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13.9 Skin cleansers, antiseptics and desloughing agents

First line drugs Second line drugs Specialist drugs Secondary care drugs

Traffic light status (TLS) explained:

  • Green: Routine prescribing within licensed indication
  • Amber 1: specialist recommendation followed by GP initiation and continuation
  • Amber 2: specialist or GP initiation in line with local guideline after 1st line failure followed by GP continuation
  • Amber 3: specialist initiation and stabilisation followed by GP continuation
  • Amber SCG: specialist initiation and stabilisation followed by GP continuation in line with an agreed shared care guideline
  • Red: Hospital or specialist prescribing only

Alcohols

Industrial Methylated Spirit

  • Solution 70% 

 

Antiseptics and disinfectants 

Hydrogen peroxide 

Hydrogen peroxide is an oxidising agent 

Prescribing and dispensing information

With topical use

The BP directs that when hydrogen peroxide is prescribed, hydrogen peroxide solution 6% (20 vols) should be dispensed.

Strong solutions of hydrogen peroxide which contain 27% (90 vols) and 30% (100 vols) are only for the preparation of weaker solutions.

With oral (topical) use

When prepared extemporaneously, the BP states Hydrogen Peroxide Mouthwash, BP consists of hydrogen peroxide 6% solution (= approx. 20 volume) BP. 

Medicinal Forms

  • Solution 3% BP (10 Vols)
  • Solution 6% BP (20 Vols)
  • Solution 30% (100Vols) – Bleach – used only to prepare weaker solutions
  • Cream, Crystacide® 1%

 

Chlorhexidine

  • Sachets, Chlorhexidine gluconate (25ML) 0.05 % Sachets 25 x 25mL
  • Cream, Chlorhexidine Obstetric 1 % Cream 250 mL

Notes:

  • Avoid contact with eyes, brain, meninges and middle ear
  • Not for use in body cavities
  • Alcoholic solutions not suitable before diathermy or for use on neonatal skin
  • In preterm neonates, use sparingly, do not allow solution to pool, and monitor for skin reactions—risk of severe chemical burns

 

Astringents

Potassium permanganate 

  • Permitabs® Solution tablets 400mg

 

 

Iodine products

Povidone iodine  

  • Antiseptic solution, povidone-iodine 10% in aqueous solution
  • Surgical scrub, aqueous solution, povidone-iodine 7.5%
  • Betadine® Dry powder spray 2.5%

 

 

Irrigation

Irrigation solutions 

  • Sodium Chloride, Sachet 0.9% and Pour bottle, 1 Litre 0.9% 

 

 

13.9.1 Minor cuts and abrasions 

Cetrimide with chlorhexidine

  • Savlon® antiseptic cream
  • Liquid,cetrimide 1.5mg per 1ml, chlorhexidine gluconate 150microgram per 1ml; 25ml sachets
  • Irrigation solution, 1 litre bottle

Notes for Savlon antiseptic cream: 

  • Should not be prescribed in Primary Care or at Discharge
  • Advise patient to purchase, unless prescription is for long-term regular use

 

 

Glycerol with magnesium sulfate and phenol

  • Paste, Magnesium Sulfate 

 

 

 

Traffic light status (TLS) explained:

  • Green: Routine prescribing within licensed indication
  • Amber 1: specialist recommendation followed by GP initiation and continuation
  • Amber 2: specialist or GP initiation in line with local guideline after 1st line failure followed by GP continuation
  • Amber 3: specialist initiation and stabilisation followed by GP continuation
  • Amber SCG: specialist initiation and stabilisation followed by GP continuation in line with an agreed shared care guideline
  • Red: Hospital or specialist prescribing only

 

 

Return to Chapter: 13. Skin

Last updated by: Dupe Fagbenro on 11-10-2018 12:27