DIAFOOT 0.2%W/W, 1%W/W, 10%W/W CREAM

Indications

• Wound healing
• Skin irritations
• Dry skin conditions
• Eczema
• Psoriasis

Dosage

Children: Refer to the BNF for Children for appropriate dosing and formulation guidance for paediatric use.

Adults: Refer to specific product guidelines for application frequency and amount, as allantoin is typically used in topical formulations.

Mechanism of action

Although there is no well-controlled data to formally substantiate its method of action, studies suggest that allantoin may induce a histological wound healing profile. This profile includes increased vasodilation, inflammatory exudate presence, and enhanced numbers of inflammatory cells, angiogenesis, fibroblast proliferation, and collagen deposition in wound sites treated with allantoin compared to untreated ones.

Pharmacodynamics

Ongoing studies indicate that allantoin possesses moisturizing and keratolytic effects. It can increase the water content of the extracellular matrix and promote the desquamation of the upper layers of dead skin cells. These activities are believed to support cell proliferation and facilitate wound healing.

Pharmacokinetics

The pharmacokinetics of allantoin are not well characterized in controlled studies. However, its application as a topical agent suggests localized effects with minimal systemic absorption, facilitating its use in dermatological applications without significant systemic effects.

Pregnancy

There is limited data on the safety of allantoin in pregnancy. Use should be based on a risk-benefit assessment.

Breast-feeding

Limited data available, use with caution and consult a healthcare professional.

Storage

Store in a cool, dry place away from moisture and direct sunlight.

Formulations

• Topical cream
• Ointment
• Gel

Indications

• Dry skin
• Skin irritation
• Eczema
• Dermatitis
• Cosmetic applications as a moisturizer and thickening agent

Dosage

Children: Refer to specific product guidelines as dosing can vary based on formulation and intended use.

Adults: Refer to specific product guidelines as dosing can vary based on formulation and intended use.

Mechanism of action

Dimethicone works by forming a protective layer on the skin, which helps to seal in moisture and protect the skin from irritants. Its anti-foaming properties are due to its ability to reduce surface tension, allowing gas bubbles to coalesce and escape more easily, thus diminishing the formation of foam in solutions.

Pharmacodynamics

Dimethicone exhibits emollient properties, which means it can soften and soothe the skin. It acts by creating a barrier that prevents transepidermal water loss, thereby enhancing hydration. Its non-irritating nature makes it suitable for sensitive skin, and it does not clog pores, making it a preferred choice in many dermatological preparations.

Pharmacokinetics

Dimethicone is not absorbed systemically; it remains on the skin surface and does not penetrate into the deeper layers of the skin. This characteristic makes it effective as a topical agent. Because it is not metabolized or excreted by the body, its pharmacokinetic profile is primarily focused on its local effects rather than systemic absorption.

Adverse effects

• Allergic reactions
• Skin irritation
• Gastrointestinal discomfort

Precautions

• Use with caution in patients with a history of allergic reactions to silicone-based compounds
• Monitor for any signs of adverse reactions during treatment

Pregnancy

Dimethicone is generally considered safe for use during pregnancy, as it is not absorbed systemically.

Breast-feeding

Dimethicone is considered safe for use during breastfeeding, as it is not absorbed and is unlikely to affect breastfed infants.

Storage

Store in a cool, dry place away from direct sunlight. Keep out of reach of children.

Formulations

• Topical creams
• Lotions
• Ointments
• Oral suspensions

Indications

• Dry skin
• Ichthyosis
• Eczema
• Psoriasis
• Dermatitis

Dosage

Children: Refer to the BNF for Children for appropriate dosing recommendations for paediatric patients.

Adults: Refer to the specific product information for dosing instructions, as doses may vary based on formulation and intended use.

Mechanism of action

The primary mechanism of ammonia toxicosis appears to be inhibition of the citric acid cycle. There is an increase in anaerobic glycolysis, blood glucose, and blood lactate. Acidosis is manifested. The exact means by which ammonia blocks the citric acid cycle is not known. It is postulated that ammonia saturation of the glutamine-synthesizing system causes a backing-up in the citrate cycle, a decrease in its intermediates, and a decrease in energy production and cellular respiration, which leads to convulsions. The decrease of citrate cycle intermediates is postulated to result from reamination of pyruvic, ketoglutaric, and oxaloacetic acids.

Pharmacodynamics

Urea is a keratolytic emollient that works to treat or prevent dry, rough, scaly, itchy skin. Its emollient properties help to maintain skin hydration and improve the overall condition of the skin.

Pharmacokinetics

Urea is absorbed through the skin and metabolized in the body. It does not have significant systemic effects when used topically, as it primarily acts locally to alter the moisture content of the stratum corneum, thereby enhancing the skin's barrier function and improving hydration.

Adverse effects

• Skin irritation
• Burning sensation
• Dryness
• Redness

Precautions

• Use with caution in individuals with renal impairment
• Avoid contact with eyes
• Discontinue use if severe irritation occurs

Pregnancy

Consult healthcare provider before use, safety in pregnancy not established.

Breast-feeding

Consult healthcare provider before use, safety in breastfeeding not established.

Storage

Store in a cool, dry place away from direct sunlight.

Formulations

• Topical cream
• Topical ointment
• Topical lotion

Mechanism of action

There is no well controlled data that can formally substantiate the method of action. However, ongoing studies suggest that there may exist a histological wound healing profile induced by allantoin in rats that leads to the amelioration and fastening of the reestablishment of normal skin. This facilitation of wound healing is supported by observations that wounds inflicted to rat subjects to which topical allantoin preparations were applied histologically demonstrated increased vasodilation, presence of inflammatory exudates, number of inflammatory cells, angiogenesis, fibroblast proliferation, and increased collagen deposition when compared to rat subjects with wounds that did not receive any allantoin administration.

Pharmacodynamics

There is no well controlled and appropriate data that can formally substantiate the pharmacodynamic properties of allantoin. Nevertheless, ongoing studies suggest that allantoin possesses moisturizing and keratolytic effects, as well as abilities to increase the water content of the extracellular matrix and enhance the desquamation of upper layers of dead skin cells, all of which are activities that can promote cell proliferation and facilitate wound healing.

Mechanism of action

... The primary mechanism of ammonia toxicosis appears to be inhibition of the citric acid cycle. There is an increase in anaerobic glycolysis, blood glucose, and blood lactate ... . Acidosis is manifested. The exact means by which ammonia blocks the citric acid cycle is not known. It is postulated that ammonia saturation of the glutamine-synthesizing system causes a backing-up in the citrate cycle, a decrease in its intermediates, and a decrease in energy production and cellular respiration, which leads to convulsions ... . The decrease of citrate cycle intermediates is postulated to result from reamination of pyruvic, ketoglutaric, and oxaloacetic acids.

Pharmacodynamics

Urea is a keratolytic emollient that works to treat or prevent dry, rough, scaly, itchy skin.