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Barrier / Astringent / Wound Dressing Pregnancy: Safe — topical zinc oxide has negligible systemic absorption; widely used in pregnancy for skin protection

Zinc Oxide

Brand names: Sudocrem, Zinc and Castor Oil Ointment BP, Metanium, Drapolene

Adult dose

Dose: Apply liberally to affected area
Route: Topical
Frequency: As often as required (at each nappy change for nappy rash; 2–3 times daily for leg ulcers, pressure sores)
Max: No maximum — apply as needed
Astringent, barrier, and mildly antiseptic topical preparation. Used for: nappy rash (prevention and treatment), leg ulcers (as paste bandage), pressure sores (barrier), minor wounds, eczema around wounds, and as a base for other topical preparations. Zinc oxide paste bandages (Viscopaste) used in venous leg ulcer management.

Paediatric dose

Dose: Apply liberally to nappy area at each nappy change topical/kg
Route: Topical
Frequency: At each nappy change (nappy rash prevention/treatment)
Max: No maximum
BNFc: zinc oxide preparations safe in all ages including neonates. Sudocrem (zinc oxide 15.25%) is widely used for nappy rash.

Dose adjustments

Renal

Not applicable (topical — negligible systemic absorption)

Hepatic

Not applicable

Paediatric weight-based calculator

BNFc: zinc oxide preparations safe in all ages including neonates. Sudocrem (zinc oxide 15.25%) is widely used for nappy rash.

Clinical pearls

  • Nappy rash prevention: zinc oxide barrier cream at every nappy change is the most effective prophylactic measure — creates physical barrier against moisture and faecal enzymes
  • Nappy rash with satellite lesions and beefy red appearance: likely candidal superinfection — add clotrimazole 1% cream (Canesten) or use combined preparation (Daktacort — miconazole + hydrocortisone)
  • Venous leg ulcer: zinc oxide paste bandages (Viscopaste) provide compression and protect surrounding eczematous skin from wound exudate
  • Zinc oxide in sunscreens: physical/mineral UV blocker — reflects UVA and UVB; preferred in photosensitive dermatoses and in patients unable to tolerate chemical sunscreens
  • Sudocrem (zinc oxide 15.25% + benzyl alcohol + benzyl benzoate + benzyl cinnamate): widely used for nappy rash; benzyl alcohol component provides mild antiseptic activity
  • Pressure sore prevention: barrier creams including zinc oxide reduce skin maceration from moisture — part of pressure ulcer prevention bundle (NICE CG179)

Contraindications

  • Hypersensitivity to zinc oxide or excipients (rare)

Side effects

  • Skin sensitivity reactions (rare)
  • Local irritation (rare)

Interactions

  • None clinically significant

Monitoring

  • Wound/skin healing progress
  • Signs of secondary infection (candidiasis, bacterial)

Reference: BNFc; BNF 90; BNFc; NICE CG179 (Pressure Ulcers); BAD Leg Ulcer Guidelines; NICE CKS Nappy Rash. Verify against your local formulary and the latest BNF before prescribing.

Related

Curated clinical cross-links plus same-class fallbacks.

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