Skin

(d) Barrier preparations (urinary or nappy rash)

ADULT AND CHILD

First Choice:
zinc and castor oil ointment (contains peanut oil)
orContotrane ® cream
Second Choice:
Metanium ® ointment (nappy rash only)
Formulations/Dose
  • zinc and castor oil ointment BP 50g or 100g pot (zinc oxide 7.5%, castor oil 50%, arachis (peanut) oil 30.5%, white beeswax 10%, cetostearyl alcohol 2%): for nappy and urinary rash and eczematous conditions, apply several times daily as necessary or after each nappy change
  • Conotrane® cream 100g pot (benzalkonium chloride 0.1%, dimeticone ‘350’ 22%): apply several times daily as necessary
  • Metanium® ointment 30g tube (titanium dioxide 20%, titanium peroxide 5%, titanium salicylate 3% in a basis containing dimeticone, light liquid paraffin, white soft paraffin, and benzoin tincture): apply several times daily as necessary or after each nappy change.
Prescribing Notes
  • Do not apply too liberally as may prevent moisture absorption by the nappy
  • Urinary (nappy) rash may clear if skin is left exposed to air
  • An ingredient of zinc and castor oil ointment is arachis oil, it should not be used if there is a known allergy to peanut or soya
  • If associated with yeast (candida) infection an antifungal such as clotrimazole is useful, should be applied two or three times daily and used for 7-10 days after rash has cleared.

When to advise patient to contact GP

If standard treatments fail or nappy rash persists
If sign of infection or eczema