Skinfect-B

Skinfect-B puts two kinds of medicine in one tube: betamethasone valerate 0.1%, a corticosteroid, and gentamicin sulfate 0.1%, an antibiotic. It is made by Bangkok Drug in a 15 g tube.

Betamethasone cream eases swelling, redness and itching. Gentamicin cream kills bacteria on the skin and prevents and treats infection. Together they suit inflamed skin when bacteria are also present.

This page follows Health Canada documents for a cream with the same two ingredients (Valisone-G), the NHS and MedlinePlus. No online package insert for Skinfect-B was found, so read the leaflet in the box too.

The box label says it is for skin diseases that respond to corticosteroids, when a bacterial infection is present or suspected. Documents for the same two-ingredient cream give these examples:

• Contact dermatitis (irritant or allergic)
• Seborrheic dermatitis (scaly, greasy patches)
• Neurodermatitis (itchy skin scratched repeatedly)
• Intertrigo (rash in skin folds)
• Stasis dermatitis (leg rash from poor blood flow) and psoriasis

The antibiotic part is for this purpose only, to limit resistant bacteria. So it is not an open-wound cream or a cream for fungal rashes. Who must not use it is in the precautions tab.

Use it as a pharmacist or doctor advises. General information:

• Amount and frequency — Health Canada's documents for the same cream say a thin film over the whole area, 2 or 3 times a day. The NHS says to follow the leaflet with a steroid and antibiotic cream, so read the one in the box too.
• How to apply — thin layer, smoothed in the direction the hair grows, over all the irritated skin. Not on broken skin or cuts. Wash your hands afterwards.
• Amount per area — one fingertip unit covers about twice the size of your palm.
• Bandages and plasters — do not cover the skin unless a doctor says so, as side effects rise. If told to, wait at least 10 minutes after applying.
• Apply as advised — even if the skin improves quickly, no more or less than advised, and do not share the tube.
• Fire — dried cream on clothes or bedding burns more easily; avoid flames and smoking.
• Storage — 15-30°C, away from children, not in the bathroom.

Side effects mostly occur where it is applied, and more with a lot of cream, long use or covering.

• Less common — burning, itching, dryness, inflammation around hair follicles and the mouth, extra hair growth, acne, skin colour change
• When covered with a dressing — skin breaking down, secondary infection, thin skin, stretch marks, heat rash
• From gentamicin — mild redness and itching in a few people, and sun sensitivity in some
• From steroid absorption — suppressed adrenal glands, a rounded face, stretch marks, slower growth in children

Stop and see a doctor straight away for an allergic reaction (rash, hives), signs of a new or worsening skin infection such as swelling, warmth, yellow oozing fluid or more redness, or heavy tiredness with unusual thirst and urination. If your lips, mouth or throat swell, or you struggle to breathe, call emergency services.

• Allergy — do not use if allergic to either ingredient or to the tube materials.
• Viral skin diseases and skin tuberculosis — do not use (for example chickenpox, herpes simplex).
• Eyes — never in or near the eyes.
• Large areas, long use or covering — the ingredients can be absorbed through the skin. Health Canada advises kidney function tests before and during such treatment, especially for infants and children.
• Kidney failure or hearing-nerve damage — too much gentamicin in the blood can permanently affect balance in these people. None was seen from the cream, but tell a pharmacist or doctor first.
• Irritation or a new infection — stop and get advice.
• Other steroid medicines — tell a pharmacist or doctor if you use one.
• Stopping after long use — burning and redness can occur; a doctor may reduce the cream step by step.

Pregnancy, breastfeeding, children and the face are covered in the questions below.

• Fucidin H (Fusidic acid + Hydrocortisone) — the closest match, also a steroid and antibiotic. Pick it when a doctor or pharmacist advises that ingredient pair.
• Myda-B (Clotrimazole + Betamethasone) and Canasone-CB (Clotrimazole + Betamethasone) — a steroid with an antifungal. Pick them when the rash is fungal, not bacterial.
• Fucidin Cream (Fusidic acid) and Bactex Ointment (Mupirocin) — antibiotic only, no steroid, for infected wounds.

In short: inflamed skin with bacteria present fits the steroid and antibiotic type such as Skinfect-B or Fucidin H. A fungal rash fits the steroid and antifungal type. An infected wound that needs no anti-inflammatory fits an antibiotic alone. If unsure, ask a pharmacist first.

Do not put other skin products on the same area without asking a doctor or pharmacist. If you need a moisturiser or another cream, wait at least 30 minutes after applying Skinfect-B.

Tell a pharmacist or doctor if you use another steroid, applied, swallowed or injected, because steroids can be absorbed. Mention other medicines you take too.

Tell any doctor who treats you later that you have used a corticosteroid before.

The documents checked give no exact time for this combination cream. For each ingredient on its own:

• Gentamicin — symptoms should start to improve in the first few days. If they do not, or they get worse, call a doctor (MedlinePlus).
• Betamethasone cream — tell a doctor if the skin gets worse or does not improve within 2 to 4 weeks (5 days for a child) (NHS).

Because this cream contains an antibiotic, keep the use as short as possible. If the skin gets worse or does not improve within a few days, stop and see a doctor rather than keep applying it in the hope it settles.

Where can you buy Skinfect-B?

Order online from Intimo Life, shipped across Thailand in 1-3 working days. Packed discreetly for privacy, with no product name on the parcel.