Mucopolysaccharide Polysulphate + Salicylic Acid

Approved (Topical Use):

• Keratolysis & Debridement:
  For hyperkeratotic lesions (e.g., plantar/hyperkeratotic warts, calluses, corns), facilitating exfoliation and removal of thickened skin.
• Topical Antithrombosis (Mucopolysaccharide Polysulphate component):
  Management of superficial thrombophlebitis, mild varicose veins, and localized bruising/hematoma by promoting microcirculation and softening hardened tissues.
• Inflammatory Skin Conditions:
  Adjunctive treatment in eczematous or pruritic dermatoses to reduce scaling and improve skin texture.

Off-label (Clinically Accepted Uses):

• Acne vulgaris with comedones:
  Mild keratolytic action helps to unplug pores and reduce comedones.
• Ingrown nails (onychocryptosis):
  Softens perionychial tissue to ease mechanical relief.
• Seborrheic dermatitis and dandruff (scalp lotions):
  Reducing scaling and improving flaking.

Adults:

• Apply a thin layer to clean, dry skin once or twice daily, alone or under occlusion.
• For plantar hyperkeratosis or callus: occlusive dressing overnight may improve efficacy.
• Treatment duration: typically 2–6 weeks, depending on lesion severity.

Pediatric Use:

• Not routinely recommended for children under 12; if used, apply once daily with careful monitoring.

Elderly:

• Standard dosing; avoid occlusion over thin or fragile skin.

Renal/Hepatic Impairment:

• Systemic absorption is minimal; no adjustment needed.

Administration Route:

• Topical cream, gel, patch, or lotion, depending on product formulation.

• Salicylic Acid acts as a keratolytic agent, softening and reducing intercellular cohesion in the stratum corneum, facilitating exfoliation and peeling of hyperkeratotic skin.
• Mucopolysaccharide Polysulphate functions similarly to low molecular weight heparins: it exerts antithrombotic and anti-inflammatory effects, enhancing capillary microcirculation, reducing edema, and preventing fibrin deposition in superficial vessels. By combining, the product both softens and debrides thickened skin while promoting improved blood flow and resolving superficial vascular changes.

• Absorption:
  Minimal systemic absorption through intact skin; increased penetration possible through occluded or abraded skin.
• Distribution:
  Remains primarily in epidermal and superficial dermal layers.
• Metabolism:
  Salicylic acid may undergo local metabolism by skin esterases; mucopolysaccharide polysulphate acts locally without systemic metabolism.
• Elimination:
  Residual salicylate may be excreted via urine if absorbed; mucopolysaccharide moiety acts locally and is cleared by skin shedding.
• Onset of Action:
  Keratolytic softening may begin within hours; thrombolytic effects develop over several days.

• Pregnancy:
  Topical salicylic acid is classified as Category C; potential for minimal systemic absorption at higher concentrations. Use with caution, avoid large areas or occlusion.
• Lactation:
  Unknown if topical absorption leads to excretion in breast milk. Avoid application on breast area and limit systemic exposure.
• Caution:
  Use minimal effective amounts; avoid prolonged use in pregnant or lactating women.

• Primary Class:
  Topical keratolytic and antithrombotic combination
• Subclass:
  Keratolytic agent + superficial antithrombotic/anti-inflammatory

• Known hypersensitivity to salicylates, mucopolysaccharide polysulphates, or formulation excipients.
• Application on large areas (>10% body surface), broken/damaged skin, or mucosal surfaces.
• Active bleeding disorders or use during anticoagulant therapy without medical supervision.
• Third-trimester pregnancy or infants <2 years due to potential systemic effects of salicylates.

• Skin irritation or allergic contact dermatitis may occur; discontinue if rash, burning, or swelling develops.
• Avoid use under occlusion on sensitive areas (e.g., face, genitals) to prevent excessive salicylate absorption.
• Monitor patients on systemic anticoagulants for bleeding risk when using extensively.
• Avoid use in individuals with Reye-like syndrome risk (children, viral infections, predisposing conditions).
• Pregnant or breastfeeding women should use only upon medical advice, with minimal quantities.

Common:

• Mild local irritation: erythema, burning, peeling
• Local dryness or scaling
• Occasional pruritus

Less Common:

• Contact allergic dermatitis
• Local edema or increased tenderness over treated area

Rare but Serious:

• Systemic salicylate toxicity (e.g., tinnitus, metabolic acidosis) from overuse on large areas or with occlusion
• Superficial bleeding or petechiae over treated area (due to antithrombotic effects)

Timing:

• Local effects typically appear within 1–7 days; systemic signs rarely develop unless high-dose or prolonged use occurs.

• Systemic Anticoagulants (e.g., warfarin):
  Risk of increased bleeding if enough salicylate is absorbed.
• Oral Salicylates, NSAIDs:
  Additive systemic effects possible — avoid concurrent large-area application.
• Other Topical Preparations:
  Use separate from other keratolytics, retinoids, or corticosteroids unless directed; wait 30 minutes between products to avoid excessive irritation.
• Enzyme Systems:
  No significant CYP450 interactions at topical doses.

• Dermatology Practice Notes (2021):
  Reaffirmed safety and efficacy for callus/wart debridement; no new systemic safety signals.
• Phlebology Guidelines (2022):
  Recognize benefit of mucopolysaccharide polysulphate in mild superficial thrombophlebitis and venous stasis changes.
• Cosmetovigilance Reports:
  Rare systemic salicylate toxicity reported in children using high-concentration patches under occlusion—label warnings updated to improve cautionary instructions.

• Temperature:
  Store at 20°C to 25°C (68°F–77°F).
  Short excursions allowed between 15°C–30°C.
• Humidity & Light:
  Protect from moisture and direct sunlight. Keep tube cap closed when not in use.
• Handling Precautions:
  Do not apply to large body areas or mucosa. Avoid contact with open wounds unless indicated. Wash hands after application.
• Refrigeration/Reconstitution:
  Not required. Do not freeze.