Definition
What are ointments?
The ointments are preparations for external use of semi-solid consistency, formulated to be applied on healthy or sick skin or on mucous surfaces,
Classification
Ointments are not defined by the official pharmacopoeia and - included in the broader category of semi-solid preparations for skin application - are implicitly divided into ointments and creams, depending on the physical system of which they are made.
- Ointments: they are almost anhydrous preparations (ie with a low water content and very rich in fat), consisting of a base poor in water and rich in fatty and resinous substances. The peculiarity of the ointments is precisely that of having a significant content of fatty substances; for this characteristic, they are indicated in the treatment of dry, scaly dermatoses with a lichenoid and hyperkeratotic imprint (in general in all cases of marked cutaneous dryness, while they are contraindicated in the presence of significant skin inflammations, especially in the acute phase). They are not absorbed by the skin, but form a superficial layer on it, which is difficult to spread and particularly greasy; consequently, due to its occlusive and "barrier" properties, this layer of fat has an advantageous long-lasting emollient effect, with a reduction in TEWL. Being waterless, the ointments are generally very well preserved, making the use of preservatives superfluous.
- Creams : they are emulsions formed by two phases - oily (O) and aqueous (A) - of which one prevails over the other (in the more common O / A, the aqueous phase prevails and are therefore defined hydrophilic; in A / Or the fatty phase prevails and are therefore defined hydrophobic or lipophilic getting closer to the ointments). They are generally used as a carrier for medicaments, since above all the O / A emulsions are easily absorbed by the skin; the fatter ones, on the other hand, are rather greasy to the touch and are mainly used in products whose functionality is linked to the permanence on the skin surface, such as protective cosmetics for the sun, massage creams and barrier-effect creams. Containing water, the creams need preservatives.
PLEASE NOTE: in the common imagination, ointment is often understood as an ointment or as a lipophilic O / A cream; not surprisingly, it is generically described by the layman as a "fat cream".
Many authors include other semi-solid preparations for skin application in the category of ointments:
- Gels : they are liquids transformed into gelatinous masses through appropriate gelling agents, such as pectin, gum arabic, isinglass, tragacanth, cellulose derivatives, starch, carbomer, etc .; they are indicated in exudative forms, or if a transparent, non-fat and non-occlusive vehicle is desired, as well as pleasant and refreshing.
- Pastes : they contain a high proportion of solid substances reduced in powder (starch, calcium carbonate, kaolin, zinc oxide, vegetable powders etc.), which do not dissolve but are finely dispersed in the excipients (fat → fatty pastes - or aqueous) → aqueous pastes that include gelled water). Their main characteristic is that they are very absorbent, so they manage to retain harmful or unwanted substances, such as exudates typical of certain skin diseases or ammonia produced by bacterial alteration of urine. They are widely used in pediatrics as a protection for the gluteal-perineal region; think for example of zinc oxide pastes in irritative dermatitis, such as diaper dermatitis or perioral licking dermatitis
In their simplest formulation, ointments are made up of a simple base (such as vaseline, animal fat or beeswax) in which one or more active ingredients are dissolved or dispersed.
Among the lipophilic or oily excipients most commonly contained in the bases of the ointments are Vaseline, cocoa butter, beeswax, animal fat (suet or pork fat, cod liver oil or shark oil, spermaceti ...), almond oil, olive oil, sunflower oil, argan oil, jojoba oil; lanolin stands out among the hydrophilic excipients. Clearly the typical excipients of folk medicine (such as animal fats), although easy to find, have some rather limiting negative aspects, such as bad smell, ease of rancidity, therefore poor shelf life and excessive oiliness.
Preparation
How to make creams and ointments
On the market are available basic formulations in which to incorporate the active substances, making the preparation of ointments much easier and affordable for everyone (just ask the pharmacist, for example the Essex base cream). Alternatively, the inexperienced will have to take into account possible initial failures, even following the recipe recommendations to the letter; in fact different tests are needed to "catch the eye" and correct the original recipes if necessary:
- in general the oily bases (for ointments or ointments understood as "fat creams") are prepared by bringing to fusion the lipidic bases by placing them inside a saucepan (preferably glass), gently heated in a bain-marie; you can only use a solid or semi-solid lipidic or waxy substance (lanolin, hen or pork fat, beeswax, etc.), or mix it with a part of the oil (those of olive and sweet almond are widely used). Once the oily base has melted, add the vegetable extracts and mix everything for a few minutes, continuing to heat over a low heat. It is filtered with a cloth or a gauze making the molten liquid come out, which once solidified inside the jars will take on a semi-solid or solid consistency.
