Dermovate-NN

How to order Dermovate-NN

1. Find the drug you need on our site.
2. Pick a clinic. See the price.
3. Fill in a short health form.
4. A doctor reads your form.
5. If it is safe for you, they say yes.
6. Your order ships fast to your door.
7. It comes in a plain, sealed box.

Why use us? We compare UK clinics. We show you the price and how fast they ship. We do not sell drugs. We just help you find the best one for you.

Is it safe? Yes. All our clinics are UK-based. A real doctor reads each form. They will not sell to you if it is not safe for you.

Dermovate-NN on Prescriptsy

Dermovate-NN is described on Prescriptsy as independent product information.

Here you can understand how online consultation works, what medical checks partner clinics carry out, and which factors matter when comparing providers.

We do not sell medicines directly, but help users compare licensed healthcare partners on price, delivery speed, service quality, and overall trustworthiness.

Dermovate-NN is a triple-combination topical medicine containing clobetasol propionate 0.05% (a very potent corticosteroid), neomycin sulphate 0.5% (an aminoglycoside antibacterial), and nystatin 100,000 units per gram (a polyene antifungal).

It is licensed in the United Kingdom for the short-term treatment of severe, resistant inflammatory skin conditions that are complicated by bacterial or candidal infection.

By combining the most potent topical corticosteroid with both antibacterial and antifungal agents, Dermovate-NN provides simultaneous control of inflammation and infection in a single preparation.

Severe inflammatory skin conditions such as recalcitrant eczema, psoriasis, and lichen planus are frequently complicated by secondary infection.

Disrupted skin barrier function, scratching, and immunological alterations create an environment that favours colonisation and invasion by Staphylococcus aureus, Streptococcus species, and Candida albicans.

The presence of infection perpetuates the inflammatory cycle, making the underlying dermatosis harder to control.

Dermovate-NN addresses both the infective and inflammatory components simultaneously, offering rapid symptom relief while eliminating the microbial contribution to disease persistence.

This page provides a comprehensive clinical overview of Dermovate-NN, covering how it works, correct use, side effects, safety warnings, and how to obtain a prescription in the UK.

Important safety information about Dermovate-NN

Before reading further, note the following essential safety points. Dermovate-NN is a prescription-only medicine (POM) and must only be used under medical supervision.

• Dermovate-NN contains the most potent topical corticosteroid available in the UK. Use the minimum amount for the shortest effective time, ideally no longer than 7 days and never exceeding 4 weeks.
• Do not use on the face, groin, or axillae unless under specialist supervision.
• Neomycin can cause allergic contact dermatitis. If the condition worsens during treatment, stop using Dermovate-NN and seek medical advice.
• The nystatin component treats Candida only; it is not effective against dermatophyte fungi (ringworm, athlete's foot).
• Do not use under occlusive dressings unless specifically directed by a dermatologist.
• Do not apply to viral skin infections, rosacea, acne, or perioral dermatitis.

Understanding infected inflammatory skin conditions

The relationship between skin inflammation and infection is bidirectional and clinically important.

Inflammatory skin diseases such as eczema compromise the skin barrier through epidermal disruption, altered lipid composition, and reduced production of antimicrobial peptides.

This creates an environment that promotes microbial colonisation.

Staphylococcus aureus colonises the skin of up to 90% of patients with atopic eczema, compared with around 5% of the general population.

Candida albicans thrives in warm, moist, macerated areas, particularly in skin folds, and is a frequent secondary coloniser in flexural eczema.

Once established, microbial colonisation exacerbates inflammation through several mechanisms. Staphylococcal superantigens activate T cells non-specifically, amplifying the immune response. Staphylococcal proteases further damage the skin barrier.

Candidal cell wall components activate innate immune pathways, contributing to ongoing erythema and pruritus. The result is a vicious cycle: inflammation promotes infection, and infection perpetuates inflammation.

Breaking this cycle requires simultaneous treatment of both components.

Using a potent corticosteroid alone on infected skin can suppress the visible signs of inflammation while allowing the infection to spread unchecked.

Conversely, using antimicrobials alone does not address the inflammatory driver.

Dermovate-NN's triple combination provides the logical pharmacological solution for the specific clinical scenario of severe, corticosteroid-resistant dermatosis complicated by bacterial and candidal infection.

How Dermovate-NN works: mechanism of action

Each of the three active ingredients in Dermovate-NN targets a different component of the disease process.

Clobetasol propionate 0.05%: anti-inflammatory action

Clobetasol propionate is the most potent topical corticosteroid in the UK formulary, classified as very potent (Group IV).

