BNF for Children 2011-2012

BNFC 2011–2012 13.8.2 Camouflagers 583Uvistat c (LPC)Cream (UVA and UVB protection; UVB-SPF 30), avobenzone5%, bisoctrizole 1.5%, octinoxate 7.5%, octocrilene 4%,titanium dioxide 5.2%, net price 125 mL = £7.45. ACBSExcipients include disodium edetate, hydroxybenzoates (parabens),propylene glycolNote For INCI synonyms, see table aboveCream (UVA and UVB protection; UVB-SPF 50), amiloxate2%, avobenzone 5%, bisoctrizole 6%, octinoxate 10%,octocrilene 4%, titanium dioxide 4.8%, net price 125 mL =£8.45. ACBSExcipients include disodium edetate, polysorbate 60, propylene glycolNote For INCI synonyms, see table aboveLipscreen (UVA and UVB protection; UVB-SPF 50), avobenzone5%, bemotrizinol 3%, octinoxate 10%, octocrilene4%, titanium dioxide 3%, net price 5 g = £2.99. ACBSExcipients include butylated hydroxytoluene, hydroxybenzoates (parabens)Note For INCI synonyms, see table abovePhotodamageActinic keratoses occur very rarely in healthy children;actinic cheilitis may occur on the lips of adolescentsfollowing excessive sun exposure.Diclofenac gel (Solaraze c ) and fluorouracil cream arelicensed for the treatment of actinic keratoses but theyare not licensed for use in children.In children with photosensitivity disorders, such aserythropoietic protoporphyria, specialists may usebetacarotene, mepacrine, chloroquine or hydroxychloroquine(section 10.1.3) to reduce skin reactions.BETACAROTENENote Betacarotene is a precursor to vitamin ACautions monitor vitamin A intake; interactions:Appendix 1 (vitamins)Hepatic impairment avoidRenal impairment use with cautionPregnancy partially converted to vitamin A, but doesnot give rise to abnormally high serum concentration;manufacturer advises use only if potential benefitoutweighs riskBreast-feeding use with caution—present in milkSide-effects loose stools; yellow discoloration of skin;rarely, bruising, arthralgiaLicensed use not licensed for use in UKIndication and doseManagement of photosensitivity reactions inerythropoietic protoporphyria (specialist useonly). By mouthChild 1–5 years 60–90 mg daily in single ordivided dosesChild 5–9 years 90–120 mg daily in single ordivided dosesChild 9–12 years 120–150 mg daily in single ordivided dosesChild 12–16 years 150–180 mg daily in single ordivided dosesChild 16–18 years 180–300 mg daily in single ordivided dosesNote Protection not total—avoid strong sunlight and usesunscreen preparations; generally 2–6 weeks of treatment(resulting in yellow coloration of palms and soles) necessarybefore increasing exposure to sunlight; dose should beadjusted according to level of exposure to sunlightBetacarotene (Non-proprietary)Capsules, 15 mg, 25 mg are available from ‘specialorder’manufacturers or specialist importing companies,see p. 809. Label: 2113.8.2 CamouflagersDisfigurement of the skin can be very distressing andmay have a marked psychological effect, especially inchildren. Cosmetic preparations may be used to camouflageunsightly scars, skin deformities, and pigmentabnormalities, such as vitiligo and birthmarks.Opaque cover foundation or cream is used to mask skinpigment abnormalities; careful application using a combinationof dark- and light-coloured cover creams setwith powder helps to minimise the appearance of skindeformities.Borderline substances The preparations marked‘ACBS’ cannot be prescribed on the NHS for postoperativescars and other deformities except as adjunctivetherapy in the relief of emotional disturbances due todisfiguring skin disease, such as vitiligo.Covermark c (Derma UK)Classic foundation (masking cream), net price 15 g (10shades) = £11.32. ACBSExcipients include beeswax, hydroxybenzoates (parabens), fragranceFinishing powder, net price 25 g = £11.32. ACBSExcipients include beeswax, hydroxybenzoates (parabens), fragranceDermacolor c (Fox)Camouflage creme, (100 shades), net price 25 mL = £9.96.ACBSExcipients include beeswax, butylated hydroxytoluene, fragrance, propyleneglycol, stearyl alcohol, wool fatFixing powder, (7 shades), net price 60 g = £8.45. ACBSExcipients include fragranceKeromask c (Lornamead)Masking cream, (9 shades), net price 15 mL = £5.68. ACBSExcipients include butylated hydroxyanisole, hydroxybenzoates (parabens),wool fat, propylene glycolFinishing powder, net price 20 g = £5.68. ACBSExcipients include butylated hydroxytoluene, hydroxybenzoates (parabens)Veil c (Thomas Blake)Cover cream (40 shades), net price 19 g = £20.63, 44 g =£30.68, 70 g = £38.74. ACBSExcipients include hydroxybenzoates (parabens), wool fat derivativeFinishing powder, translucent, net price 35 g = £22.62. ACBSExcipients include butylated hydroxyanisole, hydroxybenzoates (parabens)13.9 Shampoos and otherpreparations for scalpconditionsThe detergent action of shampoo removes grease(sebum) from hair. Prepubertal children produce verylittle grease and require shampoo less frequently thanadults. Shampoos can be used as vehicles for medicinalproducts, but their usefulness is limited by the short time13 Skin