II. Approach

  1. General
    1. Creams are most tolerable for all skin types (but less potent than ointments)
  2. Dry Skin
    1. Ointments
  3. Oily skin or hairy skin (including scalp)
    1. Gel, lotion or foam
  4. Sweaty skin (esp. intertriginous areas)
    1. Powders

III. Preparations

  1. Topical Gel or Topical Liquid
    1. Lesions on scalp or hairy areas or on oozy or wet lesions
    2. Jelly-like consistency that may be soothing to inflammatory lesions (e.g. Poison Ivy)
    3. Quick dries and does not cause hair matting
    4. Gels may be irritating in some cases, and must be frequently reapplied
    5. Lower potency medication delivery vehicle than Topical Ointments and Topical Creams
  2. Topical Lotion
    1. Indicated on oozing lesions and lesions in hairy areas
    2. Penetrates skin easily, leaves minimal residue, non-greesy, and dries quickly (contain Alcohol)
    3. Least potent vehicle for medication delivery
  3. Topical Cream
    1. Most useful and acceptable of all topical bases
    2. Higher risk of Allergic Contact Dermatitis (due to preservatives)
    3. Treats both wet and dry lesions (Eczematous Dermatitis) and Exudative inflammatory lesions
    4. Useful in Intertriginous areas (where Topical Ointments are often avoided)
  4. Topical Ointment
    1. Useful on thick, dry, itchy Plaques (hyperkeratotic lesions) or areas often rubbed off by patients
    2. Avoid on lesions in hairy areas or intertriginous areas (Risk of Superficial Folliculitis or maceration)
    3. Most potent vehicle of the Preparation Bases (due to most Occlusion) and offers best lubrication
    4. Sticky feeling and stains clothing
  5. Topical Paste
    1. Used in wet intertriginous rashes
    2. Requires oil to wipe off (not removed with water)
  6. Topical Powder (e.g. Talc)
    1. Protects intertriginous areas (but no powder absorbs moisture)
  7. Topical Preparations for the Scalp (Topical Foam, Shampoo, or Mousse)
    1. Easily applied (spread easily through hair surface)
    2. Foams are more expensive than other Preparation Bases

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