Corticosteroids (Listed in Order of Increasing Potency) |
Hydrocortisone acetate | Cream 1%: $1.38/30 g Ointment 1%: $3.91/40 g Solution 1%: $7.34/44 mL | Twice daily | Low | Seborrheic dermatitis Pruritus ani Intertrigo | Not the same as valerate or hydrocortisone butyrate Not for poison oak OTC lotion (Aquanil HC), OTC solution (Scalpicin) |
| Cream 2.5%: $11.01/30 g | | | As for 1% hydrocortisone | Perhaps better for pruritus ani Not clearly better than 1% More expensive Not OTC |
Alclometasone dipropionate (Aclovate) | Cream 0.05%: $48.08/15 g Ointment 0.05%: $20.00/15 g | Twice daily | Low | As for hydrocortisone | More efficacious than hydrocortisone Perhaps causes less atrophy |
Desonide | Cream 0.05%: $21.60/15 g Ointment 0.05%: $23.21/15 g Lotion 0.05%: $296.10/60 mL | Twice daily | Low | As for hydrocortisone For lesions on face or body folds resistant to hydrocortisone | More efficacious than hydrocortisone Can cause rosacea or atrophy Not fluorinated |
Clocortolone (Cloderm) | Cream 0.1%: $322.47/45 g | Three times daily | Medium | Contact dermatitis Atopic dermatitis | Does not cross-react with other corticosteroids chemically and can be used in patients allergic to other corticosteroids |
Prednicarbate (Dermatop) | Emollient cream 0.1%: $137.10/60 g Ointment 0.1%: $30.00/15 g | Twice daily | Medium | As for triamcinolone | May cause less atrophy No generic formulations Preservative-free |
Triamcinolone acetonide | Cream 0.1%: $3.89/15 g Ointment 0.1%: $5.57/15 g Lotion 0.1%: $90.00/60 mL | Twice daily | Medium | Eczema on extensor areas Used for psoriasis with tar Seborrheic dermatitis and psoriasis on scalp | Caution in body folds, face Economical in 0.5-lb and 1-lb sizes for treatment of large body surfaces Economical as solution for scalp |
| Cream 0.025%: $4.45/15 g Ointment 0.025%: $10.11/80 g | Twice daily | Medium | As for 0.1% strength | Possibly less efficacy and few advantages over 0.1% formulation |
Fluocinolone acetonide | Cream 0.025%: $33.77/15 g Ointment 0.025%: $33.77/15 g | Twice daily | Medium | As for triamcinolone | |
| Solution 0.01%: $180.00/60 mL | Twice daily | Medium | As for triamcinolone | |
Mometasone furoate (Elocon) | Cream 0.1%: $29.16/15 g Ointment 0.1%: $24.30/15 g Lotion 0.1%: $55.45/60 mL | Once daily | Medium | As for triamcinolone | Often used inappropriately on the face or on children Not fluorinated |
Diflorasone diacetate | Cream 0.05%: $209.68/15 g Ointment 0.05%: $209.68/15 g | Twice daily | High | Nummular dermatitis Allergic contact dermatitis Lichen simplex chronicus | |
Fluocinonide (Lidex) | Cream 0.05%: $45.55/15 g Gel 0.05%: $59.56/15 g Ointment 0.05%: $28.53/15 g Solution 0.05%: $97.19/60 mL | Twice daily | High | As for betamethasone Gel useful for poison oak | Economical generics Lidex cream can cause stinging on eczema Lidex emollient cream preferred |
Betamethasone dipropionate (Diprolene) | Cream 0.05%: $41.60/15 g Ointment 0.05%: $50.45/15 g Lotion 0.05%: $45.00/60 mL | Twice daily | Ultra-high | For lesions resistant to high-potency corticosteroids Lichen planus Insect bites | Economical generics available |
Clobetasol propionate (Temovate) | Cream 0.05%: $128.10/15 g Ointment 0.05%: $155.45/15 g Lotion 0.05%: $289.28/60 mL | Twice daily | Ultra-high | As for betamethasone dipropionate | Somewhat more potent than diflorasone Limited to 2 continuous weeks of use Limited to 50 g or less per week Cream may cause stinging; use “emollient cream” formulation Generic available |
Halobetasol propionate (Ultravate) | Cream 0.05%: $79.58/15 g Ointment 0.05%: $79.58/15 g | Twice daily | Ultra-high | As for clobetasol | Same restrictions as clobetasol Cream does not cause stinging Compatible with calcipotriene (Dovonex) |
Desoximetasone | Cream 0.05%: $62.43/15 g Cream 0.25%: $58.28/15 g Gel 0.05%: $298.38/60 g Ointment 0.25%: $18.00/15 g | Twice daily | High | As for triamcinolone | Comparable potency to fluocinonide Suggested for use when allergic contact dermatitis to topical corticosteroid is suspected; ointment useful when allergic contact dermatitis to propylene glycol is suspected |