It binds to intracellular glucocorticoid receptors and modulates the transcription of genes involved in inflammation.

Key effects include suppression of pro-inflammatory cytokines (IL-1, IL-6, TNF-alpha), inhibition of prostaglandin and leukotriene synthesis via suppression of phospholipase A2, reduced leucocyte migration and accumulation at the inflammatory site, decreased capillary permeability, and inhibition of fibroblast proliferation.

These actions produce rapid and pronounced reduction in erythema, oedema, pruritus, and scaling.

Neomycin sulphate 0.5%: antibacterial action

Neomycin is an aminoglycoside antibiotic that inhibits bacterial protein synthesis by binding irreversibly to the 30S ribosomal subunit.

It is bactericidal against many Gram-negative organisms (including Escherichia coli, Klebsiella, and Proteus species) and some Gram-positive organisms, notably Staphylococcus aureus.

However, it is not reliably active against Pseudomonas aeruginosa or anaerobes. In the context of infected eczema and other dermatoses, its primary target is S.

aureus, the most common secondary bacterial pathogen.

Nystatin 100,000 units/g: antifungal action

Nystatin is a polyene antifungal that binds to ergosterol in the fungal cell membrane.

This binding creates transmembrane channels that allow leakage of potassium and other intracellular components, leading to fungal cell death. Nystatin is effective against Candida species, including C.

albicans, C. glabrata, and C. tropicalis. It is not absorbed systemically when applied topically and is not effective against dermatophyte fungi, which have a different membrane sterol composition.

Conditions treated with Dermovate-NN

Infected recalcitrant eczema

Severe eczema that has become secondarily infected with bacteria and/or Candida is the primary indication for Dermovate-NN.

Clinical signs of infection include weeping, crusting (particularly honey-coloured crust suggestive of staphylococcal infection), pustules, increased pain, satellite lesions (suggesting candidal involvement), and failure to respond to appropriate-strength topical corticosteroids.

In these cases, Dermovate-NN simultaneously suppresses the severe inflammatory flare, eliminates bacterial superinfection, and treats candidal colonisation.

Infected psoriasis

While less common than in eczema, psoriatic plaques can become secondarily infected, particularly in flexural areas or when the surface is fissured.

Dermovate-NN can provide short-term combined treatment, but should be used with particular caution in psoriasis due to the risk of rebound flare or pustular transformation on corticosteroid withdrawal.

Other severe infected dermatoses

Dermovate-NN may be considered for other severe inflammatory dermatoses complicated by mixed bacterial and candidal infection, including lichen simplex chronicus, contact dermatitis, and discoid eczema, where the severity warrants very potent corticosteroid treatment and infection is confirmed or strongly suspected.

How to apply Dermovate-NN correctly

Wash and gently dry the affected area before application.

Apply a thin layer of Dermovate-NN cream or ointment to the affected skin once or twice daily, rubbing gently until absorbed.

Use the fingertip unit method to ensure appropriate dosing. One FTU (approximately 0.5 g) covers an area of skin equal to two flat adult palms.

Apply only to affected areas.

Treatment should ideally be limited to 7 days.

If the infective component has been controlled but inflammation persists, switch to plain Dermovate (without the antimicrobial agents) or step down to a less potent corticosteroid.

Do not continue the antimicrobial components beyond the period needed to control infection, as prolonged neomycin use promotes resistance and increases sensitisation risk.

Do not apply to healthy skin, under occlusive dressings (unless specialist-directed), or to the face, groin, or axillae without specialist supervision. If no improvement is seen within 7 days, reassess the diagnosis and consider taking microbiological swabs or skin scrapings.

Side effects of Dermovate-NN

Local corticosteroid effects

The risks associated with the clobetasol propionate component are identical to those of plain Dermovate and are the primary safety concern.

Prolonged or inappropriate use can cause skin thinning, stretch marks, telangiectasia, purpura, delayed wound healing, pigment changes, and hypertrichosis.

These effects are more likely on thin-skinned sites and under occlusion. Striae are generally permanent.

Neomycin sensitisation

Allergic contact dermatitis to neomycin is well documented and occurs in approximately 1 to 6% of patients with chronic dermatoses.

It typically presents as worsening of the treated area (increased redness, vesiculation, oozing, pruritus) despite treatment.

Paradoxically, the corticosteroid component may partially suppress the allergic response, masking the allergy until the preparation is stopped, at which point a flare occurs.

If neomycin allergy is suspected, discontinue Dermovate-NN and arrange patch testing. Cross-sensitivity with other aminoglycosides is possible.

Systemic effects

Systemic absorption of clobetasol propionate can suppress the hypothalamic-pituitary-adrenal axis, particularly with extensive or prolonged use.

