Triderm - the gold standard for the treatment of skin diseases

Compound

General information

The medication as a whole is focused on combating microorganisms in the form of fungi and bacteria and relieving inflammation. It is active in case of primary skin lesions and in case of secondary infection that has developed against the background of an existing disease. This medicine is prescribed for eczema, varieties of lichen, inguinal mycoses, allergic dermatitis and other pathologies.

The drug is hormonal. It is used only for medicinal purposes, but not for prophylaxis, since it has a strong effect. Both forms of the medical product are available in tubes. The dosage is usually 15 g. Triderm cream is sold in this form:

Cream "Triderm"

And this is Triderm ointment:

Triderm ointment

Pharmacodynamics

Combined preparation for external use.

Triderm® ointment and cream combine the anti-inflammatory, antipruritic, antiallergic and antiexudative effect of the GCS betamethasone dipropionate with the antifungal activity of clotrimazole and the broad antibacterial effect of gentamicin sulfate.

Clotrimazole has an antifungal effect by disrupting the synthesis of ergosterol, which is an integral part of the cell membrane of fungi. Active against Trichophyton rubrum, Trichophyton mentagrophytes, Epidermophyton floccosum, Microsporum canis, Candida albicans, Malassezia furfur (Pityrosporum orbiculare).

Gentamicin sulfate, a broad-spectrum antibiotic from the aminoglycoside group, is bactericidal and provides highly effective local treatment of primary and secondary bacterial skin infections. Active against gram-negative microorganisms: Pseudomonas aeruginosa, Enterobacter aerogenes, Escherichia coli, Proteus vulgaris, Klebsiella pneumoniae; gram-positive microorganisms: Staphylococcus aureus (coagulase-positive, coagulase-negative and some strains producing penicillinase).

Comparison

In each case, the basis is three active ingredients. The hormonal component is betamethasone. It soothes inflammation and itching, suppresses allergic reactions. The second part of the treatment mixture is clotrimazole, which stops the development of fungi. And the third component is gentamicin, which acts as an antibiotic.

The concentration of these substances does not depend on the form of the drug. What then is the difference between Triderm cream and ointment? The difference can be seen in the components that play a supporting role. The ointment has a few of them: paraffin and Vaseline. These substances are responsible for the uniform application of the composition and its successful absorption.

The cream also contains such additions. But besides them, such a medicine includes alcohols, which have a drying effect. Sodium compounds and phosphoric acid also occupy a certain share here. In addition, a certain amount of water is added to the cream, which, along with other components, affects the consistency.

What is the difference between Triderm cream and ointment? The fact is that the first form is easier. The cream is absorbed faster, but not too deeply. It is recommended to use it if the lesion is not very serious. However, the skin should not be hypersensitive so that alcohols and other components do not provoke additional irritation.

The ointment is gentler. It penetrates the layers of the skin a little more slowly, but to a greater depth. Its effect lasts longer. In this version, Triderm is prescribed for severe lesions, sometimes very extensive. Apply the drug in any form in a thin layer, covering the problem area and capturing the healthy surface around the edges. Regularity of procedures is important; they should be carried out daily in two approaches.

Indications for Triderm®

Dermatoses complicated by infections caused by pathogens sensitive to the drug, or when such infections are suspected, including:

simple and allergic dermatitis;

atopic dermatitis (including diffuse neurodermatitis);

limited neurodermatitis;

eczema;

dermatomycosis (dermatophytosis, candidiasis, lichen versicolor), especially when localized in the groin area and large folds of the skin;

simple chronic lichen (limited neurodermatitis).

Triderm - the gold standard for the treatment of skin diseases

Author:

Reznik Irina

6 minutes

13757

Almost every family today has an allergy sufferer: according to the World Allergy Organization (WAO), the increase in the prevalence of allergic diseases is so serious that it should be recognized as a global public health problem. Atopic dermatitis alone among children in economically developed countries occurs in 10-28%. In Russia, the official incidence rate of atopic dermatitis is two to three times lower.