Flurandrenolide (Cordran) | Tape: $816.46/24” × 3” roll Lotion 0.05%: $360.00/120 mL | Every 12 hours | Ultra-high | Lichen simplex chronicus | Tape version protects the skin and prevents scratching |
Nonsteroidal Anti-inflammatory Agents (Listed Alphabetically) |
Crisaborole (Eucrisa) | Ointment 2%: $782.69/60 g | Twice daily | N/A | Atopic dermatitis | Steroid substitute not causing atrophy or striae May sting or burn on initial application |
Pimecrolimus2 (Elidel) | Cream 1%: $608.71/60 g | Twice daily | N/A | Atopic dermatitis | Steroid substitute not causing atrophy or striae |
Tacrolimus2 (Protopic) | Ointment 0.1%: $520.90/60 g Ointment 0.03%: $520.90/60 g | Twice daily | N/A | Atopic dermatitis | Steroid substitute not causing atrophy or striae Burns in ≥ 40% of patients with eczema |
Antibiotics (for Acne) (Listed Alphabetically) |
Clindamycin phosphate | Solution 1%: $28.94/30 mL Gel 1%: $86.38/30 mL Lotion 1%: $120.18/60 mL Pledget 1%: $50.58/60 | Twice daily | N/A | Mild papular acne | Lotion is less drying than solution, gel, or pledgets for patients with sensitive skin Recommend use with benzoyl peroxide to avoid antibiotic resistance from monotherapy |
Clindamycin/Benzoyl peroxide (BenzaClin) | Gel: $204.18/25 g Gel: $408.35/50 g | Twice daily | N/A | As for benzamycin | No generic More effective than either agent alone |
Dapsone | Gel 5%: $585.50/60 g | Once daily | N/A | Mild papulopustular acne | More expensive, well tolerated Recommend use with benzoyl peroxide to avoid antibiotic resistance from monotherapy |
Erythromycin | Solution 2%: $47.63/60 mL Gel 2%: $60.48/30 g Pledget 2%: $92.65/60 | Twice daily | N/A | As for clindamycin | Many different manufacturers Economical Recommend use with benzoyl peroxide to avoid antibiotic resistance from monotherapy |
Erythromycin/Benzoyl peroxide (Benzamycin) | Gel: $199.08/23.3 g Gel: $75.00/46.6 g | Twice daily | N/A | As for clindamycin Can help treat comedonal acne | No generic More expensive More effective than other topical antibiotics Main jar requires refrigeration |
Antibiotics (for Impetigo) |
Mupirocin (Bactroban) | Ointment 2%: $11.25/22 g Cream 2%: $245.16/15 g | Three times daily | N/A | Impetigo, folliculitis | Because of cost, use limited to tiny areas of impetigo Used in the nose twice daily for 5 days to reduce staphylococcal carriage |
Retapamulin (Altabax) | Ointment 1%: $360.04/15 g | Twice daily | N/A | Impetigo | For Staphylococcus aureus or Streptococcus pyogenes infection Typically reserved for mupirocin-resistant infections |
Antifungals: Imidazoles (Listed Alphabetically) |
Clotrimazole | Cream 1%: $5.29/15 g OTC Solution 1%: $33.68/10 mL | Twice daily | N/A | Dermatophyte and Candida infections | Available OTC Inexpensive generic cream available |
Econazole (Spectazole) | Cream 1%: $30.04/15 g | Once daily | N/A | As for clotrimazole | Somewhat more effective than clotrimazole and miconazole |
Ketoconazole (Nizoral) | Cream 2%: $30.90/15 g | Once daily | N/A | As for clotrimazole | Somewhat more effective than clotrimazole and miconazole |
Miconazole | Cream 2%: $3.30/30 g OTC | Twice daily | N/A | As for clotrimazole | As for clotrimazole |
Oxiconazole (Oxistat) | Cream 1%: $614.73/30 g Lotion 1%: $771.91/30 mL | Twice daily | N/A | As for clotrimazole | |
Sertaconazole (Ertaczo) | Cream 2%: $1079.41/60 g | Twice daily | N/A | Refractory tinea pedis | By prescription More expensive |
Sulconazole (Exelderm) | Cream 1%: $72.38/15 g Solution 1%: $416.66/30 mL | Twice daily | N/A | As for clotrimazole | No generic Somewhat more effective than clotrimazole and miconazole |
Other Antifungals (Listed Alphabetically) |
Butenafine (Mentax) | Cream 1%: $8.01/12 g OTC | Once daily | N/A | Dermatophytes | Fast response; high cure rate; expensive Available OTC |
Ciclopirox (Loprox) (Penlac) | Cream 0.77%: $51.10/30 g Lotion 0.77%: $80.75/30 g Solution 8%: $52.95/6.6 mL | Twice daily | N/A | As for clotrimazole | No generic Somewhat more effective than clotrimazole and miconazole |
