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Is there a new EU directive on the making up of skin creams?

Q I understand that new EU regulations will no longer allow combination skin creams to be made up in a pharmacy. Is this true? What is the timescale and what likely effects will this have on GPs' prescribing?

A There is no official EU medicines directive obliging pharmacies within the EU to stop mixing compounds for use on the skin.

The BMA and Royal Pharmaceutical Society are not

aware of any changes in this


There is strict legislation concerning the use of coal tar preparations and a specific licence is needed by that pharmacy to prepare these products.

Many pharmacies now out-source the mixing of compounds. Flat charges of £50 are usually levied for the cost of the final product. In many cases a product's materials might only cost pennies.

There are many cream and ointment bases, specific chemical percentages and adjuvant or complementary combinations that are effective and patient friendly. These concoctions are usually passed down from one generation of skin doctors to another.

Some even get picked up by the drug companies and marketed, but the potential profit margins versus the cost of licensing mean that most will remain in the 'cook-book'.

If such a law ever came to pass, it might drive me to finally put away my magnifying glass and pack up my mortar and pestle.

Tony Downs, consultant dermatologist, Royal Devon and Exeter NHS Foundation Trust

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