However, experts believe that the real incidence in our country is much higher. Due to the lack of specialists, low availability of diagnostics and their own carelessness, a huge number of Russians have been self-medicating for many years. Meanwhile, skin allergies have a variety of manifestations - from painful, but relatively harmless urticaria to life-threatening conditions. For example, with the most dangerous form of toxicermia - Lyell's syndrome, which occurs mainly as a reaction to medications - extensive toxic necrosis of the skin develops, which in 40% leads to the death of the patient

The most common are dermatitis, neurodermatitis and eczema of an allergic nature. The inflammatory immune skin reaction to the usual external environment is protracted, accompanied by redness, rashes and itching, which cause not only physical but also psychological discomfort. Initially, the rashes are concentrated in places of direct contact with the allergen. But since the disease affects the entire body as a whole, secondary foci of damage can be localized in any other place.

Irritants and allergens

There are a great many factors that can provoke allergic dermatitis, and they are widespread everywhere. This can be food, household dust and pollen, cosmetics and household chemicals, chlorinated water, and various medications. And at the same time, allergic reactions are dose independent. For example, even a small amount of peanut butter can cause anaphylactic shock. And, by the way, in American films you can often hear people talking about peanuts in this context. In our country, thank God, this is not relevant, we do not eat peanut butter in such quantities. Russian experts most of all dislike honey and bee products.

The general mechanism of allergic inflammation is as follows: an allergen entering the body of a sensitive (or, in medical terms, “sensitized”) person binds to immunoglobulin E (immunoglobulins are a special type of antibodies). And this compound affects certain cells that release highly active substances into the surrounding tissues, causing this unpleasant condition. Stress, diseases of the endocrine system and gastrointestinal tract can contribute to the development of neuroallergic dermatitis.

Diagnostics

For specific diagnostics to determine what exactly an allergy is developing to, there are two main examination methods. The first and most common method is skin testing, which involves direct contact with the allergen. A drop of allergen concentrate is applied to the patient's skin and either a puncture of the skin with a special needle or a microscopic incision is made. In addition to allergens, drops of special substances are used to control the reaction. The specialist then assesses the size of redness and swelling at the site where the allergen drop is applied.

However, skin testing is not advisable in the presence of clinical symptoms of allergy. In this situation, the second method is preferable - a more complex modern test for determining specific antibodies to certain antigens in the blood or molecular diagnostics. During an exacerbation, laboratory changes can be seen: for example, an increase in the level of total immunoglobulin E (IgE), an increase in the values ​​of allergen-specific immunoglobulin E (that is, IgE antibodies to a specific allergen), an increase in the number of a certain subtype of leukocytes (eosinophils) in a general blood test . Some patients experience activity in a marker such as eosinophilic cationic protein, which may indicate that the body is struggling with allergies.

Treatment

The best treatment is to remove the allergen. But this is not always possible; almost everything that surrounds us can become an irritant. Therefore, it is possible to cope with allergic dermatitis only using complex treatment, including diet, general (taking antihistamines and anti-inflammatory drugs of systemic action) and local therapy. Moreover, drug therapy. Dermatitis, as a manifestation of an allergic reaction, is not just skin irritation, and this problem cannot be solved with the help of cosmetic preparations, even special ones.

Depending on the effect local products have on the skin, they are divided into several categories:

• drying agents (zinc ointment, Desitin cream),
• antipruritic ointments with antihistamine components (for example, Fenistil),
• Ointments that improve trophism and tissue regeneration (D-Panthenol, Bepanten),
• hormonal - these include all glucocorticosteroid drugs (for example, Advantan) and ointments that contain dexamethasone.

It is hormonal drugs that can form the basis of drug therapy associated with the suppression of a special inflammatory reaction that develops during allergies. Combined products combine the qualities of hormonal, antimicrobial and antihistamine or other drugs.