Features include Cushingoid changes, hyperglycaemia, and risk of adrenal crisis on abrupt withdrawal.

Systemic absorption of neomycin from large areas of damaged skin is a theoretical risk for ototoxicity and nephrotoxicity, but clinically significant systemic toxicity from topical neomycin is extremely rare with appropriate use.

When to seek medical advice

Stop using Dermovate-NN and contact your doctor if the treated area worsens, if you develop signs of skin thinning or stretch marks, if the infection appears to be spreading, or if you develop new symptoms.

Report suspected adverse reactions to the MHRA via the Yellow Card scheme at yellowcard.mhra.gov.uk .

Warnings and precautions

Very potent corticosteroid risks

All warnings applicable to plain Dermovate apply equally to Dermovate-NN. Do not exceed 50 g per week. Limit treatment duration.

Do not use on the face, groin, or axillae without specialist supervision. Do not apply under occlusion. Taper gradually after prolonged use.

Monitor children for growth and adrenal effects.

Neomycin resistance and allergy

Prolonged use of topical neomycin promotes the emergence of resistant organisms, including methicillin-resistant Staphylococcus aureus (MRSA). Keep treatment duration short.

If the infection does not respond to Dermovate-NN, take microbiological swabs to guide targeted therapy. Neomycin allergy is common; suspect it if the condition worsens during treatment.

Limitation of nystatin spectrum

Nystatin is effective against Candida species only. It does not treat dermatophyte infections (tinea).

If dermatophyte infection is suspected clinically (for example, annular lesions with raised scaly margins, positive KOH preparation), use an appropriate anti-dermatophyte agent such as miconazole, clotrimazole, or terbinafine instead.

Pregnancy and breastfeeding

Use Dermovate-NN with caution during pregnancy. Very potent topical corticosteroids should be used only when the benefit outweighs the risk.

Apply to the smallest area for the shortest time.

Neomycin has the potential for ototoxicity in the foetus if absorbed systemically in significant quantities, though this is very unlikely with appropriate topical use.

Do not apply to the breast area during breastfeeding.

Concurrent medications

If neomycin is absorbed systemically (primarily a concern with application to large areas of damaged skin), there is a theoretical risk of additive toxicity with other nephrotoxic or ototoxic drugs, including intravenous aminoglycosides, vancomycin, cisplatin, and loop diuretics.

Inform your prescriber of all current medications.

Dermovate-NN compared with other combination products

Several topical corticosteroid-antimicrobial combinations are available in the UK, differing in steroid potency and antimicrobial spectrum.

Daktacort (hydrocortisone/miconazole) is mild potency with antifungal coverage; Trimovate (clobetasone/oxytetracycline/nystatin) is moderate potency with antibacterial and antifungal coverage; Fucibet (betamethasone/fusidic acid) is potent with antibacterial coverage only.

Dermovate-NN sits at the top of this hierarchy as the only very potent combination, reserved for the most severe and resistant cases.

The choice of product depends on the severity of the inflammation (which determines the required corticosteroid potency), the type of infection present (bacterial, candidal, or both), and the site being treated.

Dermovate-NN should only be considered when less potent combinations have failed or when clinical severity clearly warrants very potent corticosteroid treatment from the outset.

How to get a Dermovate-NN prescription in the UK

Dermovate-NN is a prescription-only medicine.

Given its very potent corticosteroid content and the specialist nature of its indications, it is most commonly prescribed by dermatologists or GPs with experience in managing severe inflammatory skin disease.

The prescriber should confirm the diagnosis, document the failure of less potent treatments, and verify the clinical suspicion or confirmation of secondary infection before initiating Dermovate-NN.

The standard NHS prescription charge in England is currently 9.90 pounds per item; prescriptions are free in Scotland, Wales, and Northern Ireland.

When to seek medical advice

Contact your GP or dermatologist if the treated condition does not improve within 7 days, if it worsens during treatment, if you develop signs of skin thinning or allergy, or if the infection appears to be spreading.

Seek urgent medical attention if you develop a widespread skin reaction, signs of systemic infection (fever, malaise), or symptoms of adrenal insufficiency after stopping the medicine.

Report all suspected adverse reactions via the MHRA Yellow Card scheme at yellowcard.mhra.gov.uk .

Sources

• Dermovate-NN Cream, Summary of Product Characteristics (EMC)
• Clobetasol propionate with neomycin sulfate and nystatin, British National Formulary (BNF)
• NICE CKS: Corticosteroids, topical
• NICE CKS: Eczema, atopic
• Atopic eczema, NHS
• MHRA Yellow Card Scheme