PANDERMAL®
Topical Cream and Ointment — 15 g
1. Disclaimer
This commentary is provided for educational and informational purposes only and is not a substitute for the official product leaflet, professional prescribing information, or advice from a qualified healthcare professional. The formulation, indications, precautions, and regulatory status of medicines may vary between countries and may change over time.
We do not guarantee the accuracy, currency or completeness of information regarding medications or medical products, and official sources should be verified before making any decisions. Readers are responsible for independently verifying the information before relying on it.
PANDERMAL should be used according to the current package leaflet and the instructions of a physician or pharmacist. It is not intended to encourage self-diagnosis or unsupervised prolonged treatment.
2. Summary
PANDERMAL is a topical fixed-dose combination containing a corticosteroid, two topical antibacterial agents, and an antifungal agent: triamcinolone acetonide, neomycin, gramicidin, and nystatin. The combination is intended for inflammatory skin disorders that are responsive to topical corticosteroids and are complicated by susceptible bacterial and/or candidal infection. Available product literature describes both cream and ointment formulations, each supplied in 15-g tubes.
The current Egyptian market listings located during this review continue to identify Pandermal Topical Cream 15 g and Pandermal Ointment 15 g as Julphar products. An Egyptian medicine listing was updated on 24 August 2026 for the cream, while both presentations remain listed in current Egyptian drug directories.
Because the product contains a topical corticosteroid together with antimicrobial agents, it should not be regarded as a general-purpose treatment for every itchy, red, or infected skin lesion. Inappropriate or prolonged use can mask or aggravate infection and can increase steroid-related and antibiotic-related adverse effects.
3. Brand Name
PANDERMAL®
Available presentations identified in Egypt:
- Pandermal Topical Cream 15 g
- Pandermal Ointment 15 g
Both are currently listed with the active-ingredient combination gramicidin + neomycin + nystatin + triamcinolone and manufacturer Julphar.
4. Category
Topical corticosteroid–anti-infective combination.
Pharmacologically, PANDERMAL combines:
- Triamcinolone acetonide: topical corticosteroid with anti-inflammatory and antipruritic activity.
- Neomycin: topical aminoglycoside antibacterial.
- Gramicidin: topical antibacterial antibiotic, with particularly useful activity against many Gram-positive organisms.
- Nystatin: polyene antifungal, particularly active against susceptible yeasts such as Candida.
The corresponding combination is classified internationally under ATC D07CB01 — triamcinolone and antibiotics in official drug-product databases.
5. Active Ingredient
Each gram contains:
| Active ingredient | Amount per gram |
|---|---|
| Nystatin | 100,000 IU |
| Neomycin | 2.5 mg |
| Gramicidin | 0.25 mg |
| Triamcinolone acetonide | 1 mg |
The neomycin concentration corresponds to approximately 2.5 mg/g of neomycin equivalent, with product literature specifying neomycin sulfate as the source. Independent official product information for the same four-ingredient combination confirms the same strengths.
6. Pharmaceutical Form & Strength
Pharmaceutical forms:
- Topical cream — 15 g tube
- Topical ointment — 15 g tube
Strength per gram:
- Nystatin 100,000 IU
- Neomycin 2.5 mg
- Gramicidin 0.25 mg
- Triamcinolone acetonide 1 mg
The cream and ointment contain the same active ingredients at the same nominal strengths; the principal difference is the vehicle and consequently the characteristics of application.
7. Manufacturer & Marketing Authorization Holder
Manufacturer:
Julphar Gulf Pharmaceutical Industries, Ras Al Khaimah, United Arab Emirates. Available product literature identifies Julphar as the manufacturer, and current Egyptian medicine listings also identify Julphar as the manufacturer of the two 15-g presentations.
Marketing authorization / Egyptian registration holder:
The accessible current web sources reviewed identify the Egyptian product with Julphar, and historical Egyptian pricing documentation identifies Julphar Scientific Office in connection with Pandermal. However, a current publicly accessible Egyptian Drug Authority record that independently establishes the exact legal distinction between the Egyptian marketing-authorization holder and the UAE manufacturing entity was not located during this review. Therefore, the precise current MAH designation should be taken from the latest Egyptian regulatory record or package labeling rather than inferred.
8. Mechanism of Action
PANDERMAL acts through four complementary pharmacological components.
Triamcinolone acetonide is a topical glucocorticoid. It suppresses inflammatory responses and reduces manifestations such as redness, swelling, and itching. Topical corticosteroids also produce vasoconstrictive effects in the skin.
