Why Prescription Creams and Ointments Don't Help Your Dermatitis As Much As They Should


It’s important to understand that many prescription products in Dermatology have been developed with the understanding that “we are to get away from it as soon as we can.” However, the concept of entirely healing both skin and the epidermal barrier functions was never in the equation!


The Problem With Prescription Products In Dermatology


Many prescription products have been developed with less than optimal vehicles (the base cream, ointment, or lotion that carries the Active Ingredient). The product developer sought penetration into the active ingredient’s skin, so they used harsh solvents like propylene glycol in the base lotion. A solvent ingredient will increase the penetration of the Active ingredient into the skin but seldom contribute to the “healing progress” of the skin. When tested by the FDA, the result is a powerful antibiotic or anti-inflammatory effect on the skin. Unfortunately, “complete healing” is not an endpoint of the study. Complete healing is rarely an endpoint in an FDA study. In reality, making progress towards complete healing of the skin is hampered by the harshness of the solvent ingredient and the shortcomings of the base vehicle.


Dr. Harlan's Approach


Dr. Harlan actually does sometimes order products with Propylene glycol for initial periods of treatment if the patient has no allergy to it. However, he does not use it for the continued “healing progress” of the skin. For this, he relies on moisturizers SmartLotion®, eliminating the factors contributing to harming the skin or inciting inflammation.


The developer of a prescription product might also have been concerned that a very healing vehicle might produce confusion in the efficacy studies of the Active ingredient. For example, when submitting studies to the FDA, if the vehicle is significantly healing it might produce results by itself that are almost as good as the vehicle with the Active ingredient. This potentially could reduce the difference in results between the two versions, when the developers want a large and significant difference between the version with the Active and the version with the vehicle by itself.


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The Power Of SmartLotion


SmartLotion® is designed to counteract the harshness in many prescription dermatology products without adding side effects. It offers a vehicle that can be used, along with proper cleansing and moisturizing, after the pharmacist has instructed the prescription product should be discontinued. Continuing to treat the symptoms is essential so that further healing occurs. It can be started before the discontinuation of the prescription product and overlap, which increases the likelihood of continued “healing progress” when the prescription product is phased out. The patient need not worry so much about the vehicle in the prescription because SmartLotion® is taking over the healing responsibilities. 


In addition to helping Prescription strategies to work better, SmartLotion® is a stand-alone product for itching related to inflammation and dermatitis. It directly addresses Seborrheic dermatitis and treats it effectively as a stand-alone product, used with good cleansing of the face and scalp. But it’s also a product enhancer for use with a large number of prescription products for inflammation and immune dysregulation.


Managing The Symptoms Of Dermatitis With An Overlap


Many people with atopic dermatitis will never fully heal and stay in remission by putting a solvent on their skin or a greasy ointment that holds in heat and retains redness. Many providers writing prescriptions do not understand that atopic dermatitis patients will stay red with a greasy ointment, and the barrier functions of their skin will be less likely to heal with a greasy ointment fully. Therefore, when patients are prescribed a greasy ointment, it’s often essential for them to “overlap therapy” and to get away from the ointment as soon as they can.


More patients have done well because they better tolerate strong prescriptions to get a response, and then they have something to use when they are supposed to be tapering off the strong prescription product.


SmartLotion® replaces the soothing healing ingredients often left out of the vehicle. In addition, it counteracts the solvent-like penetration enhancers the developer added.


Skin Barrier Problems Are Persistent


When a dermatitis or psoriasis patient stops or tapers off a prescription with penetration enhancers, they still have barrier problems and damaged skin. In addition, they often have irritating yeast and bacteria living on the surface. When patients taper off SmartLotion®, they have a better-healed skin barrier and microbiome. 


A gradual taper over a month or two of SmartLotion® is ideal for many of Dr. Harlan’s patients. A taper can mean tapering to once a day with supervision by your dermatologist, a taper to 3 days a week maintenance, or a taper completely off SmartLotion®, but continuing daily moisturizing.


It’s helpful to have a product that heals the epidermis and its barrier functions, while improving the microbiome with Prebiotic properties. 


Please check out our blog for more insight into the world of eczema and dermatological concerns. In addition, you could visit our home page to see what people think about SmartLotion® or the long-term safety study if you were wondering about its efficacy over time.