Triderm cream in the complex treatment of pustular psoriasis

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How to use Triderm for acne on the face

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Do not use Triderm ointment on your face for acne unless its use has been prescribed by your healthcare professional.

Wash and dry your hands Before using the medication, clean and dry the affected area of ​​your face Apply a thin film of the medication to the affected area and rub it gently on your face in a circular motion Typically, apply this product 2 to 4 times a day or as directed by your doctor Do not cover or bandage or do not wrap the area where the ointment was applied.

After using the medication, wash your hands unless you are using this medication to treat your hands. When using this medication near your eyes, avoid getting it in your eyes because it may impair your vision or cause glaucoma. Also avoid using this medication on pimples near the nose or nose areas. mouth If the medicine gets into your eyes, nose, or mouth, rinse with plenty of water.

Use this medication only for the condition prescribed. Do not use it for longer than directed or directed by your doctor.

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Pharmacodynamics

Combined preparation for external use.

Triderm® ointment and cream combine the anti-inflammatory, antipruritic, antiallergic and antiexudative effect of the GCS betamethasone dipropionate with the antifungal activity of clotrimazole and the broad antibacterial effect of gentamicin sulfate.

Clotrimazole has an antifungal effect by disrupting the synthesis of ergosterol, which is an integral part of the cell membrane of fungi. Active against Trichophyton rubrum, Trichophyton mentagrophytes, Epidermophyton floccosum, Microsporum canis, Candida albicans, Malassezia furfur (Pityrosporum orbiculare).

Gentamicin sulfate, a broad-spectrum antibiotic from the aminoglycoside group, is bactericidal and provides highly effective local treatment of primary and secondary bacterial skin infections. Active against gram-negative microorganisms: Pseudomonas aeruginosa, Enterobacter aerogenes, Escherichia coli, Proteus vulgaris, Klebsiella pneumoniae; gram-positive microorganisms: Staphylococcus aureus (coagulase-positive, coagulase-negative and some strains producing penicillinase).

What effect does Triderm ointment have?

The instructions for Triderm ointment indicate that the drug belongs to the group of anti-inflammatory, antifungal and antibacterial agents.

The therapeutic effect of the drug is due to the properties of its constituent components:

• clotrimazole – has antifungal activity, promotes the destruction of cells of pathogenic dermatophytes, yeast and mold fungi;
• gentamicin is a broad-spectrum antibiotic that is harmful to gram-positive and gram-negative bacteria (staphylococci, Klebsiella, Escherichia coli, Proteus);
• betamethasone is a glucocorticosteroid that has antiallergic and anti-inflammatory effects, relieves itching and swelling at the site of injury.

Indications for Triderm®

Dermatoses complicated by infections caused by pathogens sensitive to the drug, or when such infections are suspected, including:

simple and allergic dermatitis;

atopic dermatitis (including diffuse neurodermatitis);

limited neurodermatitis;

eczema;

dermatomycosis (dermatophytosis, candidiasis, lichen versicolor), especially when localized in the groin area and large folds of the skin;

simple chronic lichen (limited neurodermatitis).

Triderm - the gold standard for the treatment of skin diseases

Author:

Reznik Irina

6 minutes

14215

Almost every family today has an allergy sufferer: according to the World Allergy Organization (WAO), the increase in the prevalence of allergic diseases is so serious that it should be recognized as a global public health problem. Atopic dermatitis alone among children in economically developed countries occurs in 10-28%. In Russia, the official incidence rate of atopic dermatitis is two to three times lower.

However, experts believe that the real incidence in our country is much higher. Due to the lack of specialists, low availability of diagnostics and their own carelessness, a huge number of Russians have been self-medicating for many years. Meanwhile, skin allergies have a variety of manifestations - from painful, but relatively harmless urticaria to life-threatening conditions. For example, with the most dangerous form of toxicermia - Lyell's syndrome, which occurs mainly as a reaction to medications - extensive toxic necrosis of the skin develops, which in 40% leads to the death of the patient

The most common are dermatitis, neurodermatitis and eczema of an allergic nature. The inflammatory immune skin reaction to the usual external environment is protracted, accompanied by redness, rashes and itching, which cause not only physical but also psychological discomfort. Initially, the rashes are concentrated in places of direct contact with the allergen. But since the disease affects the entire body as a whole, secondary foci of damage can be localized in any other place.

