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NHS Foundation Trust
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 Formulary Chapter 13: Skin - Full Chapter
13.01  Management of skin conditions
13.01.01  Vehicles
13.01.02  Suitable quantities for prescribing
13.01.03  Excipients and sensitisation
13.02  Emollient and barrier preparations to top
13.02.01  Emollients
 note 

Emollients, oxygen and fire risk

West Yorkshire Fire and Rescue Service have kindly provided the following information on fire risks with emoillients and oxygen :

WYFRS position is that the potential fire risk of paraffin-free emollients is potentially the same as paraffin-containing emollients when they are dried onto fabrics and an ignition source is introduced. We do not therefore recommend that clinicians switch to alternative paraffin-free products or those containing lower levels of paraffin.

Generally, patients should continue to be prescribed the most appropriate product for their condition and should always receive verbal warnings in addition to those contained on prescriptions or product labels.

Oxygen users are not generally at a higher risk of fire when using emollients if they:

  • Do not smoke if there is any chance that their clothing/ bedding/dressings are contaminated.
  • Keep away from open flames such as cooker hobs, open fires, candles and heaters if there is any chance their clothing/ bedding / dressings are contaminated.

Additionally, our general advice for oxygen users is that they should:

  • Not smoke at all.
  • Take care not to contaminate the oxygen equipment with any kind of cream or lotion including emollients and lubricants.
  • Only use water based lubricant, such as KY jelly on areas that become dry on their face, nose and lips.
  • Not smoke or go near any open flame or ignition source for at least 30 minutes after using oxygen.
  • Open their windows when using oxygen.
  • Keep oxygen equipment at least 3 meters away from open fires and 1.5 meters away from other heat and static electric sources.
  • Store oxygen cylinders in well-ventilated areas and not enclosed cupboards.
Aquadrate ®
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Cetraben ®
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DoubleBase ®
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Emollient preparation (Drapolene®)
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Emollient preparation (Epaderm®)
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Emollient preparation containing Urea (Balneum®)
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Emulsifying Ointment BP
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Liquid and White Soft Paraffin Ointment (50:50)
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White Soft Paraffin BP
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Yellow Soft Parrafin BP
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Zerobase ®
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Zerocream ®
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13.02.01  Emollients - preparations containing urea
13.02.01  Emollients - with antimicrobials
13.02.01.01  Emollient bath and shower preparations
Emollient Bath Additive (Zerolatum®)
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Emollient Bath Additive with Anitmicrobials (Emulsiderm®)
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Oilatum® Plus
(MRSA treatment)
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13.02.02  Barrier preparations to top
Barrier preparation (Metanium®)
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Barrier preparation (Siopel®)
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Barrier preparation (Sudocrem®)
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Zinc and Caster Oil Ointment BP
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13.03  Topical local anaesthetics and antipruritics
Calamine
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Crotamiton (Eurax®)
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Doxepin (Xepin®)
(topical)
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13.04  Topical corticosteriods.
Betamethasone (as Dipropionate) 0.05% with Salicylic Acid 3% (Diprosalic®)
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Betamethasone (as Valerate) 0.025% (Betnovate-RD®)
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Betamethasone (as Valerate) 0.1% (Betnovate®)
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Betamethasone (as Valerate) 0.1% with Clioquinol
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Betamethasone (as Valerate) 0.1% with Neomycin Sulphate 0.5% (was Betnovate-N®)
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Betamethasone Dipropionate 0.064% with Clotrimazole 1% (Lotriderm®)
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Betamethasone Esters (Betacap®)
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Clobetasol Propionate 0.05% (Dermovate®)
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Clobetasone Butyrate 0.05% (Eumovate®)
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Fludroxycortide  (Haelan®)
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Fluticasone Propionate (Cutivate®)
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Hydrocortisone
(skin)
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Hydrocortisone 1% with Miconazole Nitrate 2% (Daktacort®)
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Hydrocortisone Butyrate (Locoid®)
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Mometasone Furoate 0.1% (Elocon®)
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Nystaform-HC ®
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Trimovate ®
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13.04  Topical corticosteriod preparation potencies
13.05  Preparations for eczema and psoriasis
Brodalumab
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Restricted Drug Restricted

Approved for use in line with pathway moderate to severe plaque psoriasis 

 
Link  NICE TA511: Brodalumab for treating moderate to severe plaque psoriasis
   
GuselkumabBlack Triangle (Tremfya ®)
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Restricted Drug Restricted

Restricted to use as per Biologic treatment pathways

 
Link  NICE TA521 Guselkumab for treating moderate to severe plaque psoriasis
   
13.05.01  Preparations for eczema to top
Alitretinoin (Toctino®)
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High Cost Medicine
 
