the Proper Use of Antibiotic Ointments for Seborrheic Dermatitis - Pharmacology

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Antibiotic ointment


Hello, Pharmacist Hou: I have seborrheic dermatitis on my face.
After discussing with my doctor about not wanting to use corticosteroid ointments long-term, I was prescribed two ointments: Jishou Cream and Bikeduo Cream.
I'm not sure if I misheard or misunderstood, but I think the doctor told me to apply a low-potency corticosteroid ointment during flare-ups and an antibacterial agent during periods of remission.
Could you please clarify if the remission period means when there are no flare-ups? Should I apply the antibacterial agent when there are no flare-ups? Will applying the ointment during remission cause any side effects? Since the next patient has already entered the clinic, I apologize for not being able to ask the doctor further.
Could you please provide the correct usage instructions for the antibacterial agent? Thank you.

Xiao Ya, 40~49 year old female. Ask Date: 2017/06/04

Dr. Hou Fangmin reply Pharmacology


Hello, Xiaoya:
1.
Seborrheic dermatitis is treated with corticosteroids primarily for their anti-inflammatory effects.
Topical hydrocortisone cream is one of the main glucocorticoids produced by the adrenal cortex.
It participates in the synthesis and metabolism of various substances in the body.
Clinically, it is most commonly used for its ability to inhibit the synthesis of inflammatory mediators, achieving anti-inflammatory and antipruritic effects.
It is classified as a low-potency corticosteroid, which has fewer side effects, the main ones being skin atrophy and thinning.
2.
Ketoconazole is an antifungal medication that is effective in inhibiting the synthesis of fungal cell membranes, thereby achieving antifungal effects.
Due to its ointment formulation, it is less likely to be absorbed into the bloodstream through the skin, resulting in minimal systemic side effects.
3.
The combination of both treatments is generally more effective.
They should be used preventively when there are no flare-ups.
After a period of use, it is advisable to consult your physician to determine whether continued use is necessary.
Wishing you peace and joy.

Reply Date: 2017/06/04

More Info


When it comes to managing seborrheic dermatitis, particularly on the face, understanding the appropriate use of topical medications is crucial. Your inquiry about the use of weak corticosteroids during flare-ups and antibacterial agents during periods of remission is a common concern among patients dealing with this condition.

Seborrheic dermatitis is characterized by red, flaky, and sometimes itchy patches on the skin, often exacerbated by factors such as stress, hormonal changes, and environmental conditions. The treatment typically involves a combination of anti-inflammatory and antifungal agents, as the condition is often linked to an overgrowth of Malassezia yeast on the skin.


Understanding the Medications
1. Weak Corticosteroids: These are often prescribed for flare-ups of seborrheic dermatitis. They help reduce inflammation and alleviate symptoms such as redness and itching. However, prolonged use of corticosteroids can lead to skin thinning and other side effects, which is why they are usually recommended for short-term use during active flare-ups.

2. Antibacterial Agents: During periods of remission, the use of antibacterial ointments can help prevent secondary infections that may arise from scratching or irritation. These agents can also help maintain skin health by reducing the overall microbial load on the skin.


Clarifying the Terms
- Active Phase: This is when you experience symptoms such as redness, scaling, and itching. During this time, using a weak corticosteroid can help manage these symptoms effectively.


- Remission Phase: This refers to periods when symptoms are not present or are significantly reduced. During this time, using an antibacterial agent can help maintain skin integrity and prevent flare-ups.


Proper Use of Antibacterial Agents
1. Application During Remission: It is generally safe to apply antibacterial ointments during remission. These medications are designed to be used on the skin and can help prevent the overgrowth of bacteria that might lead to infections.

2. Frequency of Use: Follow your healthcare provider's instructions regarding how often to apply the antibacterial ointment. Typically, these may be applied once or twice daily, depending on the formulation and your skin's response.

3. Monitoring for Side Effects: While antibacterial agents are generally well-tolerated, it’s important to monitor your skin for any adverse reactions. If you notice increased irritation, redness, or any other concerning symptoms, consult your healthcare provider.

4. Long-term Use Considerations: While using antibacterial agents during remission is usually safe, it’s essential to avoid over-reliance on any topical medication. Regular follow-ups with your healthcare provider can help adjust your treatment plan as needed.


Conclusion
In summary, your understanding is correct: during the active phase of seborrheic dermatitis, weak corticosteroids can be beneficial, while antibacterial agents can be used during remission to maintain skin health and prevent infections. Always consult with your healthcare provider for personalized advice and to ensure that your treatment plan is effective and safe. Regular monitoring and open communication with your healthcare provider will help you manage your condition effectively and minimize the risk of side effects.

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