Irritants and allergens

There are a great many factors that can provoke allergic dermatitis, and they are widespread everywhere. This can be food, household dust and pollen, cosmetics and household chemicals, chlorinated water, and various medications. And at the same time, allergic reactions are dose independent. For example, even a small amount of peanut butter can cause anaphylactic shock. And, by the way, in American films you can often hear people talking about peanuts in this context. In our country, thank God, this is not relevant, we do not eat peanut butter in such quantities. Russian experts most of all dislike honey and bee products.

The general mechanism of allergic inflammation is as follows: an allergen entering the body of a sensitive (or, in medical terms, “sensitized”) person binds to immunoglobulin E (immunoglobulins are a special type of antibodies). And this compound affects certain cells that release highly active substances into the surrounding tissues, causing this unpleasant condition. Stress, diseases of the endocrine system and gastrointestinal tract can contribute to the development of neuroallergic dermatitis.

Diagnostics

For specific diagnostics to determine what exactly an allergy is developing to, there are two main examination methods. The first and most common method is skin testing, which involves direct contact with the allergen. A drop of allergen concentrate is applied to the patient's skin and either a puncture of the skin with a special needle or a microscopic incision is made. In addition to allergens, drops of special substances are used to control the reaction. The specialist then assesses the size of redness and swelling at the site where the allergen drop is applied.

However, skin testing is not advisable in the presence of clinical symptoms of allergy. In this situation, the second method is preferable - a more complex modern test for determining specific antibodies to certain antigens in the blood or molecular diagnostics. During an exacerbation, laboratory changes can be seen: for example, an increase in the level of total immunoglobulin E (IgE), an increase in the values ​​of allergen-specific immunoglobulin E (that is, IgE antibodies to a specific allergen), an increase in the number of a certain subtype of leukocytes (eosinophils) in a general blood test . Some patients experience activity in a marker such as eosinophilic cationic protein, which may indicate that the body is struggling with allergies.

Treatment

The best treatment is to remove the allergen. But this is not always possible; almost everything that surrounds us can become an irritant. Therefore, it is possible to cope with allergic dermatitis only using complex treatment, including diet, general (taking antihistamines and anti-inflammatory drugs of systemic action) and local therapy. Moreover, drug therapy. Dermatitis, as a manifestation of an allergic reaction, is not just skin irritation, and this problem cannot be solved with the help of cosmetic preparations, even special ones.

Depending on the effect local products have on the skin, they are divided into several categories:

• drying agents (zinc ointment, Desitin cream),
• antipruritic ointments with antihistamine components (for example, Fenistil),
• Ointments that improve trophism and tissue regeneration (D-Panthenol, Bepanten),
• hormonal - these include all glucocorticosteroid drugs (for example, Advantan) and ointments that contain dexamethasone.

It is hormonal drugs that can form the basis of drug therapy associated with the suppression of a special inflammatory reaction that develops during allergies. Combined products combine the qualities of hormonal, antimicrobial and antihistamine or other drugs.

In case of complications associated with infection of the affected areas of the skin (this can happen when dirt gets into the affected area, when scratching), topical antibiotics may be required. Unfortunately, dermatitis is almost always complicated by the addition of a secondary infection (bacterial or fungal), when just hormones may not be enough and complex help is needed (Celestoderm, Triderm).

According to experts, today Triderm is the gold standard of treatment among three-component drugs.

It contains the hormone betamethasone, the antibiotic gentamicin, which acts on many bacteria, including staphylococci and streptococci, and the antifungal drug clotrimazole. Thanks to its triple mechanism of action - anti-inflammatory, antifungal and antibacterial, Triderm is used in the treatment of inflammation associated with dermatosis or dermatitis complicated by a secondary infection (for example, eczema, pityriasis versicolor or versicolor, candidiasis, dermatomycosis).

