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Royal United Hospitals Bath NHS Foundation Trust
Great Western Hospitals NHS Foundation Trust
Salisbury NHS Foundation Trust
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 Formulary Chapter 13: Skin - Full Chapter
Notes:

Only high cost medicines to be supplied within our health economy are listed on BSW Formulary, but patients may also have access to more specialised, high cost medicines via other specialist centres, if eligible.

Dermatology-related Prescribing Guidance

Please see our Prescribing Guidelines page for all prescribing guidance relating to this chapter.

Dermatology-related Shared Care Agreements

Please see our Shared Care Agreements page for all shared care agreements (SCAs) relating to this chapter.

Self-care

Many of the products in this chapter are available for purchase over-the-counter, and patients are encouraged to self-care, with the support of their community pharmacist, in the first instance.

For further information on self-care & the NHS, please refer to https://www.england.nhs.uk/medicines/conditions-for-which-over-the-counter-items-should-not-routinely-be-prescribed/

Dermatology Specials Approved List: see section 13.14

Please note that any specials listed in the BAD list are deemed to be RED on this formulary, so that specialists can prescribe them only.

 

 

 Details...
13.02.01  Expand sub section  Emollients
 note 

Emollient guidance for primary care July 2018

MHRA guidance - Safe use of emollient skin creams for dry skin conditions (Clothing, bedding, dressings and bandages with skin cream dried on them can catch fire easily causing severe and fatal burns) Link includes information leaflets and toolkit for healthcare professionals.

Epimax Isomol
(gel)
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Formulary
Self
  • VERY LIGHT MOISTURISER FOR MILD DRY SKIN
  • 500g flexi dispenser which can be used instead of a pump by care homes
  • Low paraffin content (15%)
  • Primary care Doublebase® gel alternative
  • Useful for dermatitis of the hands and as a light moisturiser for the body

March 2020 - EPIMAX® name change

Minor name changes covering part of the EPIMAX® range came into effect in the March 2020 Drug Tariff. For the next 12 months, the products will occupy a dual listing on the drug tariff, such that prescriptions written under both the new and old name can be reimbursed. Despite the new names and associated change in the appearance of the labels, the product itself remains unchanged. 

EPIMAX® Isomol Gel (previously Isomol Gel)

 
   
Epimax Original
(cream)
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Formulary
Self
  • CREAM FOR MILD TO MODERATE DRY SKIN
  • 500g flexi-dispenser which can be used by care homes. No pump pack available.
  • Primary Care Diprobase®alternative

March 2020 - EPIMAX® name change

Minor name changes covering part of the EPIMAX® range came into effect in the March 2020 Drug Tariff. For the next 12 months, the products will occupy a dual listing on the drug tariff, such that prescriptions written under both the new and old name can be reimbursed. Despite the new names and associated change in the appearance of the labels, the product itself remains unchanged. 

EPIMAX® Original Cream (previously Epimax Cream)

 

 
   
Epimax ExCetra
(cream)
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Formulary
Self
  • CREAM FOR MILD TO MODERATE DRY SKIN
  • Cream 100g and 500g flexi dispenser which can be used instead of a pump by care homes.
  • Contains the same ingredients as Cetraben® but is more cost effective choice

March 2020 - EPIMAX® name change

Minor name changes covering part of the EPIMAX® range came into effect in the March 2020 Drug Tariff. For the next 12 months, the products will occupy a dual listing on the drug tariff, such that prescriptions written under both the new and old name can be reimbursed. Despite the new names and associated change in the appearance of the labels, the product itself remains unchanged. 

EPIMAX® ExCetra Cream (previously ExCetra Cream)

 
   
Oilatum
(Cream )
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Formulary
Self
  • CREAM FOR MILD TO MODERATE DRY SKIN
  • Available as 500ml pump or 500g tub
  • Exactly the same as Oilatum Junior cream in constituents and price

 

 

 
   
Emulsifying Ointment BP

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Formulary
Self
  • GREASY MOISTURISER FOR SEVERE DRY SKIN
  • Ointment 500g
 
   
Epimax
(Ointment)
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Formulary
Self
  • GREASY MOISTURISER FOR SEVERE DRY SKIN
  • YSP 30%, LP 40%, emulsifying wax 30%
  • 500g or 125g pack sizes available
 
   
Hydromol  
(ointment)
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Formulary
Self
  • GREASY MOISTURISER FOR SEVERE DRY SKIN
  • Ointment 125g, 500g, 1kg
  • Excellent greasy emollient for night time or very dry skin. Prescribe with a less greasy emollient for day time use.
  • Can be used as soap substitute
  • NOTE: Hydromol CREAM is non-formulary due to cost.
 
