Dermatology Medicines Used in Primary Care
Skin problems are one of the most common reasons people contact a GP. Many conditions can be managed safely in primary care with an accurate history, good-quality photos, and appropriate follow-up.
Dermatology medicines are usually chosen based on:
- The suspected diagnosis
- Body area affected (face, groin, scalp, hands)
- Severity and extent
- Age
- Pregnancy or breastfeeding
- Previous treatments and response
- Risk of infection or complications
Because different skin conditions can look similar, correct diagnosis matters. For example, eczema and fungal rashes can appear alike but require very different treatment.
These articles are intended as educational sources, not diagnostic nor taking place of a proper medical assessment. If you need help, please book an appointment with one of our GP’s.
Emollients and Barrier Treatments
Emollients are the foundation of treatment for many dry and inflammatory skin conditions, especially eczema.
They help by:
- Restoring the skin barrier
- Reducing itching
- Reducing flare frequency
- Improving response to anti-inflammatory treatments
Examples include moisturising creams, ointments, and soap substitutes.
Barrier protection is particularly important for hand dermatitis and frequent handwashing.
💡 Cream vs Ointment: Which to choose?
Creams: Lighter, easier to spread, less greasy. Better for daytime use, hairy areas, or weeping/moist skin.
Ointments: Thicker, more moisturizing, longer-lasting. Better for very dry skin, night-time use, or thick plaques.
Topical Steroids
Topical steroids reduce inflammation and itching in conditions such as:
- Eczema
- Dermatitis
- Psoriasis flares
- Inflammatory rashes
They are grouped by potency (mild to very potent). Choosing the correct strength depends on the site and condition:
- Face and skin folds usually require milder options
- Hands and thick plaques may require stronger options
- Duration should be limited and reviewed
Safety points
- Overuse can thin skin, cause stretch marks, and trigger steroid-related acne
- Sudden withdrawal after prolonged use can cause rebound flares
- Steroids are usually not appropriate for untreated fungal infections
If symptoms worsen or spread after steroid cream, review is important.
Topical steroid potency and where they are used
Topical steroid creams and ointments range from mild to very potent. The safest choice depends on the body area, diagnosis, and severity. This is a general guide, individual assessment is important.
| Potency group | Common use in primary care | Where it is usually used | Example steroid name |
|---|---|---|---|
| Mild | Mild eczema, mild dermatitis, sensitive areas | Face (including eyelids), skin folds, groin, children (often) | Hydrocortisone (topical) |
| Moderate | Eczema flares on body, dermatitis, itch inflammation | Trunk, arms, legs (selected areas), short courses on thicker skin | Clobetasone butyrate |
| Potent | More significant inflammation, thicker plaques, hands | Hands, feet, elbows, knees, thicker skin areas (usually time-limited) | Betamethasone valerate |
| Very potent | Severe localised flares under close review | Very thick plaques only, specialist-led or carefully supervised use | Clobetasol propionate |
Topical Calcineurin Inhibitors
These are non-steroid anti-inflammatory creams used for selected cases of eczema, particularly on sensitive areas such as the face or eyelids.
Common examples include:
- tacrolimus
- pimecrolimus
They are usually initiated after GP or specialist assessment and may be helpful for steroid-sparing strategies in recurrent eczema.
Antihistamines for Itching
Antihistamines may help if itching is:
- Severe
- Interrupting sleep
- Associated with urticaria (hives)
They do not treat eczema itself, but can reduce scratching and improve sleep in some cases.
Sedating antihistamines may cause next-day drowsiness.
Read more: Allergy Medicines
Acne Medicines
Acne treatment is guided by severity and type (comedonal vs inflammatory).
Topical acne treatments
Common examples include:
- benzoyl peroxide
- topical retinoids (eg adapalene)
- topical antibiotics (eg clindamycin), usually in combination products
- azelaic acid
Oral acne treatments
Some people require oral antibiotics for inflammatory acne, typically for time-limited courses and alongside topical therapy.