At the onset of the disease, with acute inflammation, which may be accompanied by swelling, weeping, the appearance of blisters, redness and severe itching, Triderm cream is more suitable. It is also more suitable for oily or baby skin. If the disease becomes chronic, requiring deeper penetration of the drug, ointment is used. Of course, Triderm is also not a panacea; the drug has clear indications for use. In addition, such potent drugs cannot be used randomly when any pimple or “unexplained” rash appears. They are also not suitable “for prevention”. A specialist should prescribe them and determine the duration of treatment.

Nutrition for allergic dermatitis

Treatment of any allergic disease is impossible without following a diet. Dietary restrictions are introduced to exclude allergenic substances and to reduce the food load on the digestive organs. The method of preparing food is also of great importance - during illness you should avoid smoked, fried and pickled foods. You can keep a food diary to identify the allergen that is causing your skin reaction. To do this, carefully note everything eaten during the day and monitor the body’s reaction to these foods.

The basis of the diet for allergy sufferers is porridge, which does not irritate the gastrointestinal tract and is quickly digested, fermented milk products, fresh vegetables and fruits, butter and vegetable oil, and boiled beef. Salt should be limited as much as possible. It is also not recommended to consume alcohol, citrus fruits, eggs, nuts, milk, chocolate, coffee, honey, mushrooms, strawberries, melons and watermelons, fish, poultry, mayonnaise, mustard and other seasonings, spices and sauces.

Treatment with folk remedies

A distinctive feature of the Russian mentality is the sacred belief in traditional medicine. This is something that specialists who are trying to exclude all herbal remedies from the list of medications are not at all happy about. There is even a joke among them: “no herbs, only chemistry and supersynthetics.” However, there are some exceptions. Thus, in combination with taking medications, it is allowed to use cucumber or apple juice to moisturize the skin and reduce itching. Decoctions of oak bark and string are a good antiseptic. Aloe juice combats skin rashes well, and various vegetable oils (linseed, corn, olive) promote skin healing.

Prevention

There are many ways, if not to protect yourself from allergies, then at least to reduce their manifestations. For example, such non-standard ones as the constant presence of a dog in the house. There are studies that explain why children who have been in contact with pet dogs since birth are much less likely to suffer from various types of allergic diseases.

As for classical non-drug prevention, the patient’s lifestyle is also very important here. And the first rule is to eliminate or minimize contact with “your” allergen. Clothing, bedding, and hygiene products should be as natural as possible, hypoallergenic and not have a strong odor. You should remove all potential dust collectors from the apartment (carpets, large plush toys, fabric curtains), regularly do wet cleaning and open the window. It is also recommended to pay attention to the material of jewelry that comes into contact with the skin and use oxidation-resistant metals (titanium, platinum, gold, silver), avoiding cheap alloys, especially those containing nickel.

ATTENTION! THERE ARE CONTRAINDICATIONS TO APPLICATION AND USE, YOU MUST READ THE INSTRUCTIONS FOR USE OR OBTAIN PROFESSIONAL ADVICE.

Side effects

Very rarely, when using the drug Triderm®, the following are observed: burning sensation, erythema, exudation, pigmentation disorders and itching.

Caused by local corticosteroids (especially when using occlusive dressings): burning sensation, itching, dry skin, folliculitis, hypertrichosis, acne, hypopigmentation, perioral dermatitis, allergic contact dermatitis, skin maceration, development of secondary infection, skin atrophy, stretch marks, prickly heat.

Caused by clotrimazole: erythema, tingling sensation, blistering, peeling, local swelling, itching, urticaria, skin irritation.

Caused by gentamicin: transient skin irritation (erythema, itching), usually not requiring discontinuation of treatment.

Contraindications for the use of ointment, possible side effects

Triderm ointment is not used in case of individual intolerance or hypersensitivity to any of the substances in the composition.

