S2k guidelines for the use of topical preparations on the skin

Abstract

The present guidelines are aimed at dermatology residents and board-certified dermatologists as well as policymakers and insurance companies. Developed by dermatologists in collaboration with pharmacists using a formal consensus process (S2k), they include general aspects with respect to pharmacokinetics and regulatory terminology. Recommendations are provided on the various indications for extemporaneous preparations and their quality assurance. The importance of pharmaceutical vehicles and problems associated with substituting one vehicle for another are discussed. The guidelines include criteria for choosing a suitable pharmaceutical vehicle and for specific aspects in terms of treatment planning. In addition, recommendations are given for managing allergic reactions to vehicles or additives.

Anti-inflammatory topical medication – new developments in the treatment of atopic dermatitis

“…The use of topical medication with anti-inflammatory agents is propagated in a phase-specific manner. This means that the choice of vehicle system and the active drug ingredient are selected and adjusted according to the disease activity in the therapeutic area [ 4 ]. This selection has a direct impact on the patient’s tolerability and adherence to topical therapy [ 5 ].…”

Hand eczema: treatment

“…1). 20 Some pharmacologically active substances may only be available in cosmetically 'unpleasant' vehicles for this reason. 20 Generally, the principles 'moist on moist' and 'greasy on dry' propose to use hydrating vehicles on acute lesions of hand eczema and lipid-rich vehicles on chronic ones.…”

“…Topical therapies should consider the appropriate choice of vehicles, suitable pharmaceutical vehicle depending on the condition of the skin and the acuteness of the eczema. 20 Generally, the principles 'moist on moist' and 'greasy on dry' propose to use hydrating vehicles on acute lesions of hand eczema and lipid-rich vehicles on chronic ones. This approach, however, is limited by the fact that patients may need to use their hands in everyday life not wishing to leave greasy marks on objects of their environment.…”

“…In addition, the function of the pharmaceutical vehicle is to ensure a stable formulation and to facilitate the bioavailability of the active agent. 20 Some pharmacologically active substances may only be available in cosmetically 'unpleasant' vehicles for this reason.…”

The Anti-Inflammatory Effect of Humulus lupulus Extract In Vivo Depends on the Galenic System of the Topical Formulation

“…Our previous in vitro and ex vivo experiments revealed that Humulus lupulus (HL, hop) extract is a promising anti-psoriatic agent with prominent anti-proliferative effects [ 1 ]. Because epidermal barrier defects and scaling are pathogenetic key factors in psoriasis, the current guidelines and therapeutic concepts for psoriasis recommend a topical therapy with lipid-rich creams [ 2 ]. Similarly, other chronic inflammatory skin conditions with reduced lipid and ceramide content, such as atopic eczema, also benefit from a lipid-rich cream [ 3 , 4 , 5 ].…”