   
Liquid and White Soft Paraffin Ointment (50:50)

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Formulary
Self
  • VERY GREASY MOISTURISER FOR SEVERE DRY SKIN &/OR ACUTE FLARES (low risk of sensitivity):
  • 50/50 ointment
 
   
Aproderm colloidal
(oat cream)
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Formulary
Self
  • VERY LIGHT MOISTURISER FOR VERY SENSITIVE MILD DRY SKIN, IF ISOMOL GEL HAS BEEN TRIED AND FAILED.
  • Branded generic version of Aveeno (cheaper than Aveeno) 
  • Patients requiring an emollient who are using medical oxygen therapy should use Aproderm Colloidal as this is a non-paraffin based emollient.

 

 
   
Aquamax

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Formulary
Red
  • SFT only for in-patients
  • NOT for use in primary care
 
   
Dermol
(Cream & Lotion )
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Formulary
Self
  • CONTAINS ANTIMICROBIALS
  • Use long-term if needed to prevent frequent skin infections, or for handwashing for carers with occupational irritant hand dermatitis.
  • Use short-term if there is a single episode of infection. Not for repeat prescription.
  • Cream 100g, 500g pump
  • Contains benzalkonium Cl and chlorhexidine HCL
  • Lotion 500ml pump
  • Can be used as hairwash and soap substitute
  • Contains benzalkonium Cl and chlorhexidine HCL
 
   
Diprobase
(Topical)
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Formulary
Red
  • SFT only
  • Cream or ointment
  • NOT for use in primary care- use epimax as an alternative instead.
 
   
Eucerin Intensive 10%
(Topical)
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Formulary
Red
  • SFT only
  • Contains Urea
  • 250ml lotion or 100ml cream
 
   
Imuderm
(cream)
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Formulary
Self
  • Use after other emollients have been tried and failed to control symptoms. Expensive emollient. 
  • Urea 5%, Glycerine 5%
  • Available as 500g pump pack
  • Preparations containing lauromacrogols and/or urea are useful to stop itching or aid hydration.
 
   
Dermatonics Heel Balm
(cream)
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Formulary
Self
  • Use after other emollients have been tried and failed to control symptoms. Expensive emollient.
  • 25% urea
  • Available as: 75g and 200g pack sizes.
  • Preparations containing lauromacrogols and/or urea are useful to stop itching or aid hydration.
 
   
White Soft Paraffin BP

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Formulary
Self
 
   
Yellow Soft Paraffin BP

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Formulary
Self
 
   
13.02.01  Expand sub section  Emollients - preparations containing urea
13.02.01  Expand sub section  Emollients - with antimicrobials
13.02.01.01  Expand sub section  Emollient bath and shower preparations
 note 

Patients should be advised to use any cream or ointment listed under emollients 13.2.1(except 50:50 ointment) as a soap substitute during baths or showers. Alternatively, patients can self-purchase bath oils from community pharmacies or supermarkets.

Bath and shower emollients should no longer be prescribed on the NHS due to lack of evidence base of benefit. See:

Emollient bath additives for the treatment of childhood eczema (BATHE): multicentre pragmatic parallel group randomised controlled trial of clinical and cost effectiveness.

BMJ 2018; 361 doi: https://doi.org/10.1136/bmj.k1332 (Published 03 May 2018) BMJ 2018;361:k1332

Oilatum Plus
(emollient bath additive)
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Formulary
Green
  • BCAP area only
  • This product has been included on formulary for the specific indication of MRSA decolonisation ONLY due to it containing Triclosan.
  • See MRSA decolonisation guidance (BCAP) below.
 
Link  BCAP MRSA treatment summary Feb 2018
   
 ....
 Non Formulary Items
Aquadrate


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Non Formulary
 
Aqueous Cream BP 

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Non Formulary
 
Aveeno


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Non Formulary
 
Balneum Plus cream

(Emollient preparation containing Urea)

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Non Formulary
 
Cetraben Bath additive


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Non Formulary
 
DoubleBase Dayleve


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Non Formulary
 
E45  

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Non Formulary
 
Emollient Bath Additive
(Alpha Keri Bath®)

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Non Formulary
 
Emollient Bath Additive
(Aveeno®)

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Non Formulary
 
Emollient Bath Additive
(Balneum®)

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Non Formulary
 
Emollient Bath Additive
(Dermalo®)

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Non Formulary
 
Emollient Bath Additive
(Diprobath)

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Non Formulary
 
Emollient Bath Additive
(E45®)

