Topical treatment is often possible

A peculiar aspect of dermatology is the option for topical treatment. This treatment modality is ideally suited to localised lesions, the main advantage being the restriction of the effect to the site of application and the limitation of systemic side-effects. A topical agent is usually described as a vehicle and an active substance, the vehicles being classified as powder, grease, liquid or combinations such as pastes and creams.

Much traditional topical therapy in dermatology has been developed empirically with so-called magistral formulations. Most of these products seem to rely on physical rather than chemical properties for their effects and it may be an arbitrary decision to consider one specific ingredient as the "active" one. Physical effects of topical agents may include cleansing, hydration and removal of keratotic scales. The border between pharmacological and cosmetic effects may be blurred and the term "cosmeceuticals" is sometimes used.19 In addition to drug treatment, various non-drug treatment modalities exist, including phototherapy and photochemotherapy, and minor surgical procedures such as electrodesiccation and cryotherapy. Large variations in treatment modalities for the same condition mainly reflect local traditions and preferences.20,21

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