60 Seconds with Idria Dimichele

In this 60 second interview, expert in Dermatology formulations, Idria Dimichele, talks about the current issues facing dermatology manufacturers.

What are the key issues relating to the production of topical formulations?

We receive orders for topical preparations from our customers every single day. As a specials manufacturer we have several formulations in our database to satisfy the high volume of special topical orders coming from our customers and prescribers. We are (on occasion) challenged with complex topical formulations but enjoy fulfilling our customer’s needs.

Our highly experienced formulation team merge experience and research to satisfy our customer enquiries. The most frequent issue that we have with new formulations is the stability of the topical preparation. Sometimes, when ingredients are mixed it can create an unstable finished product. However, our development team (in collaboration with customers and prescribers) are able to find the most effective solution to suit that patient’s clinical needs.

Sometimes we receive orders for patients who are intolerant to some excipients such as Glycerol, Chlorocresol, Cetostearyl alcohol, Castor oil etc. as they might cause a skin reaction. If a licensed product contains one of the allergens, we are able to manufacture a special formulation, free from the mentioned allergen, utilising alternative excipients that still produce an effective product, suitable to the patient's needs.

If we don’t already have the product in our system we can source a more suitable product that can meets the patient needs from one of our approved vendors. Sometimes it can be difficult to source these products in the UK market due to the limited availability of the API; however our specialised team is able to source these products from suppliers across the globe.


What are the most common topical product queries you receive from hospital pharmacies?

The most common enquiries that we receive from hospital pharmacies relate to the stability, consistency and strength of the formulations. Some topical creams are required to be stored in a cold chain at temperatures of 2°C to 8°C. However, on occasion patients may leave their medication outside the fridge and they want to know if the product is still suitable to use.

Some topical creams from “special formulations” may also have a different consistency (i.e. more or less viscous) compared to most of the topical creams that customers find in the market. This is due to the fact that the topical products from “special formulations” are formulated based on the patient’s needs and the consistency can vary due to the excipients used. The excipients are important ingredients in the formulation as they are the vehicle for active ingredients to penetrate the skin and can greatly affect the stability of the preparation.


How useful can topical formulations be in assisting medical conditions (Such as Psoriasis, Eczema, etc.)?

There are several types of psoriasis, for which chronic plaque psoriasis is the most common form. Topical formulations are the first treatment choice for chronic psoriasis while mild conditions may be managed with the use of emollients alone or with the use of other topical medications containing active ingredients such as Coal tar, Calcipotriol, Dithranol, etc. Patients who are unresponsive to one topical drug may respond to another and alternatives should be tried before considering more aggressive treatment.

Topical medications like creams or ointments containing corticosteroids are the main medications used to manage acute flares of atopic eczema.

Pruritus (itching) is a common and distressing symptom of many skin disorders. Emollients may be useful and may be applied on the skin for management of pruritus. Preparations containing menthol, give a sensation of cold and analgesia, or topical corticosteroids may be also used to relieve pruritus when there is associated inflammation.

The most common medications prescribed by consultants and GP’s for skin conditions and problems are related to Pruritus (Itching) and can be commonly solved with emollients preparations like Dermacool menthol in aqueous cream at various strengths.