Psoriasis treatments: Antifungals

Adcortyl contains triamcinolone acetonide, a potent topical corticosteroid, together with the antibiotics gramicidin and neomycin sulphate, and the antifungal nystatin. It is used for inflammatory skin conditions where bacterial and/or fungal infection is present or likely to occur, and where treatment with a potent topical corticosteroid is appropriate. It may be used for psoriasis only when this is considered appropriate by a specialist because potent topical corticosteroids can worsen some forms of psoriasis.

How does it work?

When triamcinolone is applied to the skin it works by acting inside the skin cells to decrease the release of these inflammatory substances. This reduces swelling, redness and itch.

Neomycin sulphate is a type of antibiotic called an aminoglycoside. It works by entering bacterial cells and interfering with the production of proteins that the bacteria need to divide and multiply. It doesn’t directly kill the bacteria, but leaves them unable to increase in numbers. The existing bacteria eventually die or are destroyed by the immune system.

Gramicidin is a different type of antibiotic, and the combination of these two antibiotics provides treatment against a wide variety of bacteria that may infect the skin.

Nystatin is an antifungal medicine. It kills fungi and yeasts by interfering with their cell membranes. Nystatin works by binding to a substance called ergosterol, which is a component of fungal cell membranes. Binding to ergosterol disrupts the cell membrane and causes holes to appear. The cell membranes of fungi are vital for their survival. They keep unwanted substances from entering the cells and stop the contents of the cells from leaking out. As nystatin causes holes to appear in the cell membranes, essential constituents of the fungal cells can leak out. This kills the fungi.

Who can get it?

Suitable for adults and children over 1 year of age. It is available on prescription as a cream or an ointment.

How is it used?

Apply a thin layer to the affected area twice daily, or as directed by your healthcare professional. Treatment should be used for the shortest time necessary. If the condition does not improve within 7 days, treatment should be reviewed by the prescriber.

What are the side effects?

Triamcinolone Acetonide:

The following side effects have been reported. Usually with prolonged usage: skin effects - impaired wound healing, thinning of the skin, petechiae and ecchymoses, facial erythema and telangiectasia, increased sweating, purpura, striae, hirsutism, acneiform eruptions, lupus erythematosus-like lesions and suppressed reactions to skin tests. These effects may be enhanced with occlusive dressings.

The possibility of the systemic effects which are associated with all steroid therapy should be considered. These include reversible hypothalamic-pituitary-adrenal (HPA) axis suppression, signs of Cushing’s syndrome, hyperglycaemia and glucosuria in some patients. Following discontinuation, recovery of HPA axis function is generally prompt and complete.

Neomycin:

Sensitivity reactions may occur especially with prolonged use. Ototoxicity and nephrotoxicity have been reported. The product should be used with caution and in small amounts in the treatment of skin infections following extensive burns, trophic ulceration and other conditions where absorption of neomycin is possible. The product should be used with care in patients with established hearing loss. Prolonged use may increase the risk of allergic contact dermatitis.

Gramicidin:

Sensitivity has occasionally been reported.

Nystatin:

Allergic reactions to topical nystatin are uncommon but can occur.

Other warnings

• Do not use under airtight dressings unless advised.
• Avoid prolonged use.
• Avoid use on the face unless specifically advised.
• Avoid contact with the eyes.
• Do not use on untreated viral infections such as cold sores or chickenpox.
• Potent steroids should be used cautiously in psoriasis because of the risk of rebound flares and pustular psoriasis.

Marketed by

Adcortyl is marketed in the UK by Bristol Myers Squibb Pharmaceuticals Ltd (formerly Bristol-Myers Squibb Pharmaceutical.

Reviewed: August 2026

Version ID: 2/ADC/PST/08/26

Canesten HC Cream contains clotrimazole, an antifungal medicine, together with hydrocortisone 1%, a mild topical corticosteroid. It is used to treat fungal skin infections where there is also inflammation, redness and itching.

How does it work?

Hydrocortisone reduces inflammation, redness and itching while it is being used. It helps relieve symptoms but does not treat the underlying fungal infection, which is why it is combined with clotrimazole. Topical corticosteroids are often prescribed as first-line treatment because they are effective.

Clotrimazole treats fungal skin infections by damaging the fungal cell membrane, helping to eliminate the infection.

Who can get it?

Canesten HC Cream can be bought from pharmacies without a prescription or prescribed by a healthcare professional. It is suitable only for certain fungal skin infections and should not be used for longer than seven days without medical advice. If you or your child has had an allergic reaction to any similar medicine you should not use it.

How is it used?

Canesten HC Cream should be thinly and evenly applied to the affected area twice daily and rubbed in gently. Treatment should be for a maximum of 7 days. There is no separate dosage schedule for the elderly or the young. However, long-term therapy to extensive areas of skin should be avoided particularly in infants and children. Wash your hands before and after applying the cream unless the hands are being treated.

What are the side effects?

• burning or stinging
• irritation
• itching
• redness
• dry skin
• allergic skin reactions

Rare with prolonged use:

• skin thinning
• stretch marks
• acne-like rash
• visible blood vessels
• changes in skin colour
• adrenal suppression (very rare)

Important precautions

• Do not use for more than seven days unless advised by your healthcare professional.
• Avoid applying to large areas of skin.
• Do not cover with airtight dressings unless advised.
• Avoid contact with the eyes.
• Take extra care when using in infants, as nappies can act like occlusive dressings and increase absorption of hydrocortisone.

