What is the mechanism of drug action
The ointment has 3 main effects. It promotes tissue healing, affects metabolism and relieves inflammation. After contact with the wound area, the active substance interacts with the main proteins, for example, albumin. The active substance is involved in processes such as carbohydrate and lipid metabolism, the formation of hormones, mediators and porphyrins. "Dexpanthenol" has a regenerative effect not only on tissues, but also on mucous membranes. The drug also helps stabilize cellular metabolism and accelerate cell mitosis. Elimination is very fast.
The use of dexpanthenol ointment in the treatment of diaper dermatitis in newborns
To this day, the problem of treating diaper dermatitis (ND) remains relevant. Its manifestations are observed in almost every infant [2, 5, 7], which determines the need to improve methods of its treatment. When exposed to unfavorable factors (mechanical, chemical, infectious), rapid damage to the skin occurs with the development of inflammatory reactions of varying severity. It is known that the protective function of the skin of a newborn, especially a premature and immature child, is insufficient. This is primarily explained by its anatomical and physiological characteristics (thin surface layer - epidermis, rich vascularization, tendency to proliferative reactions), which determines its easy vulnerability. In addition, the insufficiency of local immunity is important. A feature of the structure of the skin is the absence of elastic fibers, which are formed only by the 2nd year of life. Protection from mechanical damage in a newborn is to some extent provided by the large amount of moisture contained in the stratum corneum of the skin. It has been established that increased moisture in the child’s skin and fecal enzymes, mainly protease and lipase, cause the development of PD, that is, changes in the skin in the area of contact with the diaper. According to modern views, PD is a periodically occurring pathological condition provoked by exposure of the child’s skin to mechanical (diaper fabric), physical (humidity and temperature), chemical (ammonia, digestive enzymes, bile salts) and microbial factors acting inside the diaper or diaper [3]. The influence of these unfavorable factors makes the skin of children easily vulnerable and prone to inflammation [1, 6].
PD is manifested by redness, infiltration of the skin, the appearance of rashes, peeling, erosions, which is accompanied by anxiety in the child and adversely affects his general condition. The disease is more common in children with an allergic mood, which is explained by their predisposition to exudative changes and dyspeptic symptoms. Children who are breastfed are less susceptible to this disease because their feces have lower enzymatic activity. For local treatment of PD, various creams and ointments based on zinc and talc are used, which, due to their adhesive properties, protect the skin from constant exposure to urine and feces [8]. Until recent years, pediatricians did not have an equally effective and safe remedy for the treatment of skin diseases, acting locally and at the same time enhancing regeneration processes at the cellular level.
Dexpanthenol ointment (Bepanten) is a product for external use that stimulates epithelization of the skin and has an anti-inflammatory effect. The active principle of the ointment is provitamin D-pantothenic acid, which is a component of the vitamin A coenzyme, which promotes the growth of the epidermis [4]. An increase in the need for this acid is noted with damage to the skin and tissues. D-pantothenic acid stimulates the function of the adrenal glands, it is necessary for the formation of antibodies, promotes the growth and regeneration of the skin. An increased need for pantothenic acid is observed in the body during destruction or damage to tissues and skin. Its deficiency can be compensated for by local application of dexpanthenol ointment. The properties of newborn skin make it especially important for the drug to penetrate it slowly and deeply due to its hydrophilicity, low molecular weight and low polarity. Purpose of the study: to evaluate the effectiveness of the use of dexpanthenol ointment (Bepanten) in the treatment of PD in newborns. The study was conducted in the department of pathology of newborns and premature babies (department of the second stage of nursing) of the clinic of childhood diseases of the State Budgetary Educational Institution of Higher Professional Education “First Moscow State Medical University named after I.M. Sechenov." There were 48 children under our supervision - 25 boys, 23 girls. The majority of children (78%) were born full-term. The main diagnosis in all patients was perinatal CNS damage. All children showed manifestations of PD.
