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# Other dermatological medicines

Skin medicines with their own mechanisms: benzoyl peroxide for acne, vitamin D analogues and tar for psoriasis, imiquimod for warts and skin cancers.

Updated Nov 1, 2026

## What they are

A mixed group of topical medicines grouped by use rather than by target: antimicrobial and comedolytic agents for acne (benzoyl peroxide, azelaic acid), drugs that slow skin turnover in psoriasis (calcipotriol, coal tar), immune response modifiers (imiquimod), keratolytics that loosen scale (salicylic acid, urea) and cytotoxic wart paints (podophyllum resin). Topical corticosteroids have their own class page and are chosen by potency.

## Mechanism of action

Each works differently. Benzoyl peroxide is an oxidising antibacterial that is also mildly comedolytic. Calcipotriol binds the vitamin D receptor, which pairs with RXR and switches genes for epidermal differentiation and inflammation. Imiquimod acts at toll-like receptor 7 and makes immune cells release interferon-α, TNF-α and interleukins. Salicylic acid loosens the bonds between cells of the stratum corneum, and podophyllotoxin binds microtubules and arrests wart cells in mitosis.

Target: Varied: bacterial oxidation (benzoyl peroxide), vitamin D receptor (calcipotriol), toll-like receptor 7 (imiquimod), stratum corneum (keratolytics), tubulin (podophyllotoxin)

## Key points

- Topical corticosteroid potency in words: mild (hydrocortisone), moderate, potent (betamethasone valerate) and very potent (clobetasol). The weakest that works is used on the face, the folds and the genitals, and very potent ones only for short periods.
- Potent topical steroids for long periods, on large areas or under occlusion cause skin atrophy, striae, telangiectasia, perioral dermatitis and even adrenal suppression; fluorinated steroids are kept off the face.
- Benzoyl peroxide is added to topical or oral antibiotics for acne to reduce the emergence of antibiotic-resistant bacteria; it bleaches hair and fabric.
- Calcipotriol over the allowed weekly amount can cause hypercalcaemia; it is kept off the face and is inactivated by salicylic acid.
- Imiquimod treats external genital warts, actinic keratoses and superficial basal cell carcinoma; it weakens condoms and diaphragms.

## Drugs in this class

- [**Benzoyl peroxide** An oxidising gel or wash that kills acne bacteria and loosens blackheads. Added to antibiotics to limit resistance; it… Cutibacterium acnes and the keratin plug of the follicle (oxidation)](https://durgical.com/en/pharmacology/benzoyl-peroxide/)
- [**Calcipotriol** A vitamin D analogue cream or ointment for plaque psoriasis that slows skin cell overgrowth. Too much can raise blood… Vitamin D receptor (VDR), a nuclear receptor](https://durgical.com/en/pharmacology/calcipotriol/)
- [**Imiquimod** An immune-response cream that activates toll-like receptor 7 in the skin. Used for genital warts, actinic keratoses… Toll-like receptor 7 (TLR7) on immune cells of the skin](https://durgical.com/en/pharmacology/imiquimod/)
- [**Pimecrolimus** A calcineurin-inhibitor cream for atopic dermatitis when other treatments fail or cannot be used; unlike… Calcineurin, through FKBP12](https://durgical.com/en/pharmacology/pimecrolimus/)
- [**Azelaic acid** A dicarboxylic acid gel, foam or cream for papulopustular rosacea and acne; it is antibacterial, unplugs pores and… Several targets: skin bacteria, keratinisation and tyrosinase (no single receptor)](https://durgical.com/en/pharmacology/azelaic-acid/)
- [**Crisaborole** A boron-containing PDE4 inhibitor ointment for mild to moderate atopic dermatitis; its main side effect is burning or… Phosphodiesterase 4 (PDE4), mainly PDE4B](https://durgical.com/en/pharmacology/crisaborole/)
- [**Hydroquinone** A tyrosinase-blocking skin lightener used under supervision for melasma; unapproved over-the-counter creams can cause… Tyrosinase, the first enzyme of melanin synthesis in melanocytes](https://durgical.com/en/pharmacology/hydroquinone/)
- [**Methoxsalen** A psoralen that makes skin sensitive to ultraviolet A light; with UVA (PUVA) it treats severe psoriasis and vitiligo… DNA of skin cells, after activation by ultraviolet A light](https://durgical.com/en/pharmacology/methoxsalen/)

## Others in the class

- coal tar
- salicylic acid
- selenium sulfide
- podophyllum resin
- podophyllotoxin
- urea
- azelaic acid
- calamine
- tacalcitol
- pimecrolimus

## Test yourself

Think of the answer, then tap the question to see it.

## Which topical corticosteroid potency is chosen for eczema on the face?

A mild one (such as hydrocortisone), for the shortest time that works; very potent ones such as clobetasol thin facial skin and are avoided there.

## Why is benzoyl peroxide combined with topical clindamycin or erythromycin for acne?

It improves efficacy and reduces the emergence of antibiotic-resistant bacteria; antibiotic monotherapy selects resistance.

## Which receptor does imiquimod activate?

Toll-like receptor 7, leading to release of interferon-α, TNF-α and interleukins.

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Educational content on how drugs work; not a prescribing guide and no substitute for a health professional's advice. No doses are given.

Sources: [Clobetasol: steroid for skin conditions](https://www.nhs.uk/medicines/clobetasol/) (NHS, 2026); [Calcipotriol: a medicine for plaque psoriasis](https://www.nhs.uk/medicines/calcipotriol/) (NHS, 2026); [DailyMed - IMIQUIMOD cream](https://dailymed.nlm.nih.gov/dailymed/drugInfo.cfm?setid=663e39a9-a29e-473f-89ec-4c7c6bc27b8a) (DailyMed (U.S. National Library of Medicine), 2025).

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Representative model, for educational purposes only.

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Source: https://durgical.com/en/pharmacology/classes/other-dermatological-medicines/
License: CC BY 4.0 (https://creativecommons.org/licenses/by/4.0/). Cite as: DurgiPedia (durgical.com), https://durgical.com/en/pharmacology/classes/other-dermatological-medicines/
