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BNSSG Adult Joint Formulary

13.5 Photodamage

Last edited: 11-01-2024

First line drugs Second line drugs Specialist drugs Secondary care drugs

 

Photodamage

Moisturisers should be used first line for mild cases of photodamage.

 

Antimetabolites

Fluorouracil cream (Efudix®) (TLS Green)

  • Superficial malignant and premalignant skin lesions

Alternatives: (TLS Blue)

Fluorouracil 0.5% and Salicylic acid 10% (Actikerall®)

  • Hyperkeratotic actinic keratosis

 

Other

Specific indications: (TLS Blue)

Tirbanibulin ointment 

  • Solar keratosis

Diclofenac 3% gel (Solaraze®)

  • Actinic keratosis

 

Photosensitising Agents

5-aminolaevulinic acid gel (Ameluz®) (TLS Red)

  • For treatment of Basal Cell Carcinoma and complex patients already under the secondary care dermatology team with recurrent malignant skin disease where actinic keratosis is a significant part of the disease presentation

Methyl aminolevulinate (Metvix®(TLS Red) 

 

Sunscreen preparations

The following sunscreens can only be prescribed according to ACBS and are regarded as drugs when prescribed for skin protection against ultraviolet radiation in abnormal cutaneous photosensitivity resulting from genetic disorders or photodermatoses, including vitiligo and those resulting from radiotherapy and SLE; chronic or recurrent herpes simplex labialis. Anything outside of this is not permissible.

Recommended:(TLS Green)

Please refer to the Drug Tariff for approved ACBS products for prescribing and select the most cost-effective appropriate product that is available from local Community Pharmacies. If no products are available, patients will be required to purchase a high quality sunscreen.

 

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