Practical applications of topical therapy for allergic, infectious, and seborrheic disorders

Topical therapy is extremely important in the management of allergic, infectious, and seborrheic disorders. It can be used as a sole therapy or adjunctive therapy for these disorders, often minimizing the need for systemic therapy. In allergic diseases, pruritus can be decreased by removing allergen, desensitizing the skin or other antipruritic effects. Many agents can also maintain or replace moisture to the skin and have emollient effects. When used for infectious conditions, topical therapy can decrease microbial counts and reduce surface colonization of microbes and help to prevent relapses. Antiseborrheic products function by normalizing keratinocyte turnover rates by reducing epidermal division (keratoplastic), normalizing keratinization, and increasing desquamation (keratolytic). There are many different topical vehicles and modes of application: shampoos, whirlpools, soaks, rinses, sprays, lotions, gels, creams, and ointments. Shampoos are often the most practical and effective. The practitioner needs to become familiar with many active ingredients to learn what products are indicated for specific diseases.