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Notes for: Skin
Last edited [01/05/2024 14:02:15]

Emollient prescribing guidelines 2023

Bath emollients support document 2023

Moisture Associated Skin Damage (MASD) Pathway

Emollient pathway

Fire risk with emollients - advice to Health Care professionals

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 4 Drugs

First Line Drugs First Line Drugs
Second Line Drugs Second Line Drugs
Specialist Initiated Drugs Specialist Initiated Drugs
Hospital Only Drugs Hospital Only Drugs
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Antibiotics Antibiotics

NameTariffBNF Sub Paragraph
Clotrimazole Cream
1 % cream (20g tube) Pack of 20
£1.41PCT FORMULARY STATUS: First Line Drugs Antifungal Preparations
View BNF Article on 'Clotrimazole Cream'View SPC on 'Clotrimazole Cream'View PIL on 'Clotrimazole Cream'
Clotrimazole Solution (Canesten)
1 % solution (20ml unit) Pack of 20
£2.53PCT FORMULARY STATUS: First Line Drugs Antifungal PreparationsView BNF Article on 'Clotrimazole Solution'View SPC on 'Clotrimazole Solution'View PIL on 'Clotrimazole Solution'
Clotrimazole Spray (Canesten Spray)
1 % spray (40ml unit in isopropanol) Pack of 1
£4.99PCT FORMULARY STATUS: First Line Drugs Antifungal PreparationsView BNF Article on 'Clotrimazole Spray'View SPC on 'Clotrimazole Spray'View PIL on 'Clotrimazole Spray'
Amorolfine Hydrochloride Nail Lacquer
5 % 5ml pack Pack of 1
£6.73PCT FORMULARY STATUS: First Line Drugs Antifungal PreparationsView BNF Article on 'Amorolfine Hydrochloride Nail Lacquer'View SPC on 'Amorolfine Hydrochloride Nail Lacquer'View PIL on 'Amorolfine Hydrochloride Nail Lacquer'

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