They are also recommended in young children , infants , and the elderly who are more prone to local and systemic side effects. These agents are usually preferred in patients who require long term therapy or application to large areas . After initial control is obtained, maintenance therapy with a lower potency agent is often advisable. Occlusive dressings should be avoided when using Ultra-potent agents. Vehicle Ointments Ointments are more potent and effective than other formulations due to their natural occlusive nature.
Ointments are generally preferable in dry, brittle, fissured, scaly, or hyperkeratinized skin areas.
They should not be used in areas such as the axilla, groin, or skin folds as their occlusive effect may cause maceration, folliculitis and potential systemic side effects. Ointments are particularly useful in young children with infantile atopic dermatitis where dryness of the skin is a particular problem. Creams Creams are often preferred for non-acute dermatoses as they are cosmetically more acceptable . Proper application requires rubbing fully into the skin in such a way that a residue is not visible after application. Some patients with chronic conditions may benefit from application of creams during the day, followed by ointments at night to maximize efficacy.