When analyzing the health status of the parents, it was revealed that 40% of the examined children had a family history of allergies, and in more than half of these children both parents suffered from allergic diseases. In the course of ongoing research, the dependence of the incidence of PD on the type of feeding was established. PD occurred 5 times more often in children who were bottle-fed compared to children who received breast milk. In 93% of newborns, PD occurred against the background of pathological stool (liquefaction, undigested lumps, mucus, green color), which was regarded as a manifestation of intestinal dysbiosis. In the coprograms of most children, an increase in the content of neutral fat and soap was noted. A bacteriological examination of stool revealed no pathogenic microorganisms or fungi. The severity of skin changes was assessed according to the traditional classification (F. Germozo, 1984). In 16 (53%) of the examined patients, PD of moderate severity was diagnosed, which was manifested by the development of erythema, papules, erosions, infiltrates in the skin folds, dryness, and peeling of the skin. 14 (47%) children had a mild degree of PD in the form of erythema of varying prevalence. In 100% of cases, PD developed in the buttocks; in addition, 7% of children also had skin lesions on the genitals and 10% on the thighs (Fig. 1–3). In children with allergic manifestations, PD had a recurrent course.
At the first manifestations of PD, Bepanten ointment was prescribed. The ointment was applied daily in a thin layer to the affected skin of the child during swaddling 4–5 times per day. In most patients, improvement was noted on the 2nd day. Treatment with Bepanten continued until the skin changes completely disappeared. In the group of children with mild severity of the disease, the average duration of treatment was 4.2±0.7 days, in the group of children with moderate severity of PD - 4.7±0.6 days. There was no significant difference in the duration of treatment for moderate and mild forms of PD (p>0.05). A positive effect - recovery - was noted in 100% of cases (other topical medications were not used). There were no side effects when using dexpanthenol ointment; the children tolerated the drug well. The clinical effect was best when, after the acute period, the use of the ointment continued for another 2–3 days. This was especially true for children with a history of allergies.
It should be noted that in caring for patients with the development of PD, only modern disposable diapers were used, containing moisture-absorbing gel-forming materials in the inner layer, which reduced the squeezing of moisture from the diaper onto the skin (while the pH level of the skin approached normal), and prevented skin contact with secretions ( feces and urine), which led to a decrease in the exposure of the skin to ammonia, which is released when feces interact with urine and irritates the baby’s delicate skin, and also reduced the irritating effect of fecal enzymes on the skin.
Modern diapers provide close to normal skin moisture and pH levels, therefore, their use reduces the spread and severity of PD. Cosmetics for cleansing the skin (soap, bathing foam, wet wipes) were selected individually for each child. The main criterion was their good tolerability. Thus, studies have shown that dexpanthenol ointment (Bepanten) is an effective and safe treatment for PD in newborns. It should be noted that there are no side effects and the drug is well tolerated.
When to use
"Dexpanthenol" is most often used to accelerate healing for minor microtraumas. Can be used on mucous membranes in the presence of erosions. The drug helps fight dry and cracked skin and is indicated for burns and minor abrasions. Sometimes the ointment is prescribed to patients with bullous dermatitis, suppuration and trophic ulcers. It is allowed to be used for the treatment and prevention of bedsores in bedridden patients. The ointment is applied to aseptic wounds for transplantations that do not take root well after operations, but constant monitoring by the attending physician is required.
Panthenol or D - Panthenol - which is better?
We will also find out what is the difference between the drugs Panthenol, D-Panthenol and Bepanten. Let's get acquainted with the methods of using the product in cases of pregnancy, breastfeeding and for infants.
What is PANTHENOL?
Panthenic acid (or vitamin B5) is formed due to the action of biochemical oxidation processes in the hairy parts of the body and on the skin.
Panthenol is a provitamin B5, and it is divided into two types, namely D-Panthenol and L-Panthenol.
Only D-Panthenol is used for medicinal and cosmetic purposes due to its unique biological activity.
D-Panthenol promotes the beginning of the natural process of tissue repair and trophism; the drug is a pharmaceutical agent.
Its main active ingredient is dexpanthenol, which has a positive effect on the epithelial cells of the epidermis, thereby restoring their structure. In addition, it has anti-edematous and antipruritic effects.