Also, the medication is not used:

• skin lesions due to tuberculosis;
• with syphilis;
• chickenpox;
• skin reactions to vaccine administration;
• herpetic rashes;
• chicken pox;
• open wounds;
• in the treatment of children under two years of age.

The ointment can be used with caution during pregnancy, in pediatrics, when using bandages, for long courses and on large areas of the skin.

Adverse reactions occur rarely. These are mainly local unpleasant sensations - burning, itching, severe redness, wetting of the skin at the site of application.

The manufacturer also points out the possibility of side effects that have been recorded when using glucocorticosteroids:

• stretch marks;
• prickly heat;
• feeling of dryness;
• increased hair growth;
• acne;
• secondary infection;
• swelling or atrophy of the skin.

Due to the action of clotrimazole, the following may occur: tingling, blisters, swelling at the site of application, peeling and itching, redness, and urticaria-type rashes.

Overdose

Symptoms: with long-term use of local corticosteroids in high doses, suppression of adrenal function with the development of secondary adrenal insufficiency and symptoms of hypercortisolism, including Cushing's syndrome, is possible. An overdose of clotrimazole when applied topically does not lead to the appearance of any symptoms. With a single overdose of gentamicin, the appearance of any symptoms is also not expected. Long-term treatment with gentamicin in high doses can lead to the growth of insensitive flora.

Treatment: symptomatic. Acute symptoms of hypercortisolism are usually reversible. If necessary, electrolyte imbalance is corrected. In case of chronic GCS toxicity, gradual withdrawal of GCS is recommended.

Additional recommendations

The ointment is not used for infectious diseases of the organs of vision. With long-term use of a local antibiotic, pathogenic microorganisms may develop resistance to it.

Do not apply the product to open wound surfaces or severely damaged skin. The use of dressings and application of the product to large areas of skin contribute to higher absorption of gentamicin and glucocorticosteroids, resulting in an increased risk of adverse reactions.

If use has been long-term, then it should be discontinued gradually.

special instructions

Cannot be used in ophthalmic practice.

Prolonged topical use of antibiotics can sometimes lead to the growth of resistant microflora. In this case, as well as if irritation, sensitization or superinfection develops while using the drug Triderm®, treatment should be interrupted and appropriate therapy should be prescribed. Cross-allergic reactions with aminoglycoside antibiotics have been observed.

Any side effects that occur with the use of systemic corticosteroids, including suppression of the function of the adrenal cortex, can also be observed with local use of corticosteroids, especially in children.

Systemic absorption of GCS or gentamicin when applied topically will be higher if treatment is carried out over large surfaces of the body or when using occlusive dressings. Avoid applying gentamicin to open wounds or broken skin. Appropriate precautions should be taken in such cases, especially when treating children.

It is recommended to discontinue the drug after long-term use gradually.

Use in pediatrics

Children from 2 years of age are prescribed only according to strict indications and under medical supervision, because Systemic side effects associated with betamethasone may develop. When using the drug Triderm®, like many other topical corticosteroids on large surfaces and/or with an occlusive dressing, the function of the hypothalamic-pituitary-adrenal system may be suppressed, a decrease in the excretion of growth hormone, as well as an increase in ICP may be observed.

Impact on the ability to drive vehicles and operate machinery. No effect of Triderm® on the ability to drive vehicles or operate machinery has been identified.

Using Triderm ointment

Triderm ointment is used in addition to treating acne, also for the control, prevention and improvement of the following diseases:

• Different forms of acne;
• Wrinkles;
• Dry, rough patches and tiny bumps on the skin;
• White blood cell cancer;
• Lightens light brown spots on the skin;
• Age spots;
• Skin damage associated with pregnancy;
• Skin injuries;
• Eczema;
• Dermatitis;
• Allergies;
• Rashes.

Triderm cream is designed to reduce the swelling of pimples and other inflammations, accompanied by itching and redness, which can occur in certain conditions affecting the body or face This drug is a moderate to severe corticosteroid The effectiveness of the drug depends on both the dosage and the form of the drug that was prescribed to you by your doctor Doctor For more information about the effectiveness of your product, consult your dermatologist.