Skin, Wound & Topical Medicines Used-For Guides

What Skin, Wound & Topical Medicines covers

This section covers medicines applied to the skin: creams, ointments, gels, lotions and antiseptics. It includes treatments for fungal infections, bacterial skin infections, eczema and inflammation, wound care products, and the combination creams widely dispensed in South Africa.

It is one of the largest medicines sections by number of guides, and the reason is that topical products are easy to buy, easy to confuse and frequently used for the wrong thing. A cream for a fungal rash and a cream for an inflamed one are different medicines, and using the wrong one can make the problem visibly worse.

Four groups cover most of what is here. Antifungals such as Canex V and Fungistop treat thrush, athlete’s foot and ringworm. Topical antibiotics such as Fucidin and Supiroban treat bacterial skin infection. Corticosteroid creams such as Clomaderm reduce inflammation and itch in eczema and dermatitis. Antiseptics and wound products clean and protect broken skin.

A number of widely used products are combinations — typically a steroid plus an antifungal, sometimes plus an antibiotic. These are convenient but blunt: a steroid applied to an undiagnosed fungal rash can suppress the inflammation while the infection spreads underneath. That is the single most useful thing to understand about this section.

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How the guides in this section differ

What kind of problem is it. Fungal, bacterial and inflammatory skin conditions look more alike than they behave. Getting this wrong is the usual reason a cream does not work.

Steroid potency. Topical corticosteroids range from mild to very potent. The potency that suits a patch of eczema on a forearm is not what belongs on a face, in a skin fold or on a child, where thinning and other effects occur far more readily.

Cream, ointment or lotion. The base matters. Ointments are greasier, hold moisture better and suit dry scaly skin. Creams suit weeping or moist areas. Lotions cover large or hairy areas. The same active ingredient behaves differently in each.

Single or combination. A combination product is appropriate when a diagnosis genuinely warrants both components. Used speculatively on an undiagnosed rash, it can mask and prolong the problem.

Safety, accuracy and next-step checks

These guides explain what a product is used for. They do not diagnose a rash, and a rash is one of the harder things to identify from a description.

The points worth carrying:

Do not use a steroid cream on an undiagnosed rash. If it is fungal, the steroid can suppress the appearance while the infection spreads.
Potent steroids do not belong on the face, groin or skin folds unless a doctor has specifically directed it, and only for the stated period.
Steroid creams on children need advice. Skin is thinner and absorbs more.
Use topical antibiotics for a short defined period. Extended use encourages resistance.
Do not put antiseptics into an open wound routinely. Running water is the standard first step; strong antiseptics can damage healing tissue.
Watch for spreading infection. Increasing redness, heat, swelling, pus, red streaking or fever needs same-day medical attention, not a stronger cream.
Stop if the skin reacts. Increased burning, itching or a new rash may be a reaction to the product or its preservative.

See a doctor for a rash that is spreading rapidly, blistering, painful out of proportion to its appearance, accompanied by fever, near the eyes, or not improving after the expected treatment period. Rashes in babies, and any skin problem in someone with diabetes or a suppressed immune system, deserve a lower threshold for professional review.

Frequently asked questions

How do I know whether my rash is fungal or inflammatory? Often you cannot from appearance alone, which is exactly why speculative treatment goes wrong. A pharmacist can advise, and a doctor can examine or scrape it.

Why did my cream stop working? Common reasons are that the diagnosis was wrong, that a steroid suppressed an underlying infection, or that the course was too short. A cream that stops working is a reason to be assessed rather than to escalate potency.

Can I use a leftover cream on a new rash? Not advisable. It may be the wrong class, the wrong potency for that body area, or past its expiry — and creams in opened tubes do not keep indefinitely.

Is an ointment stronger than a cream? Not stronger in active ingredient, but ointments hold moisture better and can deliver more of it into the skin. The choice depends on the skin, not on strength.

How long should I use a steroid cream? Only for the period stated on the label or by your prescriber. Continuing indefinitely risks skin thinning and other effects, particularly on delicate areas.