The drug D-Panthenol has the following positive properties:
• has a pronounced anti-inflammatory effect; • relieves irritation from the surface of the epidermis; • heals wounds; • relieves skin from peeling, restoring it and moisturizing it; • after sunburn, regenerates the skin; • used for chafing and redness.
Cosmetologists use D-Panthenol as a cream after depilation procedures in the bikini area and armpits.
D-Panthenol is presented in the form:
• 5% cream for external use, 25 and 50 g. • 5% ointment for external use, dosage 25, 35, 50 and 100 g.
Panthenol is presented in the form:
• Aerosols Panthenol; • 5% ointment for external use; • Cream foams for external use; • Body milk; • Sprays with different levels of protection from UV rays for safe tanning; • Balm for restoring skin after sunburn.
We also list ointments for children's skin based on Panthenol:
• Spray for protection against ultraviolet radiation; • 3% children's universal cream Panthenol; • Baby body milk after sunbathing Panthenol + Sea buckthorn.
Panthenol restores damaged skin.
Cream D-Panthenol:
If we talk specifically about D-Panthenol cream, it helps to increase the skin's resistance to various negative factors, and also accelerates the process of synthesis of elastin and collagen.
The product promotes the healing of thermal burns by actively stimulating skin regeneration.
D-Panthenol ointment - at the site of damage to the skin, replenishes the lack of pantothenic acid. It is also involved in the synthesis of the breakdown of steroid hormones and fatty acids.
The hydrophilicity of D-Panthenol allows the ointment to penetrate the lower layers of the epidermis, softening it and improving tissue trophism. It is quickly absorbed from the surface of the skin, and then binds to blood beta globulins and albumins.
Indications for use and contraindications:
Due to its properties, D-Panthenol cream is actively used in various fields of medicine: cosmetology, surgery and pediatrics.
• in case of violations of the integrity of the skin: cracks, burns, scratches. • for bedsores and extensive skin damage; • for trophic ulcers; • for cracks and inflammation of the nipples in nursing mothers; • for sunburn; • for postoperative aseptic wounds; • for anal intercourse; • with non-healing skin grafts; • for the prevention and treatment of diaper rash in children; • for cosmetic defects: for the treatment of acne, boils, acne; • for diaper dermatitis in babies.
For prevention purposes, Panthenol is used to moisturize the skin and eliminate dryness.
The drug is absorbed from the surface of the skin instantly, leaving no greasy marks on the skin, and the therapeutic effect will be noticeable immediately.
There are also restrictions on the use of the drug in cases where there is hypersensitivity to one of the constituent components. Or in cases of severe renal failure and in the presence of weeping wounds.
Use during pregnancy:
Both Panthenol and D-Panthenol are also used by pregnant women, since the components included in the products do not penetrate the placental barrier and are not able to have any effect on the developing fetus.
Women confirmed the effectiveness of D-Panthenol ointment and cream, which they used during pregnancy and while caring for a newborn baby.
How to use?
Use of the ointment is recommended up to 4 times a day. The product is applied in a thin layer to intact skin areas and gently rubbed in.
Please note:
Before applying the ointment to wounds and abrasions, the skin area must be treated with any antiseptic solution, it can be chlorhexidine or miramistin, but not hydrogen peroxide. There is no need to wash off the ointment with water.
• In cases of diaper rash and diaper dermatitis in children, the ointment is applied after hygiene procedures using water and soap. In this case, the use of wet wipes is unacceptable. D-Panthenol is applied to reddened and inflamed areas of the child’s body 4-5 times a day.
• When breastfeeding, cracked and bleeding nipples should also be treated with D-Panthenol. The ointment should be rubbed in a circular motion until completely absorbed after each feeding and pumping of the breast.
• If you receive burns, the use of ointment is possible from the very first minutes. The product is applied to the burn surface in a thin layer, with smooth rubbing movements, while the fingers should “barely touch” the skin.
What is the difference between Panthenol and D-Panthenol?
There is no significant difference between these drugs. They are identical in their composition and spectrum of action, so they are interchangeable. The difference between the drugs lies only in the manufacturer of the drug substance, which sets its own price for the drug.
What analogues of D-Panthenol exist?