- the creams need a more articulated and complex preparation to prevent the two phases (aqueous and oily) from separating. In essence, it is like preparing a mayonnaise, so the use of an immersion mixer can help, while the emulsifiers (which are given by egg lecithins in mayonnaise) are used to prevent the phases from separating. In addition to the fat part, it is therefore necessary to add a certain percentage of water and an aqueous base (such as glycerine). A recipe for an A / O cream involves the fusion of about 150 grams of pure beeswax placed in a glass jar heated in a bain-marie, after which, vigorously mixing, 70 g of glycerin and 80 ml of water are added; at this point vegetable extracts are also added, stirring and then left to simmer over a low heat for a few tens of minutes (again using the bain-marie); everything will then be filtered with gauze and mixed until it has cooled and thickened like a cream. To invade and to mix with the help of a spatula: to first put some cream around the edge, therefore to fill the center of the container. The "leaner" preparations are often more problematic and require the addition of specific emulsifiers such as glyceryl stearate.
PLEASE NOTE: to test the consistency of the ointment or cream, during the processing it is possible to drop a few drops of the mixture on a cold plate: if the sample remains too soft, a certain amount of thickener is added (eg cocoa butter, beeswax or lanolin); if, on the contrary, it is too dense, an additional quantity of water or oil must be added.
Natural ingredients
Among the most used plant extracts in the formulation of phytotherapeutic ointments we find:
- marigold extracts: against redness, cuts, burns, sunburn, venous circulatory disorders (varicose veins, phlebitis, haemorrhoids) and bedsores. When applied locally, the calendula accelerates healing and hinders inflammation and staphylococcal infections; finally it improves the skin spray making the skin more elastic, therefore more resistant to mechanical insults.
- horse chestnut extracts, centella, witch hazel: hemorrhoids, varicose veins, tired and heavy legs, fragile capillaries
- propolis: antiseptic action, antibiotic
- hypericum: softening, healing, anti-inflammatory action
- arnica montana, devil's claw, willow, uncaria, spirea: anti-inflammatory action against bruises and rheumatism
Important recommendations for those wishing to produce ointments directly at home
To produce ointments in your own home - where the technologies and tools in a laboratory or in an industry are certainly not available - you need to follow some guidelines, so as to avoid getting unsuitable products (for consistency, smell, etc. .), or worse, dangerous to health.
- first and foremost cleaning: to ensure the effectiveness and durability of homemade creams and ointments it is necessary to carefully clean the worktops, utensils, containers, etc. This implies their "sterilization" in boiling water, with the possible use of detergent which in any case must be rinsed thoroughly and with particular care.
- prefer glass containers over metal ones
- prefer dark glass jars for storage
- the fusion of fats must be carried out in a bain-marie over a low heat, reaching the minimum complete melting temperature (the oils are very delicate, and even more so are the vegetable extracts added in the ointments)
- protect yourself with gloves or pot holders to avoid getting burned when handling hot mixtures
- in general, homemade creams and ointments are kept for a short time (as they do not normally require the use of specific preservatives); therefore, better keep them in the refrigerator and avoid using them a couple of months after production
- in the preparation of creams (emulsions) prefer the use of minimally mineralized bottled water to tap water
- become aware of the possible side effects (see the following chapter); in any case, avoid self-treatment.
Examples
Examples of Galen formulations and DIY pomades
In addition to commercial products available in pharmacies, in literature there are recipes for numerous galenic preparations, handed down over the centuries by folk medicine and particularly sought after by internet users interested in natural medicine and phytocosmetics. The preparation of these ointments should take place exclusively in pharmacies or herbal medicine, with dispensing to the patient following specific advice from the doctor or from the same pharmacist or herbalist.
