Ichthammol with zinc oxide

How it works

Ichthammol has mild anti-inflammatory and antipruritic properties and is less keratolytic than coal tar, while zinc oxide provides a protective, astringent and mildly soothing barrier over the skin.

Prescribing in practice

• It is intended for chronic or lichenified eczema rather than acute weeping or infected lesions, on which it should be avoided.
• When used as an impregnated bandage, ensure correct application to avoid constriction, particularly over the limbs.
• Patch-test sensitivity or irritation can occur, so discontinue if the skin worsens.

Monitoring

Review the treated skin for improvement and for any irritation or sensitisation, and reassess if eczema is not settling.

Counselling the patient

• This is best for thickened, dry, itchy patches rather than weeping areas.
• If applied under a bandage, leave it in place as directed and report any tightness or discomfort.
• Continue prescribed emollients to support the skin barrier.

Evidence & guidelines

Ichthammol-containing pastes and bandages are long-established adjuncts for chronic lichenified eczema in standard dermatology practice.