D-Panthenol ointment can be replaced with the following means:
Dexpanthenol ointment is a medicine made from pantothenic acid. The drug has regenerating and anti-inflammatory properties;
Pantoderm ointment is an analogue of Panthenol, also used for scratches, burns, cuts and wounds;
Bepanten cream significantly accelerates the launch of regeneration processes in damaged skin areas.
Bepanten is recommended for use in caring for the delicate skin of infants - it eliminates diaper rash and relieves redness.
The product is used to treat deep abrasions and microtraumas.
Things to note:
D-Panthenol is actively used by expectant mothers during pregnancy and lactation. Panthenol is considered a representative of the class of vitamins; the product is not hormonal. It can also be used in caring for a baby from the first day of his life.
It should be noted that D-Panthenol does not protect the skin from exposure to sunlight, but it does a good job of restoring the epidermis after UV radiation burns. There were no allergic reactions to the use of the product.
In the “Solnechnoe Zdorovye” pharmacy chain you can always buy the drugs mentioned in the article at the best price in the city.
A wide range of medicines and beauty products are always close to you.
How to use for pregnant women and children
Use in children is no different from adults.
The ointment is approved for use by pregnant and lactating women. For treatment in the breast area around the areola in women during breastfeeding, Dexpanthenol is recommended in the form of compresses. Before starting feeding, it is necessary to remove the remaining ointment with running water, without using soap, which can dry out the treated area.
"Dexpanthenol" is also necessary for restoring the skin from diaper rash in newborns.
Dexpanthenol
Tissue regeneration stimulator dexpanthenol is a derivative of pantothenic acid, known as vitamin B5. The drug is available in the form of an ointment for external use and is used in the treatment of skin injuries of various origins: wounds, burns, abscesses, dermatitis, etc. It is used in the care of newborns and infants, in the treatment and prevention of inflammation of the nipples during breastfeeding. The drug takes an active part in the processes of oxidation and acetylation, plays an important role in the metabolism of carbohydrates and fats, and participates in the synthesis of corticosteroids, acetylcholine, and porphyrins. Has an accentuated effect on the formation of epithelial tissue. Endowed with moderate anti-inflammatory activity. Dexpanthenol is an almost ideal drug for caring for the mammary gland during lactation. Clinical studies have shown that a seven-day course of treatment with dexpanthenol is enough to reduce pain in the nipples by 35 (!) times, and the effectiveness of pharmacotherapy using this drug is close to 100%. When using dexpanthenol ointment by nursing mothers, a thin layer of it was applied to the surface of the nipple and adjacent skin at the end of each act of feeding. Pediatrics is another wide area of application of this drug. We are talking here, first of all, about the heat rash of newborns, which appears due to clogging of the sweat glands with sebum. The traditional localization of miliaria is the face and upper torso. It looks like rashes with cheesy or watery contents. This disease is successfully treated with dexpanthenol, regularly applied to the affected areas of the skin. The drug quite easily copes with chapping of the skin, which occurs due to exposure of the baby’s skin to adverse weather factors (low temperatures, strong wind, etc.) and manifests itself in the form of redness and dryness of the unprotected skin of the face and hands. A very common problem for young mothers is diaper dermatitis in their babies, which is an acute irritation of the skin in areas of contact with diapers or diapers.
Most often, diaper dermatitis develops in girls, and in general its prevalence in newborns and infants reaches 50%. In children who are breastfed, diaper dermatitis is less common, because their feces have low enzymatic activity. To avoid the occurrence of this disease, it is recommended to use various protective agents at each diaper change, a striking example of which is dexpanthenol. The vitamin component of the drug accelerates the healing of dermatological microtraumas, while providing (which is a kind of “trick” of vitamin B5, since it is not an antibiotic) a bactericidal effect. Clinically significant negative side effects with the use of dexpanthenol have not yet been recorded in medical practice. One of the studies on the effectiveness of the use of dexpanthenol in children suffering from atopic dermatitis was conducted at the allergy department of the Federal State Budgetary Institution Research Institute of Nutrition of the Russian Academy of Medical Sciences. As a result of the use of dexpanthenol, a significant improvement in the condition of the skin of children was noted: hyperemia decreased, dry skin decreased, and skin itching disappeared. Elimination of signs of atopic dermatitis was observed in 84% of cases. Thus, the use of this drug contributed to the achievement of an accentuated clinical effect, which made it possible to provide proper skin care and control the course of the disease, protect the skin from adverse environmental factors and improve the child’s quality of life.