   
13.05.02  Preparations for psoriasis
Dimethyl Fumarate
(Skilarence ®)
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High Cost Medicine
 
   
Ixekizumab (Taltz® )
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High Cost Medicine
 
   
13.05.02  Topical preparations for psoriasis
Calcipotriol
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Calcipotriol 50micrograms/g with Betamethasone 0.05%
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Dovobet 50 microgram/g + 0.5 mg/g ointment is formulary 

Dovobet 50 microgram/g + 0.5 mg/g gel is formulary 

 

Restricted Item Enstilar 50 micrograms/g + 0.5 mg/g cutaneous foam – restricted to initiation by Dermatologists

 
   
Calcitriol 3micrograms/g (Silkis®)
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Coal tar lotion 5% (Exorex®)
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Coal Tar Solution 2.5%, Arachis (peanut) Oil extract of Coal Tar 7.5%, Tar 7.5%, Cade Oil 7.5%, Liqiud Paraffin 35% (Polytar Emollient®)
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Dithranol (Dithrocream®)
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Dithranol Ointment BP
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Dithranol Paste BP
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Sebco ®
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Zinc and Salicylic Acid Paste BP
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13.05.02  Oral retinoids for psoriasis
Acitretin (Neotigason®)
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13.05.03  Drugs affecting the immune response
Adalimumab (Humira®)
(Dermatology)
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Restricted Drug Restricted
High Cost Medicine
 
Link  NICE TA392: Adalimumab for treating moderate to severe hidradenitis suppurativa
   
Cytotoxic Drug Azathioprine
(Dermatology)
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Ciclosporin
(Dermatology)
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Etanercept (Enbrel®)
(Dermatology)
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Restricted Drug Restricted
High Cost Medicine
 
Link  NICE TA103: Psoriasis - efalizumab and etanercept
   
Infliximab (Remicade®)
(Dermatology)
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Restricted Drug Restricted
High Cost Medicine
 
Link  NICE TA134: Infliximab for psoriasis
   
Cytotoxic Drug Methotrexate
(Dermatology)
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Pimecrolimus (Elidel®)
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Link  NICE TA82: Pimecrolimus and tacrolimus for atopic dermatitis (eczema)
   
Tacrolimus (Protopic®)
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Tacrolimus ointment (Protopic): reminder of a possible risk of malignancies including lymphomas and skin cancers - Drug Safety Update - June 2012 Healthcare professionals are reminded that topically applied tacrolimus (Protopic) may be associated with a possible increased risk of malignancy. Protopic must not be used in patients aged younger than 2 years, and only the lower strength 0.03% version may be used in children aged 2 - 16 years. Drug Safety Update - June 2012
 
Link  NICE TA82: Pimecrolimus and tacrolimus for atopic dermatitis (eczema)
   
Ustekinumab
(Stelara)
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Restricted Drug Restricted
High Cost Medicine

For treatments meeting NICE TA's only (see below) 

 
Link  NICE TA180: Psoriasis - ustekinumab
Link  NICE TA340: Ustekinumab for treating active psoriatic arthritis
Link  NICE TA455 : Adalimumab, etanercept and ustekinumab for treating plaque psoriasis in children and young peopl
Link  NICE TA456 : Ustekinumab for moderately to severely active Crohn’s disease after previous treatment
Link  Ustekinumab for treating moderately to severely active ulcerative colitis
   
13.06  Acne and rosacea to top
Ivermectin cream (Soolantra®)
(Rosacea)
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13.06.01  Topical preparations for acne
13.06.01  Benzoyl peroxide and azelaic acid
Azelaic Acid (Skinoren®)
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Benzoyl Peroxide 5% with Clindamycin 1% (Duac® Once Daily)
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13.06.01  Topical antibacterials for acne
Clindamycin 1% (Dalacin T®)
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13.06.01  Topical retinoids and related preparations for acne
Adapalene (Differin®)
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Isotretinoin (Isotrex® gel)
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13.06.01  Other topical preparations for acne to top
13.06.02  Oral preparations for acne
13.06.02  Oral antibiotics for acne
13.06.02  Hormone treatment for acne
Co-Cyprindiol
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13.06.02  Oral retinoid for acne
Isotretinoin (Roaccutane®)
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13.07  Preparations for warts and calluses to top
Formaldehyde (Veracur®)
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Salicylic Acid (Occlusal®)
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Salicylic Acid 16.7% with Lactic Acid 16.7% (Salactol®)
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Silver Nitrate 40% pencil with potassium nitrate 60% (AVOCA®)
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Silver Nitrate 95% with Potassium Nitrate 5% (AVOCA®)
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13.07  Anogenital warts
Imiquimod (Aldara®)
(Genital warts/ BCC)
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Podophyllotoxin (Condyline®)
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13.08  Sunscreens and camouflagers
13.08.01  Sunscreen preparations
Sunscreen (SunSense)
(Borderline Substances)
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Restricted Drug Restricted

This is restricted to dermatology use only for photosensivitive disorders.

