GGC Medicines: Sunscreens, camouflagers and photodamage

Key to symbols

The medicine should be initiated by, or on the advice of a specialist, but is suitable for continuation by a GP

The medicine should only be used and prescribed by a specialist

Indicates the preferred choice within a class or group of medicines

13. Skin

13.8. Sunscreens, camouflagers and photodamage

13.8.1. Sunscreen preparations and photodamage

13.8.1.2. Conditions associated with photodamage

Total Formulary

AFAMELANOTIDE (implant)

Restrictions:

Prevention of phototoxicity in adult patients with erythropoietic protoporphyria (EPP) is restricted to specialist use.

Prescribing Notes:

This therapy is available via the Scottish Government Ultra-orphan pathway
Formulary status will be reconsidered following the reassessment by SMC (expected 2024)

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5-AMINOLEVULINIC ACID (AMELUZ) (GEL)

Restrictions:

Restricted to use by Consultant Dermatologists for the treatment of actinic keratosis of mild to moderate intensity on the face and scalp (Olsen grade 1 to 2).
Restricted to specialist use for the treatment of superficial and/or nodular basal cell carcinoma (BCC) in adults unsuitable for surgical treatment due to possible treatment-related morbidity and/or poor cosmetic outcome.

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5-AMINOLEVULINIC ACID (ALACARE) (medicated plaster)

Restrictions:

Restricted to use by Consultant Dermatologists for the treatment of mild actinic keratosis lesions with a maximum diameter of 1.8cm on the face and scalp.

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FLUOROURACIL (EFUDIX) (cream)

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FLUOROURACIL, SALICYLIC ACID (ACTIKERALL) (solution)

Restrictions:

For use in the topical treatment of hyperkaratotic actinic keratosis (grade I/II) in adults

Prescribing Notes:

The relevant SMC advice for this product can be accessed here

BNF Link

IMIQUIMOD (ALDARA) ( 5% cream)

Restrictions:

The treatment of clinically typical, nonhyperkeratotic, nonhypertrophic actinic keratoses on the face or scalp in immunocompetent adult patients is restricted to specialist initiation. The topical treatment of small superficial basal cell carcinoma is restricted to second line use by specialist dermatologists in adults where standard treatment with surgery or cryotherapy is contraindicated and fluorouracil is not appropriate.

Prescribing Notes:

For the use of imiquimod in genital and perianal warts, see section 13.7

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IMIQUIMOD (ZYCLARA) (3.75% CREAM)

Restrictions:

Restricted to specialist initiation by clinicians experienced in the management of actinic keratoses only in patients with large field actinic keratosis (>25cm²) when other topical treatments are contraindicated or less appropriate.

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METHYL AMINOLEVULINATE (METVIX) (cream)

Restrictions:

Restricted to use by specialist dermatologists when other treatments are inappropriate or contra-indicated

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TIRBANIBULIN (Ointment)

Prescribing Notes:

It should be noted that tirbanibulin is currently only licensed for non-hypertrophic, non-hyperkeratotic actinic keratosis of the face and scalp (Olsen grade 1).

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