Neomycin is an aminoglycoside antibacterial that interferes with bacterial protein synthesis after interaction with bacterial ribosomes, thereby inhibiting bacterial growth and promoting bacterial death.
Gramicidin is a topical peptide antibiotic that increases bacterial membrane permeability by forming ion channels, disrupting essential ion gradients. Its activity is predominantly directed toward Gram-positive organisms, although activity against some other susceptible organisms may occur.
Nystatin binds to sterols in susceptible fungal cell membranes, particularly ergosterol, altering membrane permeability and causing leakage of intracellular components. It is particularly active against Candida and other susceptible yeasts.
The combination therefore addresses inflammation + susceptible bacterial infection + susceptible candidal infection rather than treating each component as an independent disease.
9. Spectrum of Activity
Antibacterial activity
The antibacterial component consists of neomycin and gramicidin.
- Neomycin has activity against a broad range of susceptible Gram-positive and Gram-negative bacteria commonly associated with superficial skin infections.
- Gramicidin contributes antibacterial activity particularly against many Gram-positive organisms.
The actual clinical usefulness depends on the susceptibility of the infecting organism; the presence of an antibiotic in the formulation does not imply activity against every bacterial skin infection.
Antifungal activity
Nystatin is mainly useful against susceptible yeasts, particularly Candida species. It is not a broad-spectrum treatment for dermatophyte infections such as typical tinea/ringworm.
Important limitation
PANDERMAL should not be interpreted as a treatment for viral skin infections or tuberculosis of the skin, and corticosteroid-containing combinations may suppress clinical inflammation and mask progression of an untreated infection.
10. Pharmacokinetics
PANDERMAL is intended for topical administration, and systemic exposure is generally limited when it is applied appropriately to intact skin. However, absorption can increase substantially under certain conditions.
Nystatin: topical nystatin is not appreciably absorbed through intact skin or mucous membranes.
Neomycin: little or no clinically significant absorption is expected through intact skin, but absorption can increase markedly through abraded, denuded, ulcerated, burned, or otherwise damaged skin. This is clinically important because substantial systemic exposure to an aminoglycoside may produce nephrotoxic and ototoxic effects.
Triamcinolone acetonide: percutaneous absorption varies according to the vehicle, integrity of the skin barrier, degree of inflammation, treated surface area, duration, and especially the use of occlusive dressings. Once systemically absorbed, topical corticosteroids follow pharmacokinetic pathways broadly similar to systemic corticosteroids, including hepatic metabolism and renal/biliary elimination of drug and metabolites.
Consequently, prolonged treatment, application to large areas, application under occlusion, or use on damaged skin can increase systemic exposure.
11. Indications
PANDERMAL is intended for corticosteroid-responsive inflammatory dermatoses complicated by susceptible bacterial and/or candidal infection, where the combined anti-inflammatory and anti-infective actions are appropriate. Available product literature describes it as being indicated for corticosteroid-sensitive dermatoses complicated by microorganisms susceptible to the anti-infective ingredients.
Examples of clinical situations may include appropriately diagnosed inflammatory skin disorders in which secondary bacterial or candidal infection is present or likely, provided that the infecting organisms are susceptible to the ingredients.
The formulation should not be used simply because a skin lesion is itchy or inflamed. The corticosteroid component can suppress visible inflammation while allowing an inappropriate infection to persist or worsen.
Older product wording also referred to conditions such as eczema and chronic lichenified inflammatory lesions. Such conditions should be understood in the context of the requirement for an appropriate corticosteroid-responsive diagnosis and, where relevant, susceptible infection.
12. Administration
Route: Topical application to the skin.
Available product literature recommends:
Apply to the affected area two times daily, or occasionally three times daily, according to medical direction.
General administration principles:
- Apply a thin layer to the affected area.
- Wash hands before and after application unless the hands themselves are being treated.
- Avoid unnecessary application to large areas.
- Do not routinely cover the treated area with an occlusive dressing unless specifically instructed by a healthcare professional.
- Avoid contact with the eyes and other unintended mucosal surfaces.
- Treatment should be reassessed rather than continued indefinitely, particularly when there is no clear improvement.
The exact duration should depend on the diagnosis and clinical response.
13. Method of Preparation
No patient preparation or reconstitution is required.
PANDERMAL is supplied as a ready-to-use semisolid topical preparation in a tube. The cream and ointment are applied directly to the affected skin.
The product should not be diluted, mixed with another topical medicine in the same container, or otherwise reformulated by the patient.
14. Contraindications
PANDERMAL should not be used in the following circumstances:
- Known hypersensitivity to triamcinolone, neomycin, gramicidin, nystatin, or another component of the formulation.
