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INTRODUCTION TO CHAPTER

Most common skin disorders can be treated with a formulary of cost-effective, widely available topical and oral products. Topical medications are effective for most common skin disorders and they have fewer serious adverse side effects when compared with their oral counterparts. Oral medications may be needed if a skin disease is widespread or more severe.

There are several things to consider before prescribing a topical product such as the active ingredient, the vehicle, and the quantity to dispense.

VEHICLE SELECTION

The vehicle of a topical product may be as important as the active ingredient. Table 6-1 lists commonly used vehicles. "If it's dry, wet it and if it is wet, dry it" is still a good general guideline for treatment of common dermatoses. Most skin disorders, especially the chronic dermatoses (eg, psoriasis, chronic contact dermatitis), are "dry"; therefore, ointments are preferred as they are more moisturizing. Also, ointments do not contain preservatives that can cause stinging and burning. The main problem with ointments, is that they are greasy and can stain clothing and bedding. Creams are a good option for the "wet" dermatoses, such as acute contact dermatitis, and other blistering or exudative dermatoses. They are also a good option for adults who do not want to use an ointment. However, some cream preparations are slightly drying and preservatives and other ingredients in the vehicle may sting or burn.

Table 6-1.Vehicles for topical products arranged from most moisturizing to most drying.

QUANTITY TO DISPENSE

The quantity of medication to be dispensed and the amount of medication ...

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