In fact, simple and commonly used ingredients could be contraindicated in certain circumstances and trigger important side effects.
- In general, these products should not be applied to open wounds (unless otherwise indicated): talc is not used on open lesions due to the possible onset of granulomas; similarly, the application of mineral oils (Vaseline, paraffin) on open wounds could cause the appearance of paraffinomas.
- Maximum caution in atopic patients (subject to allergies); possibly test the tolerability of the preparation by applying it in small quantities to the skin of the forearm; if there are swellings or redness in the area of application, avoid using them.
- Attention to sun exposure in case of application of photosensitizing preparations, even if natural (eg hypericum, often included in healing and anti-inflammatory ointments)
- Any essential oils should never be used pure, but properly diluted (1-2%)
Below are some examples of galenic and commercial ointments, reaffirming that their preparation and indication is exclusively for qualified doctors, pharmacists and herbalists. On the one hand, these are examples taken from traditional and popular phytotherapeutic recipe books, whose therapeutic value is generally bland and whose safety profile must be assessed in the specific case by an expert before use; on the other hand, an immediate comparison with commercial preparations is possible.
Pomades Against Hemorrhoids and Anal Rhagades
| EXAMPLES OF GALENIC PATIENTS | EXAMPLE OF PHARMACEUTICAL POMATE |
Achillea pomade against hemorrhoids
Preparation: prepare an ointment by heating the drugs in 10 gr. of melted lard for bain-marie. It is left to rest, after having turned the whole thing, and it is heated in the same way the next day. Then it is filtered hot through a linen cloth, put into a glass jar and stored in the refrigerator. Massage the painful part with this ointment. | Rectogesic 4mg / g Rectal Ointment - indicated to relieve pain associated with chronic anal fissure One gram of rectal ointment contains 40 mg of trinitroglycerin in propylene glycol corresponding to 4 mg of trinitroglycerin (TNG). Approximately 1.5 mg of TNG are contained in 375 mg of this formulation. In each gram of rectal ointment are also contained 36 mg of propyleneglycol and 140 mg of lanolin. A dose of 4 mg / g ointment contains 1.5 mg of trinitroglycerin. This dose should be applied intra-anal every twelve hours. Treatment can be prolonged until the pain is reduced, up to a maximum of 8 weeks. |
Horse chestnut pomade against hemorrhoids
Preparation: by simple cold incorporation of the extracts in the base cream (EF means fluid extract, found in the pharmacy) | Doxiproct - Pomade for topical use. 100 g of ointment contain: Active principles:
Excipients: polysorbitan monoleate, propylgallate, butylated hydroxyanisole, anhydrous citric acid, cetyl alcohol, polyethylene glycols, propylene glycol. Suitable for internal and external hemorrhoids. Anal itching. Anite, perianite, cryptite, papillitis, acute hemorrhoidal thromboses, fissures. Pre and post operative treatment of hemorrhoidectomy. Hemorrhoids of pregnancy. |
Astringent ointment against hemorrhoids and varicose veins
| POMATA RECTO-REPARIL GEL 1% 100 g of ointment contain: Active ingredients: escin g 0.5, Tetracaine hydrochloride g 4.5. Excipients: Polyglycolic cotenside of fatty acids 2.0 g, polyglycolic ester of 21 g fatty acids, polyglycol ester of 3 g saturated fatty alcohols, 7 g fatty acid partial glyceride, 0.1 g methyl-p-hydroxybenzonate, ethylene ester of g linol-linoleic acid 20 g, anoxid SBN g 0.5, deionized water 41.4 g. Indicated for: anorectal varicose syndrome, external and internal hemorrhoids; Hemorrhoid complications: anal congestion, anal itching. Proctitis. Anal fissures. |
Ointment against anal itching
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Pomades Against Varicose Veins