Isotretinoin is specialist-led and requires strict monitoring.
Safety and review
Acne treatments often take weeks to show meaningful improvement. If acne is scarring, nodular, affecting mental health, or not responding, review is appropriate.ration, severe abdominal pain, or blood in vomit requires urgent assessment.
Learn more: Acne and breakouts
Antibiotics and Antiseptics for Skin Infection
Impetigo and local bacterial infection
May be managed with topical antiseptics or antibiotics depending on severity.
Cellulitis and spreading infection
Usually requires oral antibiotics and timely assessment.
If infection is rapidly spreading, painful, associated with fever, or affecting the face or around the eyes, urgent assessment is required.
Learn More: Skin Infections
Antifungal Medicines
Fungal infections are common and can affect:
- Feet (athlete’s foot)
- Groin (tinea cruris)
- Body (ringworm)
- Scalp (tinea capitis)
- Nails
Topical antifungals
Common examples include:
- clotrimazole
- terbinafine
- miconazole
Oral antifungals
Some infections (scalp, nails, extensive disease) may require oral antifungal treatment after assessment.
Important note: steroid creams can worsen fungal rashes if used alone.
Treatments for Scabies and Infestation
Scabies is common and can cause:
- Intense itching, often worse at night
- Household spread
- Typical distribution on wrists, fingers, waistline
Treatment usually involves topical scabicides and treating close contacts, alongside washing bedding and clothing appropriately.
If symptoms persist despite correct treatment, reassessment is needed.
Psoriasis Medicines in Primary Care
Mild psoriasis may be managed with:
- emollients
- topical steroids
- vitamin D analogues in selected cases
More extensive psoriasis often requires dermatology input.
Scalp psoriasis may require specific preparations.
Rosacea and Facial Inflammatory Rashes
Rosacea may present with:
- facial flushing
- persistent redness
- papules and pustules
Treatments may include topical agents and, in some cases, oral antibiotics.
Rosacea differs from acne and requires a different approach.
Red Flags: Seek Urgent Help
Seek urgent medical assessment if you have:
- Rapidly spreading rash with fever
- Facial swelling, lip or tongue swelling, or breathing difficulty
- Rash with severe blistering or skin peeling
- Painful rash around the eye
- Signs of severe infection (hot, red, worsening area with systemic symptoms)
Frequently Asked Questions
1. How do I know if a rash is fungal or eczema?
Fungal rashes often have a clearer edge and may affect groin, feet, or body folds, while eczema is usually drier and more inflamed. Because they can look similar, assessment is helpful before using steroid creams.
2. Are steroid creams safe?
Steroid creams can be safe and effective when used correctly, but strength and duration depend on the body area and diagnosis. Overuse can cause side effects, so review is recommended for persistent symptoms.
3. When should a skin rash be assessed urgently?
Seek urgent assessment for rapidly spreading rash with fever, severe blistering, facial swelling, eye involvement, or signs of a severe infection.
When to contact a GP
You should consider contacting a GP if:
- A rash is persistent or recurring
- Over-the-counter treatment has not worked
- You are unsure if a rash could be fungal, eczema, or infection
- Acne is scarring or affecting confidence
- You need a safe treatment plan for sensitive areas such as the face or groin
Further Reading and Hub Links
Visit our Medication and Prescribing hub or browse more health topics in the AccessGP Knowledge Base.
If a skin problem is affecting your quality of life, a GP can help guide you on the safest next step or visit the Skin Clinic for non-urgent queries.
How to Take Good Skin Photos
Use natural daylight
Take photos near a window in bright, indirect daylight. Avoid flash or warm indoor lighting so the skin appears true to colour and texture.
Take three views
Upload a close-up shot, a mid-range photo and a wider image that shows where the area sits on the body for better clinical accuracy.
Keep it steady and in focus
Hold your phone with both hands or stabilise it on a surface. Tap to focus on the skin before taking the photo to keep details sharp.
Last reviewed by Dr Zamiel Hussain, GMC registered GP
Updated: 15 February 2026