Sunsense SPF 50+ is the current product in use (last updated Aug 2019)

 
   
13.08.01  Photodamage
Diclofenac (Solaraze®)
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Fluorouracil (Actikerall®)
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Cytotoxic Drug Fluorouracil (Efudix®)
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Ingenol mebutate (Picato®)
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Methyl-5-Aminolevulinate (Metvix®)
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Restricted Drug Restricted

Restricted Item Information on restriction

 

Restricted to dermatology use only

 
   
13.08.02  Camouflagers to top
Veil ®
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13.09  Shampoos and other preparations for scalp and hair conditions
Capasal ®
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Coal Tar Extract 5% (Alcoholic) (Alphosyl 2 in 1®)
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Ketoconazole
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Polytar ®
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Selenium Sulphide (Selsun®)
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Shampoos (Ceanel Concentrate®)
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13.09  Hirsutism
13.09  Androgenetic alopecia
13.10  Anti-infective skin preparations
13.10.01  Antibacterial preparations to top
13.10.01.01  Antibacterial preparations only used topically
Mupirocin 2% (Bactroban®)
(skin)
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Restricted Drug Restricted

Restricted to MRSA suppression treatment and trust antibacterial guidelines

 
   
Polyfax ®
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Silver Sulfadiazine (Flamazine®)
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13.10.01.02  Antibacterial preparations also used systemically
Metronidazole topical 0.75%
(malodourous wounds)
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13.10.02  Antifungal preparations
Clotrimazole
(skin)
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Miconazole (Daktarin®)
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Terbinafine Hydrochloride 1% (Lamisil®)
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13.10.03  Antiviral preparations
Aciclovir (Zovirax®)
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13.10.04  Parasiticidal preparations to top
Dimeticone (Hedrin®)
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Malathion 0.5% (Derbac-M®)
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Permethrin 1% (Lyclear® Creme Rinse)
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Permethrin 5% (Lyclear® Dermal Cream)
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13.10.04  Scabies
13.10.04  Head lice
13.10.04  Crab lice
13.10.04  Benzyl benzonate
13.10.04  Carbaryl to top
13.10.04  Dimeticone
13.10.04  Malathion
13.10.04  Permethrin
13.10.04  Phenothrin
13.10.05  Preparations for minor cuts and abrasions to top
Magnesium Sulphate Paste BP
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Proflavine Cream, BPC
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13.10.05  Collodion
Collodion Flexible BP
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Formulary  
   
13.10.05  Skin tissue adhesive
Histoacryl ®
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13.11  Skin cleansers, antiseptics, and desloughing agents
13.11.01  Alcohols and saline
Alcohol
(Surgical spirit BP)
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Sodium Chloride 0.9%
Formulary  
   
13.11.02  Chlorhexidine salts to top
Chlorhexidine 4%
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13.11.03  Cationic surfactants and soaps
Cetrimide
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13.11.04  Iodine and Chlorine
Povidone-Iodine (Betadine® or Videne®)
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13.11.05  Phenolics
13.11.06  Oxidisers, and dyes
Hydrogen Peroxide (Crystacide®)
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Formulary  
   
Potassium Permanganate (Permitabs®)
Formulary  
   
13.11.07  Desloughing agents to top
Sterile Larvae (Maggots) (LarvE®)
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13.11.07  Desloughing agents
13.11.07  Growth factor
13.12  Antiperspirants
Aluminimum Salts
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Glycopyrronium
(iontophoresis)
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Formulary  
   
13.13  Topical circulatory preparations
Heparinoid 0.3% (Hirudoid®)
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Formulary  
   
 ....
Key
note Notes
Section Title Section Title (top level)
Section Title Section Title (sub level)
First Choice Item First Choice item
Non Formulary Item Non Formulary section
Restricted Drug
Restricted Drug
Unlicensed Drug
Unlicensed
Track Changes
Display tracking information
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Link to adult BNF
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Link to children's BNF
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Link to SPCs
Cytotoxic Drug
Cytotoxic Drug
CD
Controlled Drug
Homecare
Homecare

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