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Non Formulary
 
Emollient Bath Additive
(Imuderm®)

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Non Formulary
 
Emollient Bath Additive
(Oilatum)

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Non Formulary
 
Emollient Bath Additive
(QV®)

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Non Formulary
 
Emollient Bath Additive
(Zerolatum®)

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Non Formulary
 
Emollient Bath Additive with Anitmicrobials
(Dermol®)

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Non Formulary
 
Emollient Bath Additive with Anitmicrobials
(Dermol)

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Non Formulary
 
Emollient Bath Additive with Anitmicrobials
(Emulsiderm®)

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Non Formulary
 
Emollient Bath Additives
(Zeroneum®)

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Non Formulary
 
Emollient Bath Additives
(Zerozole®)

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Non Formulary
 
Emollient preparation
(Decubal Clinic)

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Non Formulary
 
Emollient preparation
(Dermamist)

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Non Formulary
 
Emollient preparation
(Drapolene)

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Non Formulary
 
Emollient preparation
(Epaderm)

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Non Formulary
 
Emollient preparation
(Hewletts)

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Non Formulary
 
Emollient preparation
(Kamillosan)

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Non Formulary
 
Emollient preparation
(Keri)

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Non Formulary
 
Emollient preparation
(Linola Gamma)

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Non Formulary
 
Emollient preparation
(Lipobase)

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Non Formulary
 
Emollient preparation
(Neutogena Dermatological Cream)

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Non Formulary
 
Emollient preparation
(Ultrabase)

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Non Formulary
 
Emollient preparation
(Vaseline Dermacare)

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Non Formulary
 
Emollient preparation
(ZeroAQS)

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Non Formulary
 
Emollient preparation
(Zeroguent®)

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Non Formulary
 
Emollient preparation containing Urea
(Balneum®)

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Non Formulary
 
Emollient preparation containing Urea
(Calmurid)

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Non Formulary
 
Emollient preparation containing Urea
(E45® Itch Releif Cream)

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Non Formulary
 
Emollient preparation containing Urea
(Nutraplus®)

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Non Formulary
 
Emollient preparation with antimicrobials
(Eczmol)

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Non Formulary
 
Emollient preparation with antimicrobials
(Zerolatum® Plus)

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Non Formulary
 
Emollin


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Non Formulary
 
Flexitol


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Non Formulary
 
Hydromol bath and shower


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Non Formulary
 
Lanolin emollient spray

(Evolve plus)

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Non Formulary
 
Oilatum shower emollient gel


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Non Formulary
 
Proprietary Emollient Preparations
(Doublebase®)

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Non Formulary
 
QV  

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Non Formulary
 
Skin Salvation Cream


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Non Formulary
 
Unguentum M


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Non Formulary
 
Urea 5% Special Preparation


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Non Formulary
 
Zerobase


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Non Formulary
 
Zerocream


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Non Formulary
 
Zerodouble Gel


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Non Formulary
 
Zerodouble Gel


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Non 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
click to search medicines.org.uk
Link to adult BNF
click to search medicines.org.uk
Link to SPCs
SMC
Scottish Medicines Consortium
Cytotoxic Drug
Cytotoxic Drug
CD
Controlled Drug
High Cost Medicine
High Cost Medicine
Cancer Drugs Fund
Cancer Drugs Fund
NHSE
NHS England
Homecare
Homecare
CCG
CCG
Blueteq
High Cost Drug Approval System

Traffic Light Status Information

Status Description

Red

RED - Hospital only to be prescribed by a specialist and supplied from secondary care ONLY throughout treatment.  

Amber

Amber medicines are considered suitable for GP prescribing following specialist initiation or recommendation.  

Amber with Shared Care

Shared Care - these medicines require specialist initiation and stabilisation. Ongoing division of responsibility for drug and disease monitoring between specialist and GP by a Shared Care Guideline (SCG). If no SCG in place status reverts to red.  

Green

These medicines are appropriate for initiation in both primary and secondary care. Prescribing is appropriate within licensed or local recommendations.  

Self

Suitable for patient to be directed to buy themselves  

Grey

Not currently used. We intend to include this TLS in future to highlight where a decision to use this medicine is under review.   

Black

Not currently used. We intend to include this TLS in future to highlight where a decision has been made by either or both the local or national NHS not to routinely commission this preparation for its licensed indications. Do not prescribe.  

Red Specialist Centre

Not currently used. We intend to include this TLS in future to highlight where this medicine and indication is ONLY available through a Specialist Centre according to a NICE Highly Specialised Technology or NHSE Specialised Commission Circular / Policy.  

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