate cream (clobetasone butyrate 0.05%, oxytetracycline 3% (as calcium salt), nystatin 100 000 units/g)

Daktacort cream or ointment (hydrocortisone 1%, miconazole nitrate 2%)

Fucidin H cream (hydrocortisone acetate 1%, fusidic acid 2%)

Canestan HC cream (hydrocortisone 1%, clotrimazole 1%)

 

Drug Traffic Light Key:

Green – On Formulary

Amber – Restricted use, see local guidelines      

Purple – Specialist use/initiation

Red – Non Formulary

 

Relative Costs Key (where indicated):

£££££ - high

£££ - moderate

£ - low

 

Drug Traffic Light Key:

Green – On Formulary

Amber – Restricted use, see local guidelines      

Purple – Specialist use/initiation

Red – Non Formulary

 

Relative Costs Key (where indicated):

£££££ - high

£££ - moderate

£ - low

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