Canesten HC should not be used for:

• acne
• rosacea
• perioral dermatitis
• untreated bacterial infections
• untreated viral infections such as cold sores or chickenpox
• tuberculosis affecting the skin

Marketed by

Canesten HC is available as a cream and it is marketed in the UK by Bayer plc

Reviewed: August 2026

Version ID: 2/CAN/PST/08/26

Daktacort Hydrocortisone cream is a mild topical corticosteroid broad-spectrum antifungal and anti-bacterial cream containing the active ingredients hydrocortisone and Miconazole. It belongs to the group of medicines for application to the skin called topical corticosteroids combinations which should not be confused with anabolic steroid tablets or injections which can be misused by some athletes. Topical corticosteroids have been shown to reduce the itching, redness and inflammation of certain skin problems

How does it work?

Topical Corticosteroids suppress the inflammatory reaction during use; they are not curative and on discontinuation a rebound exacerbation of the condition may occur. They are generally used alongside topical corticosteroids to relieve symptoms and suppress signs of the disorder when other measures such as emollients are ineffective.

Topical corticosteroids are often prescribed as first-line treatment. Daktacort reduces inflammation while miconazole treats the fungal infection.

Miconazole works by damaging the fungal cell membrane, causing the fungi to die. It also has activity against some Gram-positive bacteria that may be present in infected skin.

Who can get it?

Daktacort HC is available on prescription. It should not be used in the following conditions:

• On open wounds
• On large areas of skin
• Used for longer than 7 days
• To treat cold sores and acne
• Use on the face, eyes and mucous membranes
• On the ano-genital region unless prescribed by a doctor
• To treat secondary infected conditions unless prescribed by a doctor
• Hypersensitivity to any of the excipients
• Untreated viral skin infections (for example, cold sores, chickenpox or shingles)
• Tuberculosis affecting the skin
• Skin reactions following vaccination
• Rosacea Perioral dermatitis

How is it used?

Apply a thin layer to the affected area two or three times a day for up to seven days, or as directed by your healthcare professional. Wash your hands after applying the cream unless your hands are being treated.

What are the side effects?

Side effects

• burning or stinging
• itching
• irritation
• allergic skin reactions
• skin thinning with prolonged use
• acne-like rash
• changes in skin colour

Warnings

• avoid prolonged use
• avoid large areas
• avoid occlusive dressings
• avoid contact with eyes

How do I get Daktacort?

Daktacort Cream is available on prescription from a healthcare professional.

Marketed by

It is marketed in the UK by Janssen-Cilag Ltd.

Reviewed: August 2026

Version ID: 2/DAH/PST/08/26

Timodine Cream contains hydrocortisone, a mild topical corticosteroid, together with nystatin, an antifungal medicine, benzalkonium chloride, an antiseptic, and dimeticone, which helps protect the skin. It is used to treat inflamed skin conditions where Candida infection is present or likely, such as infected eczema, intertrigo and infected nappy rash. It belongs to the group of medicines for application to the skin called topical corticosteroids combinations which should not be confused with anabolic steroid tablets or injections which can be misused by some athletes. Topical corticosteroids have been shown to reduce the itching, redness and inflammation of certain skin problems.

How does it work?

Topical Corticosteroids suppress the inflammatory reaction during use;. They are generally used to relieve symptoms and suppress signs of the disorder. Timodine Cream contains hydrocortisone, a mild topical corticosteroid, together with nystatin, an antifungal medicine, benzalkonium chloride, an antiseptic, and dimeticone, which helps protect the skin. It is used to treat inflamed skin conditions where Candida infection is present or likely, such as infected eczema, intertrigo and infected nappy rash.

Nystatin

Nystatin works by damaging the cell membrane of fungi and yeasts, helping to clear Candida infections. Dimeticone

Dimeticone forms a protective barrier over the skin, helping to reduce irritation from moisture and other irritants. Hydrocortisone

Hydrocortisone is a mild, but effective anti-inflammatory agent.

Benzalkonium chloride

Benzalkonium chloride is an antiseptic that helps reduce bacteria on the skin.

Who can get it?

Timodine is available on prescription for adults and children.

Timodine should not be used in:

• viral skin infections (for example, cold sores or chickenpox)
• tuberculosis affecting the skin
• acne vulgaris
• rosacea
• perioral dermatitis

How is it used?

For topical application to the skin.

Adults (including the elderly) and children

Dermatoses: Sufficient Timodine should be applied to cover the lesion in a thin layer. It should then be massaged into the skin until the cream disappears. The treatment should be repeated three times a day until the lesion has healed. There is no indication that dosage need be modified for the elderly. Your doctor may tell you to cover this with a special "occlusive" dressing, but this is not usually necessary.  Wash your hands after applying the cream unless your hands are the area being treated.

What are the side effects?

• skin thinning
• irritation
• infection worsening
• pigment changes
• acne
• burning
• itching
• rash
• allergic contact dermatitis
• redness
• swelling
• hypersensitivity reactions
• adrenal suppression (rare after prolonged or extensive use)
• blurred vision (rare corticosteroid effect)

Warnings

• avoid prolonged use unless advised
• avoid contact with the eyes
• avoid applying to large areas unless directed
• seek medical advice if the condition worsens or does not improve

Marketed by

Timodine is marketed in the UK by Alliance Pharmaceuticals Ltd

Reviewed: August 2026

Version ID: 2/TIM/PST/08/26