BNF for Children 2011-2012

550 BNFC 2011–201213 Skin13 Skin13.1 Management of skin conditions55013.1.1 Vehicles 55113.1.2 Suitable quantities for prescribing55113.1.3 Excipients and sensitisation 55113.2 Emollient and barrier preparations55213.2.1 Emollients 55213.2.1.1 Emollient bath additives andshower preparations 55413.2.2 Barrier preparations 55613.3 Topical antipruritics 55713.4 Topical corticosteroids 55813.5 Preparations for eczema andpsoriasis 56513.5.1 Preparations for eczema 56513.5.2 Preparations for psoriasis 56613.5.3 Drugs affecting the immuneresponse 57213.6 Acne and rosacea 57413.6.1 Topical preparations for acne 57413.6.2 Oral preparations for acne 57813.7 Preparations for warts andcalluses 58013.8 Sunscreens and camouflagers 58213.8.1 Sunscreen preparations 58213.8.2 Camouflagers 58313.9 Shampoos and other preparationsfor scalp conditions 58313.10 Anti-infective skin preparations58513.10.1 Antibacterial preparations 58513.10.1.1 Antibacterial preparations onlyused topically 58613.10.1.2 Antibacterial preparations alsoused systemically 58713.10.2 Antifungal preparations 58813.10.3 Antiviral preparations 59113.10.4 Parasiticidal preparations 59113.10.5 Preparations for minor cuts andabrasions 59313.11 Skin cleansers, antiseptics,and preparations for promotionof wound healing 59413.11.1 Alcohols and saline 59413.11.2 Chlorhexidine salts 59513.11.3 Cationic surfactants and soaps 59513.11.4 Iodine 59613.11.5 Phenolics 59613.11.6 Oxidisers and dyes 59613.11.7 Preparations for promotion ofwound healing 59613.12 Antiperspirants 59713.13 Topical circulatory preparations597This chapter also includes advice on the managementof the following:candidiasis, p. 588dermatophytoses, p. 588head lice, p. 592nappy rash, p. 556pityriasis versicolor, p. 588scabies, p. 592For information on wound management products andelasticated garments, see the relevant BNF appendix.The British Association of Dermatologists’ list of preferredunlicensed dermatological preparations (specials)is available at www.bad.org.uk/site/495/default.aspx.13.1 Management of skinconditionsWhen prescribing topical preparations for the treatmentof skin conditions in children, the site of application, thecondition being treated, and the child’s (and carer’s)preference for a particular vehicle all need to be takeninto consideration.Neonates Caution is required when prescribing topicalpreparations for neonates—their large body surfacearea in relation to body mass increases susceptibilityto toxicity from systemic absorption of substancesapplied to the skin. Topical preparations containingpotentially sensitising substances such as corticosteroids,aminoglycosides, iodine, and parasiticidal drugsshould be avoided. Preparations containing alcoholshould be avoided because they can dehydrate theskin, cause pain if applied to raw areas, and the alcoholcan cause necrosis.In preterm neonates, the skin is more fragile and offers apoor barrier, especially in the first fortnight after birth.Preterm infants, especially if below 32 weeks post-