Efinaconazole (Jublia) | Solution 10%: $728.63/4 mL | Once daily for 48 weeks | N/A | Onychomycosis | No generic; more effective than ciclopirox for nail disease |
Naftifine (Naftin) | Cream 1%: $375.38/60 g Gel 1%: $472.63/60 mL | Once daily | N/A | Dermatophytes | No generic Somewhat more effective than clotrimazole and miconazole |
Tavaborole (Kerydin) | Solution 5%: $725.21/4 mL | Once daily for 48 weeks | N/A | Onychomycosis | No generic available |
Terbinafine (Lamisil) | Cream 1%: $8.72/12 g OTC | Once daily | N/A | Dermatophytes | Fast clinical response OTC |
Antipruritics (Listed Alphabetically) |
Camphor/menthol (Sarna) | Lotion 0.5%/0.5%: $8.28/222 mL | Two to three times daily | N/A | Mild eczema, xerosis, mild contact dermatitis | |
Capsaicin (various) | Cream 0.025–0.1% Cream 0.025%: $9.95/60 g Cream 0.075%: $10.39/56 g | Three to four times daily | N/A | Topical antipruritic, best used for neuropathic itching | Burning/stinging with initial application that subsides with consistent ongoing use |
Doxepin (Zonalon) | Cream 5%: $722.32/45 g | Four times daily | N/A | Topical antipruritic, best used in combination with appropriate topical corticosteroid to enhance efficacy | Can cause sedation |
Pramoxine hydrochloride (Prax) | Lotion 1%: $17.86/120 mL OTC | Four times daily | N/A | Dry skin, varicella, mild eczema, pruritus ani | OTC formulations (Prax, Aveeno Anti-Itch Cream or Lotion; Itch-X Gel) By prescription mixed with 1% or 2% hydrocortisone |
Emollients (Listed Alphabetically) |
Aqua Glycolic | Cream, lotion, shampoo, others: $17.94/177 mL | Once to three times daily | N/A | Xerosis, ichthyosis, keratosis pilaris Mild facial wrinkles Mild acne or seborrheic dermatitis | Contains 8% glycolic acid Available from other makers, eg, Alpha Hydrox, or generic 8% glycolic acid lotion May cause stinging on eczematous skin |
Aquaphor | Ointment: $5.82/50 g | Once to three times daily | N/A | Xerosis, eczema For protection of area in pruritus ani | Not as greasy as petrolatum |
Aveeno | Cream, lotion, cleanser, others: $7.18/354 mL | Once to three times daily | N/A | Xerosis, eczema | Many formulations made Some facial and body moisturizers contain sunscreen |
CeraVe | Cream, lotion, cleanser, others: $13.29/453 g | Once to three times daily | N/A | Xerosis, eczema | Many formulations made CeraVe SA formulation contains salicylic acid, ammonium lactate as keratolytics Some facial and body moisturizers contain sunscreen |
Cetaphil | $10.50/480 mL | Once to three times daily | N/A | Xerosis, eczema | Many formulations made Some facial and body moisturizers contain sunscreen |
DML | Cream, lotion, facial moisturizer: $5.95/240 mL | Once to three times daily | N/A | As for Complex 15 | Face cream has sunscreen |
Eucerin | Cream: $13.99/454 g | Once to three times daily | N/A | Xerosis, eczema | Many formulations made Eucerin Plus contains alpha hydroxy acid and may cause stinging on eczematous skin Facial moisturizer has SPF 25 sunscreen |
Lac-Hydrin-12 Lac-Hydrin-5 | Lotion: $13.25/226 g OTC | Twice daily | N/A | Xerosis, ichthyosis, keratosis pilaris | Contains ammonium lactate Most effective strength is 12% May sting on eczematous skin |
Lubriderm | Lotion: $6.13/473 mL | Once to three times daily | N/A | Xerosis, eczema | Unscented usually preferred |
Neutrogena | Cream, lotion, facial moisturizer: $8.05/240 mL | Once to three times daily | N/A | Xerosis, eczema | Face cream has titanium-based sunscreen |
Petrolatum (plain) | Lotion, cream, cleanser, others: $12.99/453 g | Once to three times daily | N/A | Xerosis, eczema | Many formulations available Branded as hypoallergenic |
U-Lactin | Lotion: $22.99/480 mL OTC | Once daily | N/A | Hyperkeratotic heels | Contains urea and lactate. Moisturizes and removes keratin May sting on eczematous skin |
Urea (various) | Cream 20%: $20.73/120 g Lotion 10%: $15.57/240 mL | Twice daily | N/A | Xerosis | Contains urea as humectant Nongreasy hydrating agent (10%); debrides keratin (20%, 40%) |