Prescriptions written for topical steroids should include explicit instructions about where and how often to apply the preparation, and the body areas where use must be avoided. Pharmacists should ensure these directions are included on the dispensing label. Prescribers should bear in mind that patients may keep unused or leftover corticosteroid skin preparations for some time after they are prescribed and thus forget the original indication or instructions for use. The prescribing of unnecessarily large quantities should be avoided. Patients should be warned not to share their topical steroid preparation with other people as this may result in unsafe application to unsuitable areas such as the face, as well as the potentially inappropriate treatment of undiagnosed skin conditions.
Occlusive Dressing Technique
Occlusive dressings may be used for the management of psoriasis or other recalcitrant rub a small amount of cream into the lesion until it disappears. Reapply the preparation leaving a thin coating on the lesion, cover with pliable nonporous film, and seal the edges. If needed, additional moisture may be provided by covering the lesion with a dampened clean cotton cloth before the nonporous film is applied or by briefly wetting the affected area with water immediately prior to applying the medication. The frequency of changing dressings is best determined on an individual basis. It may be convenient to apply Triamcinolone acetonide cream under an occlusive dressing in the evening and to remove the dressing in the morning (., 12-hour occlusion). When utilizing the12-hour occlusion regimen, additional cream should be applied, without occlusion, during the day. Reapplication is essential at each dressing change. If an infection develops, the use of occlusive dressings should be discontinued and appropriate antimicrobial therapy instituted.
Transdermal patches can be a very precise time released method of delivering a drug. Cutting a patch in half might affect the dose delivered. The release of the active component from a transdermal delivery system (patch) may be controlled by diffusion through the adhesive which covers the whole patch, by diffusion through a membrane which may only have adhesive on the patch rim or drug release may be controlled by release from a polymer matrix. Cutting a patch might cause rapid dehydration of the base of the medicine and affect the rate of diffusion.