In case of complications associated with infection of the affected areas of the skin (this can happen when dirt gets into the affected area, when scratching), topical antibiotics may be required. Unfortunately, dermatitis is almost always complicated by the addition of a secondary infection (bacterial or fungal), when just hormones may not be enough and complex help is needed (Celestoderm, Triderm).

According to experts, today Triderm is the gold standard of treatment among three-component drugs.

It contains the hormone betamethasone, the antibiotic gentamicin, which acts on many bacteria, including staphylococci and streptococci, and the antifungal drug clotrimazole. Thanks to its triple mechanism of action - anti-inflammatory, antifungal and antibacterial, Triderm is used in the treatment of inflammation associated with dermatosis or dermatitis complicated by a secondary infection (for example, eczema, pityriasis versicolor or versicolor, candidiasis, dermatomycosis).

At the onset of the disease, with acute inflammation, which may be accompanied by swelling, weeping, the appearance of blisters, redness and severe itching, Triderm cream is more suitable. It is also more suitable for oily or baby skin. If the disease becomes chronic, requiring deeper penetration of the drug, ointment is used. Of course, Triderm is also not a panacea; the drug has clear indications for use. In addition, such potent drugs cannot be used randomly when any pimple or “unexplained” rash appears. They are also not suitable “for prevention”. A specialist should prescribe them and determine the duration of treatment.

Nutrition for allergic dermatitis

Treatment of any allergic disease is impossible without following a diet. Dietary restrictions are introduced to exclude allergenic substances and to reduce the food load on the digestive organs. The method of preparing food is also of great importance - during illness you should avoid smoked, fried and pickled foods. You can keep a food diary to identify the allergen that is causing your skin reaction. To do this, carefully note everything eaten during the day and monitor the body’s reaction to these foods.

The basis of the diet for allergy sufferers is porridge, which does not irritate the gastrointestinal tract and is quickly digested, fermented milk products, fresh vegetables and fruits, butter and vegetable oil, and boiled beef. Salt should be limited as much as possible. It is also not recommended to consume alcohol, citrus fruits, eggs, nuts, milk, chocolate, coffee, honey, mushrooms, strawberries, melons and watermelons, fish, poultry, mayonnaise, mustard and other seasonings, spices and sauces.

Treatment with folk remedies

A distinctive feature of the Russian mentality is the sacred belief in traditional medicine. This is something that specialists who are trying to exclude all herbal remedies from the list of medications are not at all happy about. There is even a joke among them: “no herbs, only chemistry and supersynthetics.” However, there are some exceptions. Thus, in combination with taking medications, it is allowed to use cucumber or apple juice to moisturize the skin and reduce itching. Decoctions of oak bark and string are a good antiseptic. Aloe juice combats skin rashes well, and various vegetable oils (linseed, corn, olive) promote skin healing.

Prevention

There are many ways, if not to protect yourself from allergies, then at least to reduce their manifestations. For example, such non-standard ones as the constant presence of a dog in the house. There are studies that explain why children who have been in contact with pet dogs since birth are much less likely to suffer from various types of allergic diseases.

As for classical non-drug prevention, the patient’s lifestyle is also very important here. And the first rule is to eliminate or minimize contact with “your” allergen. Clothing, bedding, and hygiene products should be as natural as possible, hypoallergenic and not have a strong odor. You should remove all potential dust collectors from the apartment (carpets, large plush toys, fabric curtains), regularly do wet cleaning and open the window. It is also recommended to pay attention to the material of jewelry that comes into contact with the skin and use oxidation-resistant metals (titanium, platinum, gold, silver), avoiding cheap alloys, especially those containing nickel.

ATTENTION! THERE ARE CONTRAINDICATIONS TO APPLICATION AND USE, YOU MUST READ THE INSTRUCTIONS FOR USE OR OBTAIN PROFESSIONAL ADVICE.

