Topicals

According to Medicinenet.com a topical is “pertaining to a particular surface area. For example, a topical agent is applied to a certain area of the skin and is intended to affect only the area to which it is applied. Whether its effects are indeed limited to that area depends on whether the agent stays where it is put or is absorbed into the bloodstream”.

Topicals are used in the treatment and/or management of many skin conditions, diseases or traumas, and are often the first line of treatment before moving on to stronger medications such as systemics or biologics.

Topicals come in a range of classes such as creams, ointments, lotions and more and there is often confusion as to when to use which type of product:

1. Ointments – They are often stiff or greasy
   • Very effective for dry skin
   • Seals the moisture in
   • The greasy coating is what protects the skin.
   • Usually contain very few irritants (i.e. fragrances, preservatives etc.)
2. Creams – Feel light and cool on the skin
   • Absorbs into the skin so it doesn’t feel as greasy
   • Creams are less effective in protecting the skin as they are not as greasy
   • They often contain more irritants so they may sting
3. Lotions – They are more liquidy than creams or ointments
   • They are spread easily and have a cooling effect on the skin
   • They are only mildly effective at moisturizing the skin
   • They may cause discomfort or stinging
   • They contain more irritants than ointments or creams
4. Gels – They are thicker than lotions
   • They are often semi-solid and sometimes use alcohol as an active ingredient
   • They tend to be self drying and liquify when they come into contact with the skin
   • Useful in hairy areas
   • Higher risk of sensitivity due to irritants
   • Can cause stinging especially if applied to an open wound or sore
5. Foams – Increasing importance in topical dermatology
   • Can take the form of aerosol foam with a dense creamy consistency (i.e. mousse)
   • Can be non-aerosol pump foams that have a looser, less dense consistency
   • Foams allow for a clean and precise application

Topicals can also be inhaled like many asthma medications, or applied to surfaces other than the skin, such as eye drops or ear drops.

This information has been reviewed by a certified dermatologist September 2019