Topical Therapy in Neonates

Abstract

Topical therapy offers the potential to achieve higher concentrations of a drug in the skin with minimal exposure of other organs. This can greatly increase efficacy and safety relative to systemic administration1-2. Successful topical therapy depends not only on selection of the most appropriate pharmacologically active ingredient but also on the most optimal vehicle for delivery. Gels enhance penetration through the epidermis, while lotions offer the convenience of easy spreadability over large areas3,4. Creams are emulsions of oil and water and the ratio of these ingredients determines the texture, emollient and occlusive properties of the product. Ointments are water-insoluble occlusive mixtures of animal, vegetable or mineral lipids. Several antibiotics, antifungal, antiviral and antiparasitic agents are commercially available, but due consideration should be given to their efficacy and side effects before prescribing them in neonates56. Children are more susceptible to local and systemic effects of topical corticosteroids than are adults. Several types of adverse reactions are possible following the use of topical corticosteroids, so they should be used more cautiously and only when specifically indicated.