Hydrocortisone with benzalkonium, dimeticone & nystatin

How it works

Hydrocortisone reduces local inflammation, nystatin binds fungal membrane sterols to treat Candida, benzalkonium provides antibacterial/antiseptic action and dimeticone forms a protective water-repellent barrier over the skin.

Prescribing in practice

• Apply thinly to the affected area for short courses only, as occlusion in skin folds or under nappies enhances steroid absorption and the risk of skin thinning, especially in infants.
• It is intended for inflamed candidal or intertriginous eruptions, not for untreated bacterial or viral skin infection where the steroid component could worsen the picture.
• Avoid the face and prolonged use unless specifically directed.

Monitoring

Review the skin response over the short treatment course and reassess if there is no improvement or signs of spreading or unresolved infection.

Counselling the patient

• Apply a thin layer to the affected skin only, for as long as advised and no longer.
• Use a separate barrier or emollient routine for nappy care as directed, and change nappies frequently.
• Seek review if the rash worsens, weeps or fails to settle.

Evidence & guidelines

Combined topical mild corticosteroid, antifungal and barrier preparations are established for short-term treatment of inflamed candidal napkin and flexural dermatitis per the SPC.