What are the benefits of malaseb over chlorhexidine?

RE: What are the benefits of malaseb over chlorhexidine?

David Bentley — Mon, 02 Sep 2024 09:06:40 GMT

The consensus guidelines published in Vet Derm in 2020, said “strong” evidence for Malaseb twice weekly and only “moderate” evidence for 3% chlorhexidine .

Bond R, Morris DO, Guillot J, et al. Biology, diagnosis and treatment of Malassezia dermatitis in dogs and cats. Clinical Consensus Guidelines of the World Association for Veterinary Dermatology. Vet Dermatol 2020;31:28-74

However, in practice I often use Douxo pyo S3 (3%) or Clorexyderm (4%) usually very effectively.

RE: What are the benefits of malaseb over chlorhexidine?

Rob Loxley — Mon, 02 Sep 2024 08:57:13 GMT

[quote userid="5012" url="~/f/clinical-questions/31026/what-are-the-benefits-of-malaseb-over-chlorhexidine/245435#245435"]Can we advise these under the cascade regs as they are not POM-V?[/quote]

I don't see any issue. Similarly I might prescribe neutraceuticals for itchy skin or joint stiffness rather than a POM-V such as Apoquel or NSAIDs

RE: What are the benefits of malaseb over chlorhexidine?

Clive Ansell — Mon, 02 Sep 2024 08:30:15 GMT

[quote userid="4181" url="~/f/clinical-questions/31026/what-are-the-benefits-of-malaseb-over-chlorhexidine/245434#245434"]Why can't you use Malabeze or Coatex Medicated Shampoo, both of which seem to work as well as Malaseb and shorter contact time, and if you want a smaller (cheaper) bottle Malabeze comes in 125ml, or if using longterm a more cost effective 500ml bottle[/quote]

Yes of course, but they are different products with different active ingredients. Do they work as well, I don't know? Can we advise these under the cascade regs as they are not POM-V?

[quote userid="4181" url="~/f/clinical-questions/31026/what-are-the-benefits-of-malaseb-over-chlorhexidine/245434#245434"]Or £20 online (incl delivery) plus a prescription cost[/quote]

True. I found it somewhere online for £16.69 plus delivery. Add on c£30 prescription fee ant it's still aroung £50. Lot of money to many people.

RE: What are the benefits of malaseb over chlorhexidine?

Rob Loxley — Sun, 01 Sep 2024 15:21:56 GMT

[quote userid="5012" url="~/f/clinical-questions/31026/what-are-the-benefits-of-malaseb-over-chlorhexidine/245432#245432"]If we make an actual or presumptive diagnosis of malassezic dermatitis, we must prescibe according to the regs[/quote]

Why can't you use Malabeze or Coatex Medicated Shampoo, both of which seem to work as well as Malaseb and shorter contact time, and if you want a smaller (cheaper) bottle Malabeze comes in 125ml, or if using longterm a more cost effective 500ml bottle

[quote userid="5012" url="~/f/clinical-questions/31026/what-are-the-benefits-of-malaseb-over-chlorhexidine/245432#245432"]Malaseb is or would be declined based on costs (c£70 a bottle)[/quote]

Or £20 online (incl delivery) plus a prescription cost

RE: What are the benefits of malaseb over chlorhexidine?

Clive Ansell — Sun, 01 Sep 2024 08:58:12 GMT

One again the cascade regs raise their ugly head.

If we make an actual or presumptive diagnosis of malassezic dermatitis, we must prescibe according to the regs. Malaseb is licenced for malassezia, Chorhexidine products are not.

It states in the Malaseb data sheet that miconazole and chorhexdine have a synergistic action.

Also in the data sheet, it talks about controlling ringworm in cats used in conjunction with Griseofulvin, but we are unable to use it because of the cascade (Intrafungol is licenced for ringworm in cats, Griseofulvin is not) (Unsure if it is still available anyway)

I have used Chlorhexidine in probably 1000's of skin cases, where malassezia is probably one of many mixed pathogens. Does seem to work. No testing or specific diagnosis in most of these, and more often that not Malaseb is or would be declined based on costs (c£70 a bottle)

RE: What are the benefits of malaseb over chlorhexidine?

Elizabeth — Sat, 31 Aug 2024 13:40:09 GMT

Out of interest what dilution instructions do you give when washing with chlorhexidine, or do you just expect them to use it like any other shampoo?

RE: What are the benefits of malaseb over chlorhexidine?

Beats — Sat, 31 Aug 2024 12:33:19 GMT

I rarely use malaseb. I keep one bottle on the skin topical shelf. Use it occasionally for malassezia dermatitis on occasional individual case. I would not describe it as the go to. My 2 usual choices are douxo pyo (pump action) or 500ml hibiscrub.

I don't think washing dogs in chlorhexidine is very responsible, however like many others I do it and it works reasonably well.