Getting topical creams right

The importance of topical creams and getting it right

Introduction

Topical creams are an important part of everyday care and help make sure skin conditions or pain are managed properly. Many older adults are prescribed several creams, so it's vital these are stored, applied, and recorded safely. In this blog, I'll look at some of the key points around safe storage, application, and fire safety to support good practice and compliance.

Supporting regulation

Health and Social Care Act 2008 (Regulated Activities) Regulations 2014: Regulation 12 – Safe care and treatment. This regulation underpins safe practice for all types of medicines management, including topical creams, where mistakes or poor use can lead to skin damage or even fire risks.

Recording topical medicines

Every prescribed cream should have a body map showing clearly where to apply it. Staff must record each use on the body map and MAR.
If the direction says, "as directed", staff should shade or mark the relevant area on the body map, for example, the whole body or a specific part.
All applications must be signed for on the MAR and body map to show that residents are receiving their creams as prescribed.
Regular checks or audits should confirm records are accurate, and action taken quickly where things aren't being completed.

Who should apply and where to store

Services should have clear guidance on who applies topical creams and how they're stored.
Medicated creams like steroids or pain relief must be applied by medication-trained staff. These should be kept securely in the trolley, medication room, or fridge if refrigeration is required.
Non-medicated creams such as moisturisers and emollients can be applied by care staff and stored in the resident's room. These must still be signed for on the TMAR and body map.
Storage of non-medicated creams should be checked regularly. They can stay in a bedroom or bathroom, but if there's any risk of someone misusing or ingesting them, a risk assessment must be completed. In those cases, the cream should be locked away. Always think about all residents, not just the person prescribed the cream. For example, those who walk with purpose might enter other people's rooms and pick up items that aren't theirs.

Fire risks

Creams containing paraffin or alcohol, like ibuprofen gel or Zerobase, can catch fire easily. This risk is higher for residents who smoke or help with cooking. Staff should make sure precautions are followed, for example, avoid smoking after applying these creams and wash bedding and clothes regularly if they come into contact with them.

Additional reading

For more information on fire safety and topical creams:

Final thoughts

Getting topical creams right is a small but important part of medicines management. Good record keeping, safe storage, and awareness of fire risks protect both residents and staff. Regular audits and refresher training help prevent mistakes and keep services compliant with Regulation 12. At Orobo Healthcare, we support care services to strengthen their medicines management processes and promote safe, person-centred care.