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Fundamentals of Dermatology
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Anatomy and Physiology of the Skin
10:11
Classification of Skin Lesions
06:12
Skin Barrier Function and Pathophysiology
03:12
End of Topic Quiz
00:25:00
Common Dermatological Conditions
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Eczema
14:55
Dermatitis
04:37
Psoriasis
09:56
Acne
05:04
Rosacea
13:12
Skin Infections
04:26
Pigmentation Disorders
07:10
Skin Cancers
14:53
End of Topic Quiz
00:30:00
Advanced Dermatology Management
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Topical Dermatological Preparations
07:16
Systemic Treatments in Dermatology
Allergies and Hypersensitivity Reactions
Phototherapy and Laser Treatments
End of Topic Quiz
00:30:00
Fundamentals of Wound Management
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Physiology of Wound Healing
09:18
Classification of Wounds
08:14
Wound Assessment
13:42
End of Topic Quiz
00:30:00
Clinical Management of Wounds
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Principles of Wound Care
05:51
Wound Dressings and Their Applications
21:54
Managing Chronic Wounds
08:08
Infection Management in Wounds
End of Topic Quiz
00:30:00
Clinical Guidelines and Resources
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NICE Guidelines in Dermatology and Wound Care
Role of the Pharmacist in Dermatology and Wound Care
End of Topic Quiz
00:30:00
Dermatology and Wound Management

Introduction

Topical formulations are applied directly to the skin.

  • Advantages:
    • Deliver higher drug concentration at the target site.
    • Fewer systemic side effects.
  • Disadvantages:
    • Can be messy or time-consuming.
    • May require multiple applications or products.

Each formulation contains an active ingredient (e.g., corticosteroid, antifungal) and a vehicle/base (e.g., cream, ointment, gel) designed to deliver the drug effectively.

Types of Formulations

FormulationKey FeaturesBest For
CreamsOil-in-water emulsions (approx. 50/50). Moisturising. Require preservatives.Normal to dry skin
OintmentsGreasy, semi-solid, occlusive (80% oil), water-free. No preservatives needed.Dry, scaly skin
GelsAqueous/alcoholic, often cellulose-based. Liquefy on contact. May contain preservatives/fragrances.Oily/combination skin
LotionsThicker than solutions, lighter than creams. Often water-based.Oily skin, warm climates
PatchesAdhesive systems for systemic drug delivery. Bypass first-pass metabolism.Long-term, precise dosing

Active Ingredients (Selected Examples)

CategoryPurposeExamples
CorticosteroidsInflammation, itching (eczema, dermatitis)Hydrocortisone, Clobetasol, Triamcinolone
AntifungalsTinea, candidiasis, fungal infectionsClotrimazole, Terbinafine, Nystatin
AntibacterialsImpetigo, folliculitis, cellulitisMupirocin, Polymyxin B, Bacitracin
KeratolyticsExfoliation, acne, wart removalSalicylic acid, Glycolic acid, Lactic acid, Podophyllotoxin

Choosing the Right Formulation

Based on Skin Type

Skin TypeRecommended FormulationIngredients to Look For
OilyLightweight gels, water-based lotionsHyaluronic acid, Glycerin
DryThick creams, ointmentsShea butter, Ceramides, Urea
SensitiveHypoallergenic, fragrance-free creamsAloe vera, Oatmeal
NormalLight non-greasy moisturisersBalanced humectants/emollients
CombinationGel/lotion hybrids or mix by areaVaries

Based on Skin Condition

Condition TypeSuggested Formulation
Wet/oozing lesionsCreams, lotions, drying pastes
Dry/scaly skinOintments, oils
Inflamed skinSoaks → creams/ointments
Cracked/sore skinBland preparations
Palms/solesCreams or ointments
Hairy areasGels, foams, solutions
Skin foldsCreams or lotions (not ointments)
Mucosal areasNon-irritating formulations

Key Pharmacological Considerations

Factors Influencing Absorption:

  • Skin thickness: Thinner = greater absorption

  • Barrier integrity: Damaged skin absorbs more

  • Occlusion: Increases drug penetration

  • Lipophilicity & molecule size

  • Concentration & excipients

Special Populations:

  • Babies: Fragile barrier, immature organs — use with caution

  • Pregnancy/Breastfeeding: Avoid potentially teratogenic topicals (e.g., Podophyllin, 5-FU, high-strength salicylic acid)

Application Tip:

  • For best results, apply topicals to damp skin (within 3 minutes of bathing) to improve absorption and hydration.

Common Ingredients in Vehicles

  • Occlusives: Petrolatum, mineral oil (seal in moisture)

  • Humectants: Hyaluronic acid, glycerin (draw moisture in)

  • Emollients: Ceramides, shea butter (soothe and smooth)

  • Preservatives: Prevent bacterial/fungal growth

  • Enhancers: Propylene glycol, alcohol — may aid penetration

Summary

  • Choose formulation based on skin type, condition, location, and patient preference.
  • Know when to use emollient-rich ointments vs. lightweight lotions or gels.
  • Topical corticosteroids are potent anti-inflammatory agents — use appropriate potency and avoid long-term use.
  • Tailor treatment and base formulation to maximise therapeutic benefit while minimising irritation.

References

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