| EXAMPLES OF GALENIC PATIENTS | EXAMPLE OF PHARMACEUTICAL POMATA |
An ointment is prepared by mixing the drug with 200-300 g of heated pork lard. Pour it in hot oil and stir it all up frying briefly. It is left to rest for 4-5 hours then the mixture is warmed slightly and filtered by keeping it in glass jars. Use: massage the affected limbs with ointment once a day. | VENOSMINE ointment 100 g of ointment contain: Active ingredient: diosmin g 4. Excipients: semisynthetic glycerides (softisan 100), anionic emulsifying wax (lanette SX), anhydrous lanolin, polysorbate 80, dimethyl polysiloxane 100, dimethyl polysiloxane, methyl p-hydroxybenzoate, propyl p-hydroxybenzoate, lemon essence, purified water. Indicated for topical treatment of varicose disease (varicose ulcers, phlebitis, superficial venous thrombosis, malleolar edema, superficial venous stasis ...). Adjunct in the treatment, in general, of capillary fragility states and their manifestations (ecchymoses, hematomas, purpura ...). |
POMATA AGAINST CAPILLARY FRAGILITY
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Ointments Against Dermatitis
| EXAMPLES OF GALENIC PATIENTS | PHARMACEUTICAL |
Pasta Lassar (fatty paste)
Suitable for surfaces and intertriginous areas, diaper dermatitis, irritative and macerative intertrigines, chronic and lichenified eczema in the post-critical phase (nummular eczema, prurigo, rubbing), dry dehydrosis, hand eczema, etc. Well adherent to the skin it is not removed with water but with oil. | Dermatop 0.25% lipophilic cream 1 g of cream contains: prednicarbate 2.5 mg. Excipients: Purified water, edetic acid, monoleate glycerol, magnesium sulfate hydrate, octyldodecanol, white vaseline Indicated for Dermatosis, including contact dermatitis, atopic dermatitis, seborrheic eczema, psoriasis, psoriasis of the head and in general all inflammatory cutaneous forms sensitive to topical corticosteroid therapy. |
Pomades Against Burns and Burns
| EXAMPLE POMATA GALENICA | EXAMPLE OF PHARMACEUTICAL POMATA |
Calendula ointment
It is applied to margins and burns because it hastens the healing process. | FOILLE SCOTTATURE 100 g of cream contain: Active principles: benzyl alcohol 4 g benzocaine 5 g chloroxylenol 0.10 g. Excipients: Hydrogenated vegetable oil, ceresin (solid paraffin), yellow beeswax, monodiglycerides (of higher fatty acids), corn oil, calcium hydrate, sodium borate, PEG 32, sodium lauryl sulfate, maleic anhydride, eugenol, sodium calcium EDTA, 8-hydroxyquinoline, purified water. Suitable for minor burns, sun rashes, skin irritations from various chemical-physical agents, insect bites. In the dressing of excoriations, abrasions and superficial skin wounds. |
Pomades Against Rheumatism and Joint Pain
| EXAMPLE POMATA GALENICA | EXAMPLE OF PHARMACEUTICAL POMATA |
Arnica ointment
Suitable for insect bites, hematomas and sprains. | LASOARTRO 5% CREAM 100 g of cream contain: active ingredient: ketoprofen lysine salt 5 g Excipients: Stearic acid, purified water, lanolin, methyl p-hydroxybenzoate, methylpolysiloxane, polyethylene glycol monostearate, vaseline oil, propyl p-hydroxybenzoate. Indicated for the symptomatic treatment of acute painful episodes in progress during inflammatory diseases of the musculoskeletal system. Treatment of local painful inflammatory diseases. |
Pomades Against Psoriasis
| EXAMPLE GALENIC POMATE | EXAMPLE OF PHARMACEUTICAL POMATA |
Alternative forum
For external use 1-2 times a day. | Cortical cream 0.2% 100 g of cream contain: Active ingredient: diflucortolone valerianate g 0.2 Excipients: polyethylene glycol monostearate g 3, stearyl alcohol g 8, liquid paraffin g 10, white vaseline g 10, sodium edetate g 0.1, carboxypolymethylene g 0.3, sodium hydroxide 0.067 g, methyl p-hydroxybenzoate g 0.07, propyl p-hydroxybenzoate 0.03 g, purified water qb g 100. Indications: resistant localized plaques of: psoriasis, lichenification, discoid lupus erythematosus, hypertrophic lichen. Hypertrophic scars |