- Tuberculous skin lesions.
- Most viral infections of the skin, including herpes simplex and particularly varicella and vaccinia.
- Fungal infections caused by organisms not susceptible to nystatin.
- Acne vulgaris, rosacea, or perioral dermatitis, where the corticosteroid component may be inappropriate.
- Ophthalmic use.
- Application into the external auditory canal when the tympanic membrane is perforated, because of the risk associated with neomycin-containing preparations.
It should also not be used indiscriminately on extensive areas or damaged skin because systemic absorption of neomycin and/or triamcinolone may increase.
15. Warnings & Precautions
Corticosteroid-related precautions
Prolonged or inappropriate topical corticosteroid use can cause:
- Skin thinning and atrophy
- Striae
- Telangiectasia
- Purpura and easy bruising
- Delayed wound healing
- Acneiform eruptions
- Masking or worsening of infection
- With sufficient systemic absorption, suppression of the hypothalamic–pituitary–adrenal axis and other systemic corticosteroid effects
The risk increases with larger treatment areas, prolonged use, inflamed or damaged skin, and occlusive dressings.
Neomycin-related precautions
Neomycin can produce contact sensitization, particularly with prolonged or repeated topical exposure. Systemically absorbed neomycin may cause nephrotoxicity and ototoxicity; therefore caution is particularly important when treating large areas, burns, ulcers, trophic lesions, or other damaged skin where absorption may be substantial.
Patients with established hearing impairment warrant particular caution.
Failure to improve
Corticosteroid-antibiotic combinations should not simply be continued for an extended period when there is no clinical improvement. Lack of response may indicate an incorrect diagnosis, an organism not susceptible to the antimicrobial components, or an infection that requires different treatment. Available product literature specifically advises reassessment when adequate improvement has not occurred.
Children
Available Pandermal product literature states that the product is not recommended for children under one year of age and recommends avoiding prolonged continuous topical corticosteroid use in children.
Pregnancy and lactation
Human pregnancy safety data for the combination are inadequate. Topical corticosteroids should be used during pregnancy only when the expected benefit justifies potential risk, particularly when large amounts, extensive areas, prolonged treatment, or occlusion are involved. Neomycin exposure is also a consideration when absorption may be increased.
Use during breastfeeding should likewise be medically directed, with care to prevent unintended exposure of the infant to treated skin.
16. Drug Interactions
No specific clinically significant drug interactions were reported in the accessible Pandermal product literature.
Nevertheless, clinically relevant precautions include:
- Concomitant use with other aminoglycosides may increase concern about aminoglycoside toxicity if substantial systemic absorption occurs.
- Extensive application to damaged skin can increase neomycin exposure and consequently increase toxicity risk.
- Other topical corticosteroid preparations used over the same area may increase total corticosteroid exposure and local adverse effects.
- Occlusive dressings can markedly increase corticosteroid absorption and should not be used routinely unless specifically directed.
These considerations are particularly important when large areas, ulcers, burns, or prolonged courses are involved.
17. Side Effects
Common or clinically important local effects
Possible reactions include:
- Burning, irritation, itching, redness, or discomfort
- Allergic/contact sensitization, particularly from neomycin
- Skin thinning or atrophy with prolonged corticosteroid exposure
- Telangiectasia
- Striae
- Purpura or easy bruising
- Acneiform eruptions
- Delayed wound healing
Less common but important systemic effects
With excessive absorption of the corticosteroid component, systemic corticosteroid effects such as:
- HPA-axis suppression
- Cushingoid manifestations
- Hyperglycemia
- Glucosuria
may occur.
With significant systemic absorption of neomycin, nephrotoxicity and ototoxicity are recognized potential serious adverse effects.
If marked irritation, an allergic reaction, worsening of the underlying lesion, or a new infection develops, treatment should be stopped and medical assessment obtained.
18. Use in Special Populations
Children
PANDERMAL product literature does not recommend use in children under one year of age. In older children, topical corticosteroids should be used sparingly and for limited periods because children may be more susceptible to systemic corticosteroid exposure.
Elderly
Older adults may have thinner skin and may therefore be more susceptible to corticosteroid-induced skin atrophy. Product literature recommends corticosteroids be used sparingly and for short periods in elderly patients.
Pregnancy
Use only when medically justified after consideration of the potential benefits and risks. Avoid unnecessary extensive or prolonged treatment.
Breastfeeding
Use under professional guidance, particularly where treatment involves large areas or damaged skin. Avoid direct contact between treated skin and the infant.
