KCC Referral
Management System
Shared Care
Guidelines
Care Home
Resources
Local Resource
Packs
Chronic Pain
in Cornwall
Diabetes Resources
Respiratory Resources
Flu Resource Pack
Patient Group Direction (PGD)
Palliative Care Resources
Search   
        Click to View ALL BNF
 >>  >> 
   (Click to View Drug List)


Cost
Packs
Items
Other - Cost: £697,875,227.36 Trimbow - Cost: £10,324,890.00 Atorvastatin - Cost: £12,062,751.27 Empagliflozin (Jardiance) - Cost: £13,056,158.02 Beclometasone / Formoterol MDI (Fostair) - Cost: £15,201,921.56 Rivaroxaban - Cost: £19,148,081.40 FreeStyle Libre 2 Sensor  - Cost: £19,152,735.00 Edoxaban (Lixiana) - Cost: £20,533,835.00 Dapagliflozin (Forxiga) - Cost: £22,535,048.30
Formulary Notes (BNF Chapter)
Formulary Notes (BNF Sub Paragraph)
NICE Guidance (0)
Other Links (0)
Important Local Documents (4)
Notes for: Skin
Last edited [20/03/2024 11:51:41]

Emollient prescribing guidelines 2023

Bath emollients support document 2023

Moisture Associated Skin Damage (MASD) Pathway

Emollient pathway

Fire risk with paraffin-containing products


Management of skin conditions
With skin disease it is extremely important to consider patient acceptability of a product to maximise patient compliance. There is a wide range of products available and patient acceptance of individual products is very variable.
Where a consultant or GP with specialist interest asks a GP to prescribe a non-formulary agent they should check that formulary agents have been tried and not tolerated by the patient

Greasy preparations (ointments) are often preferable to creams in most circumstances because:

  • They contain fewer skin sensitisers
  • They are more hydrating (i.e. water retaining)
  • There is better penetration of active ingredients

However, patient preference or activity may necessitate a combination of ointments and creams, for example, patients may prefer to apply creams during the day and use ointments at night, or different preparations on different parts of the body.

Application technique: It is important to educate patients with the correct application technique. Ointments and creams should be applied down the direction of hair growth. They should also be smeared on and not rubbed in.

Pot Hygiene: When supplying patients with pots of emollient, it is important to educate them about the hygiene required. Patients should be advised to decant from the pot onto plate/bowl etc. using a spoon or a spatula. Hands should not be put into the pot as this will lead to the introduction of foreign particles.

In many cases generic prescribing will be difficult because products contain a combination of active ingredients. In this chapter brand names are used for products which should not be prescribed generically.

Extemporaneous preparations: A product should only be extemporaneously prepared when there is no product with a marketing authorisation available. Depending on the formulation this may be done in a pharmacy, or by a specials manufacturer, usually depending on the formulation. Where a specials manufacturer prepares the product, additional charges will be incurred. The cost can, and usually does, exceed £100 for a cream. The cost is usually the same whether 500 g or 50 g of a product is ordered. Specials all have a very short shelf life with an expiry date of a maximum of 28 days from manufacture.

A range (but not all) of specials preferred by the British Association of Dermatologists has been approved for use within Cornwall mainly for prescribing by secondary care.



 

Cornwall Joint Formulary Recommended Choices     (...Top)
Displaying 3 Drugs

Key:
First Line Drugs First Line Drugs
Second Line Drugs Second Line Drugs
Specialist Initiated Drugs Specialist Initiated Drugs
Hospital Only Drugs Hospital Only Drugs
Discouraged Discouraged
No comment available No comment available
Antibiotics Antibiotics

NameTariffBNF Sub Paragraph
Dimeticone Lotion (Hedrin Lotion)
4 % lotion Pack of 50
£4.36PCT FORMULARY STATUSFirst Line Drugs Parasiticidal PreparationsView BNF Article on 'Dimeticone Lotion'View SPC on 'Dimeticone Lotion'View PIL on 'Dimeticone Lotion'
Permethrin Cream (Lyclear Dermal Cream)
5 % cream Pack of 30
£7.11PCT FORMULARY STATUS: First Line Drugs Parasiticidal PreparationsView BNF Article on 'Permethrin Cream'View SPC on 'Permethrin Cream'View PIL on 'Permethrin Cream'
Ivermectin
3 mg tablets Pack of 4
£103.44PCT FORMULARY STATUS: Specialist Initiated Drugs [Notes:] May be prescribed in primary care on the recommendation /  guidance of dermatology for the treatment of scabies Parasiticidal PreparationsView BNF Article on 'Ivermectin'View SPC on 'Ivermectin'View PIL on 'Ivermectin'
May be prescribed in primary care on the recommendation / guidance of dermatology for the treatment of scabies

 
© Kernow Clinical Commissioning Group 2024 - All Rights Reserved
The Sedgemoor Centre, Priory Road, St Austell, Cornwall, PL25 5AS