The dosage regimen for dexpanthenol is as follows: the ointment is applied to the affected areas of the skin once a day; in the area of the nipple and areola it is applied in the form of a compress. When treating lesions of the uterine mucosa, the ointment can be applied several times a day.
Cream "Dexpan Plus" for dry skin care
Peeling, irritation and redness are not all that a person may experience with dry skin.
Much more unpleasant are itching, scratching and cracks - manifestations of xeroderma (the scientific name for dry skin), which increase the risk of contracting a bacterial or fungal infection. In addition, dry skin ages quickly and reacts sharply to sunlight, wind and low air temperatures.
Products used to care for dry skin should help soften, restore and moisturize the skin, protect, and in case of cracks, help restore the barrier function of the skin. To care for your skin during the day, it is preferable to use water-based creams that are quickly absorbed and leave no residue. It is better to apply fatty creams and ointments in a thick layer before bedtime.
Products containing lactic, malic, salicylic acid, resorcinol, urea or allantoin have keratolytic (exfoliating) properties. They soften and painlessly remove dead scales from the skin. In addition, allantoin, a natural compound found in the roots of the plant Symphytum officicale (Comfrey), has a softening and moisturizing effect, stimulates the regeneration and renewal of epidermal cells, eliminates flaking of the skin, making it smooth and elastic.
Moisturizing components create a hydrophobic film on the surface of the skin that prevents moisture evaporation. These include vegetable and animal fats, which also contain vitamins. The most popular components of moisturizing creams are olive, sunflower, flaxseed, sea buckthorn oil, jojoba, argan and avocado oils, and Shea butter.
Humidification creates the necessary conditions for nutrition and regeneration: cells saturated with water, unlike dry and damaged ones, are able to normally perform their functions, including carrying nutrients, oxygen and building new elements. Special nourishing creams contain complexes of vitamins A, B, C, PP, E and others. In addition, for example, provitamin B5 (panthenol) promotes the healing of small wounds, maintains water balance and skin resistance to external environmental influences, and stimulates skin regeneration.
It is not always possible to find a skin care product that contains the full range of properties important for dry and damaged skin.
Cream "Dexpan Plus" - contains a combination of dexpanthenol, allantoin, as well as emollients including shea butter (shea butter), designed to care for dry and damaged skin from the first days of life.
The cream contains components that restore, soften and moisturize the skin. It does not contain aromatic substances or dyes and is hypoallergenic. The cream is quickly absorbed, suitable for delicate areas with sensitive thin skin, does not leave greasy stains, has no odor, which indicates good organoleptic properties and its high compliance.
Cream "Dexpan plus" from Dr. Reddy's was developed by dermatologists specifically for dry and dehydrated skin.
Thanks to the combination with Dexpanthenol, Allantoin and Shea butter, the cream helps restore the skin's protective barrier, softening and moisturizing, eliminating the feeling of dryness and tightness.
Dexnanthenol enhances the skin's ability to retain moisture and soothes particularly dry areas of the skin, Allantoin activates microcirculation of moisture in skin cells. Shea butter has a softening and moisturizing effect, which makes it indispensable for caring for dry and irritated skin.
It should be noted that the cream is well absorbed and does not leave a greasy film on the skin. The formula with panthenol strengthens the skin's protective barrier, preventing moisture loss and soothing irritated areas of the skin.
Prepared based on
1. Sirmais N.S., Tsykin A.A., Kuznetsova Yu.K. Skin xerosis. Solving the problem with external means. RMJ. 2015;9:496
2. Belousova T.A., Kail-Goryachkina M.V. A personalized approach to the selection of basic therapy for dry skin. Con med. 2017;(2):38-42
3. Leaflet cream “Dexpan plus”
Related product: [product](DEXPAN PLUS CREAM 30.0)
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