Side effects

Very rarely, when using the drug Triderm®, the following are observed: burning sensation, erythema, exudation, pigmentation disorders and itching.

Caused by local corticosteroids (especially when using occlusive dressings): burning sensation, itching, dry skin, folliculitis, hypertrichosis, acne, hypopigmentation, perioral dermatitis, allergic contact dermatitis, skin maceration, development of secondary infection, skin atrophy, stretch marks, prickly heat.

Caused by clotrimazole: erythema, tingling sensation, blistering, peeling, local swelling, itching, urticaria, skin irritation.

Caused by gentamicin: transient skin irritation (erythema, itching), usually not requiring discontinuation of treatment.

Side effects of Triderm ointment for acne

Burning, itching, irritation or dryness may occur especially in the first days of using the drug on the skin. Such effects should disappear after a few days as your body adapts to this medicine. If any of these effects persist or worsen during use of the cream, then Tell your doctor immediately.

Remember that it was your doctor who prescribed this medication after assessing that the benefits of Triderma ointment to you are greater than the risk of side effects. Many people using this drug have had absolutely no serious side effects. Therefore, tell your doctor immediately if there is redness, swelling or irritation does not improve.

Rarely, however, it is possible that the drug will be absorbed from the skin into the bloodstream. This may result in side effects and too much corticosteroid in the skin. These side effects of Triderm Ointment are more likely in children and in people who use this drug for a long time or for large areas of skin with acne.

Tell your doctor right away if any of the following side effects occur: unusual extreme tiredness, weight loss, headache, swelling of ankles/legs, increased thirst/urination, vision problems.

A very serious allergic reaction to this drug is unlikely, but seek emergency medical help if such a reaction eventually occurs. Symptoms of a serious allergic reaction may include: rash, itching/swelling (especially of the face/tongue/throat), severe dizziness, labored breathing.

This is not a complete list of possible side effects of Triderm ointment for acne. If you notice other effects not listed above, then you definitely need to contact your doctor.

Overdose

Symptoms: with long-term use of local corticosteroids in high doses, suppression of adrenal function with the development of secondary adrenal insufficiency and symptoms of hypercortisolism, including Cushing's syndrome, is possible. An overdose of clotrimazole when applied topically does not lead to the appearance of any symptoms. With a single overdose of gentamicin, the appearance of any symptoms is also not expected. Long-term treatment with gentamicin in high doses can lead to the growth of insensitive flora.

Treatment: symptomatic. Acute symptoms of hypercortisolism are usually reversible. If necessary, electrolyte imbalance is corrected. In case of chronic GCS toxicity, gradual withdrawal of GCS is recommended.

How to take it correctly

Ointment

The medicine in the form of an ointment is used according to the following scheme: applied in a thin layer to the damaged area of ​​​​the skin and around it 2 times a day. To achieve a therapeutic effect, it is important to observe regularity. The duration of the treatment course depends on the degree of infection, as well as the body’s reaction.

If the condition improves after a month, then it is worth informing a specialist so that he can make a diagnosis again.

Cream

The product in cream form is intended for topical use. The application regimen is identical to the ointment.

special instructions

Cannot be used in ophthalmic practice.

Prolonged topical use of antibiotics can sometimes lead to the growth of resistant microflora. In this case, as well as if irritation, sensitization or superinfection develops while using the drug Triderm®, treatment should be interrupted and appropriate therapy should be prescribed. Cross-allergic reactions with aminoglycoside antibiotics have been observed.

Any side effects that occur with the use of systemic corticosteroids, including suppression of the function of the adrenal cortex, can also be observed with local use of corticosteroids, especially in children.

Systemic absorption of GCS or gentamicin when applied topically will be higher if treatment is carried out over large surfaces of the body or when using occlusive dressings. Avoid applying gentamicin to open wounds or broken skin. Appropriate precautions should be taken in such cases, especially when treating children.

It is recommended to discontinue the drug after long-term use gradually.

