Topical treatments

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OTC (Over the Counter) Treatments

These are products that are available without a prescription.

Americaine

Americaine is a family of benzocaine based topical pain relievers. It is a "hospital strength" pain reliever. There are two varieties of Americaine—Americaine First Aid Spray, and Americaine Hemorrhoidal Ointment. They contain the highest level of benzocaine pain relief allowable without a prescription.

K6a patient "During pregnancy, my sores actually changed texture and seemed to have more exposed nerve endings and blood vessels. The pain was constant and agonizing and to even touch a sore would put me through the roof. Because I had so many holes, or open parts in my sores, the things I used helped a lot. So, the best thing I used was Americaine. It's an over the counter hemorrhoidal ointment. I know that sounds funny since I didn't have hemorrhoids, but it has benzocaine in it - a numbing ingredient. So I put this stuff in my open sores and basically it numbed them so I could handle the pain. I went through tubes of the stuff during my last months of pregnancy."

Americaine is available on [shopinprivate.com].

Aquaphor

[Aquaphor Healing Ointment] protects dry, cracked or irritated skin to help enhance the natural healing process and restore smooth, healthy skin.

1. Clinically proven to reduce healing time of minor wounds
2. Creates a protective barrier that seals in moisture
3. Helps heal raw, irritated skin caused by radiation treatments, facial resurfacing procedures and atopic dermatitis
4. Soothes and helps protect extremely dry, chapped or chafed skin and lips caused by winter weather or diabetes
5. Soothes and protects minor burns
6. Fragrance-free, preservative-free, non-irritating

K16 patient "Aquaphor - an ointment that soften dry callouses and smothes dry skin/chapped lips for those of us on an accutane. PCers can get this at their local pharmacy or online."


Callex Creme

[CalleX Ointment] thins and softens hardened skin and exfoliates dry, cracked heels. Its patented, natural enzymes selectively exfoliate only dry, cracked, thickened and scaly skin while its petrolatum base retains natural skin moisture.

K16 patient "I use callex creme that is a mix of urea and salicylic acid."






Lamisil

Lamisil also comes in sprays
Lamisil also comes in sprays

Informal comments from physicians on the IPCRR Physician Panel:

Dr. Peter Hull said "It is possible that the abnormal nails could become infected with fungi including non-dermatophytes. Lamisil would only work to get rid of dermatophyte fungi but the nail would remail abnormal if it was affected by PC."

Dr. Philip Fleckman said "Terbinafine (Lamisil) is a good drug for dermatophyte infections (but not Candida or other yeast infections) of the skin. Dermatophytes are a group of fungi that live in the top part of the outer, barrier layer of the skin (the stratum corneum of the epidermis). Dermatophytes cause athelete's foot (tinea pedis), jock itch (tinea cruris), and most types of nail fungal infections (onychomycosis). Because the nails in PC are thicker than normal, they are often mistaken for nail fungal infection and treated with terbinafine. Unless the nails or feet are infected, I know of no reason why terbinafine would improve PC."

It is possible for those with PC, to get a secondary fungal infection (such as a nail infection or athlete's foot, etc.) An antifungal treatment will not improve the PC condition; it may work well to treat a secondary infection. Most of these drugs are not designed for long term use; they are designed only to treat an infection.

K16 patient "Me on the other hand have it quite bad, well worst after the kids anyway. Now I am at the point where I don't even have PC in spots it is just raw skin and itches really bad. I also see that I am getting athletes foot or real bad itching on top of toes and between as well." Physician "It is possible she could have athlete's foot on top of her PC and if that is the case it should respond to to Lamisil which is a OTC medicine."

??? patient "I've been using Lamisil about 4 months & doctor asked me to stop taking it because it is not going to be get rid my problem."

K16 patient "While chatting with my brother, he told me his new doctor has been giving him Lamisil for his feet (fungal infection) and cordisone shots!! He just doesn't get it about his own feet....and apparently this new doctor hasn't a clue about what PC is!"

K6a patient "The doctor asked that we pick up an anti-fungal cream. She first thought lamisil, but changed to miconazole. At the store the only Miconazole was a 'vaginal' cream, but the pharmacist said okay to use on feet; they just didn't carry the 'foot care' package, but it would be the same. I started immediately to soak my feet with a capful of bleach and then applied the anti-fungal cream (Miconazole). I did that yesterday evening and today morning, and I would say it's already helping me a lot. Since the last 4 or 5 years my feet started to itches a lot, specially in the heels, and since I started with this medication it is not itching anymore. That's great!"


Neosporin

Original [NEOSPORIN® First Aid Antibiotic Ointment] provides long-lasting infection protection and may help minimize the appearance of scars. #1 Doctor Recommended Brand for over 25 years. No other triple antibiotic ointment kills more types of bacteria then even the leading prescription based in laboratory results.

NEOSPORIN® + Pain Relief Ointment & Cream

NEOSPORIN® + Pain Relief First Aid Antibiotic/Pain Relieving Ointment and Cream help prevent infection and provides temporary relief of pain or discomfort in minor cuts, scrapes, and burns. From the #1 Doctor Recommended Brand. Soothes painful cuts. Soothes the pain of burns.

K6a patient "Cracks on feet, sore and painful. Sometimes splits are in sores, sometimes extend to regular skin. Trim down callus carefully around split, put ointment like Neosporin into crack to keep soft. If gets dry it will split more and hurt more. Keeping cracks soft and not so deep seems to help them heal faster."

Phytex Paint

Phytex Paint for the treatment of fungal infection. Pain on to the affected areas, morning and evening and after washing.

K6a patient "I prefer hard skin to soggy blisters and soft skin. Phytex Paint which is for athletes foot, this works a treat to soak up the soft skin"

Phytex paint is available [Here]

Topical Ibuprofen

FDA NEWS RELEASE AUGUST 20, 2009
FDA ISSUES WARNING LETTERS TO MARKETERS OF TOPICAL IBUPROFEN DRUG PRODUCTS
PC Project applied and received IRB approval for a study of topical ibuprofen believing these were approved over-the-counter products. However, the FDA has ordered all companies to stop marketing this product as it has not been approved for safety.

FDA News Release

FDA Warning Letters to each company selling topical ibuprofen

We know that several patients found this very effective. We are disappointed to not be able to go forward with the study at this time. We note that some companies are continuing to sell the product on-line and have included disclaimers regarding non-FDA approval.

Also, at the 2009 Patient Support meeting in Salt Lake City, one of the physicians suggested a similar product Soloraze gel which is by prescription only. Several patients are trying this on their own and will report feedback. We're gathering additional information and will post it when available.

Prescription Treatments

Anti-inflammatory medications

K6a patient "Anti inflammatories or enzyme inhibitors such as Vioxx or Celebrex. Takes one each night before going to bed. Cannot function without them."

K6a patient "An anti-inflammatory medicine that helped his feet for long walks and every day use of feet. Worked extremely well."

Bactroban

Bactroban is an antibiotic that treats or prevents infection that is caused by bacteria.

K6a patient "When I get feet infections I use Rx Bactroban."

See the PC Wiki section on infections for more information on treating and preventing infections associated with PC symptoms.

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