Renal impairment or hearing impairment
Extra caution is appropriate when significant neomycin absorption is possible because systemic aminoglycoside exposure is associated with nephrotoxicity and ototoxicity. Patients with established hearing impairment warrant particular caution.
19. Storage Conditions
Current accessible Pandermal product literature states:
Store at a temperature not exceeding 30°C.
The original packaging should be kept closed and protected from inappropriate heat. Keep out of the reach of children.
The 30°C limit is preferable to the older wording sometimes reproduced online stating 25°C; the accessible later product literature reviewed for this commentary specifies not more than 30°C.
20. Additional Sections
Cream versus ointment
Both forms contain the same active ingredients and strengths, but the bases differ.
The cream is generally more suitable for relatively moist or weeping areas because of its cream vehicle and easier spreadability.
The ointment provides a more occlusive, emollient vehicle and may be more suitable for dry, scaling, or lichenified lesions. However, the increased occlusion produced by an ointment base can also increase penetration of topical corticosteroids; prolonged or extensive use should therefore remain medically controlled.
Key clinical limitation
PANDERMAL is a combination product, not a substitute for establishing the diagnosis. The presence of three antimicrobial components does not make it appropriate for all bacterial or fungal lesions, while the corticosteroid can suppress inflammatory signs and potentially obscure an inadequately treated infection.
Current Egyptian market status
As of the current review in August 2026, accessible Egyptian medicine listings continue to show:
- Pandermal Topical Cream 15 g — Julphar
- Pandermal Ointment 15 g — Julphar
The cream listing was specifically updated on 24 August 2026, and both presentations remain listed in Egyptian drug databases.
The exact retail price is intentionally not treated here as a definitive regulatory fact because Egyptian medicine prices can change and different online databases currently display conflicting historical/current figures.
21. Frequently Asked Questions (FAQ)
What is PANDERMAL used for?
It is intended for inflammatory skin disorders that are responsive to topical corticosteroids and are complicated by susceptible bacterial and/or candidal infection.
Does PANDERMAL treat all fungal infections?
No. Its antifungal component is nystatin, which is particularly useful against susceptible yeasts such as Candida. It should not be assumed to treat every dermatophyte or other fungal infection.
Can PANDERMAL be used for any itchy rash?
No. The corticosteroid may reduce itching and redness without addressing the true underlying cause. Some viral, fungal, or other dermatoses can worsen or become masked when corticosteroids are used inappropriately.
How often is PANDERMAL applied?
Available product literature recommends application to the affected area twice daily, or occasionally three times daily, according to medical direction.
Can PANDERMAL be used on burns or ulcers?
Particular caution is required. Damaged skin can substantially increase absorption of neomycin and potentially increase the risk of systemic toxicity. Large or severely damaged areas should not be treated routinely without appropriate medical supervision.
Can it be used in the eye?
No. PANDERMAL is not an ophthalmic preparation.
Is the ointment stronger than the cream?
Not in terms of the nominal active-ingredient strengths. The cream and ointment contain the same listed strengths per gram; they differ primarily in their vehicles and application characteristics.
Can it be used for children?
The accessible product literature states that PANDERMAL is not recommended for children below one year of age. Use in older children should be limited and medically directed because of corticosteroid exposure.
22. References
- Pandermal product literature / prescribing information — composition, pharmacodynamic properties, indications, dosage, contraindications, precautions, pregnancy/lactation, adverse effects, interactions, presentation, storage, and manufacturer. Julphar Gulf Pharmaceutical Industries.
- Health Canada Drug Product Database — product information confirming the four active ingredients and strengths: gramicidin 0.25 mg/g, neomycin 2.5 mg/g, nystatin 100,000 IU/g, and triamcinolone acetonide 1 mg/g; ATC D07CB01.
- DailyMed — Nystatin Cream — topical pharmacokinetics and antifungal activity of nystatin.
- DailyMed — Triamcinolone Acetonide Cream — topical corticosteroid pharmacology and safety information.
- Drug monograph information for topical neomycin — absorption through intact versus damaged skin and associated systemic toxicity considerations.
- Medicines.org.uk — topical corticosteroid/antibiotic SmPC — principles governing percutaneous corticosteroid absorption, influence of skin integrity and occlusion, and systemic pharmacokinetics.
- Australian Government medicine information for Kenacomb — independently confirms the same four-component combination and strengths and provides supporting clinical particulars for the combination.
- Current Egyptian medicine listings — current listings for Pandermal Topical Cream 15 g and Pandermal Ointment 15 g, identifying Julphar as manufacturer; the cream listing shows an update dated 24 August 2026.