Use in pediatrics

Children from 2 years of age are prescribed only according to strict indications and under medical supervision, because Systemic side effects associated with betamethasone may develop. When using the drug Triderm®, like many other topical corticosteroids on large surfaces and/or with an occlusive dressing, the function of the hypothalamic-pituitary-adrenal system may be suppressed, a decrease in the excretion of growth hormone, as well as an increase in ICP may be observed.

Impact on the ability to drive vehicles and operate machinery. No effect of Triderm® on the ability to drive vehicles or operate machinery has been identified.

Using Triderm ointment

Triderm ointment is used in addition to treating acne, also for the control, prevention and improvement of the following diseases:

• Different forms of acne;
• Wrinkles;
• Dry, rough patches and tiny bumps on the skin;
• White blood cell cancer;
• Lightens light brown spots on the skin;
• Age spots;
• Skin damage associated with pregnancy;
• Skin injuries;
• Eczema;
• Dermatitis;
• Allergies;
• Rashes.

Triderm cream is designed to reduce the swelling of pimples and other inflammations, accompanied by itching and redness, which can occur in certain conditions affecting the body or face This drug is a moderate to severe corticosteroid The effectiveness of the drug depends on both the dosage and the form of the drug that was prescribed to you by your doctor Doctor For more information about the effectiveness of your product, consult your dermatologist.

Cream "Triderm"

The composition of the main substances is identical. It includes quantitatively and qualitatively the same substances:

1. Gentamicin is an antibiotic. Powerful in its action, it helps to destroy the pathogenic environment. Content – ​​1 mg/g.
2. Glucocorticoid betamethasone is a hormonal agent. Perfectly relieves inflammation, redness in areas of the skin and itching. Content – ​​0.5 mg/g.
3. The antimycotic clotrimazole is a substance that helps in the fight against fungal infections and infections. Content – ​​10 mg/g.

The main difference is the content of excipients. For cream the list is as follows:

• Soft paraffin, Vaseline - creates a thin film when applied to the skin, which helps the substances to be better absorbed and not evaporate.
• Phosphoric acid – protects the cream from oxidation, preservative.
• Macrogol.
• Alcohols.
• Propylene glycol.
• Sodium hydroxide.

Analogs

Proven analogues include:

Kanizon. Available in the form of cream, solution and tablets. The drug is effective for various diseases and joint problems.

Lokoid. It is produced in the form of ointment and cream. It has a local antipruritic and anti-inflammatory effect.

Betasalik. Available in the form of an ointment. It is a drug of combined action. has anti-inflammatory, antiseptic and antiallergic effects.

Triactutan. Sold in the form of ointment and cream. It has antifungal, antibacterial and anti-inflammatory effects.

Basically, the price of analogues will be lower than Triderma.

Is it possible to take Triderm during pregnancy?

During the period of bearing a child, the use of the drug is possible only as prescribed by a doctor and under constant supervision. In this case, the possible beneficial result must significantly outweigh the possible threat to the developing fetus and the expectant mother. It is better not to use the cream for a long time or on large areas of skin.

During breastfeeding, it is strictly forbidden to take the drug, since there is no data regarding the possibility of excretion of the constituent components together with breast milk.

Contraindications and adverse reactions

You should refrain from taking Triderm in the following cases:

• chickenpox;
• tuberculosis of the skin;
• common herpes;
• children under 2 years old;
• skin manifestations of syphilis;
• skin manifestations of the vaccine;
• increased susceptibility to constituent components.

Particular caution should be taken when taking the medicine during long-term treatment, in young children, pregnant women, on large skin areas, or in the presence of injuries.

The following adverse reactions may occur:

• local manifestations: burning, itching, impaired pigmentation;
• negative reactions after taking glucocorticosteroids: burning, itching, dry skin, allergies in the form of a rash;
• undesirable reactions after using clotrimazole: local swelling, skin irritation;
• negative manifestations after taking gentamicin: itching (no need to stop treatment).