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Gel de mebutato de ingenol

Picato

Clinical author's note Michael Stewart 01/03/2020: In February 2020, the licence of ingenol mebutate (Picato®) was suspended as a precautionary measure while the European Medicines Agency (EMA) continues to investigate concerns about a possible increased risk of skin cancers. Ingenol mebutate will no longer be prescribed by doctors in the UK and EU. The advice for anyone who has used Picato® gel is to check your skin regularly and tell a doctor if you notice any new scaly red patches, open sores, or elevated or warty growths in the treatment area.

At a glance

  • Ingenol mebutate gel is a topical treatment for solar keratosis.

  • Solar keratoses are rough, scaly patches on the skin caused by sun exposure.

  • Apply the gel precisely as directed by your doctor.

  • Expect redness, swelling, and peeling in the treated area, which shows the gel is working.

  • Contact your doctor if side effects become severe or if you are concerned.

  • Always protect your skin from the sun to prevent further damage.

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About ingenol mebutate gel

Tipo de medicamento

A topical treatment for sun-damaged skin

Usado para

Treating solar keratosis

También llamado

Picato® (discontinued)

Disponible como

Gel

A queratosis solar is a small, thickened, scaly growth which develops on the skin. It is the most common skin condition resulting from sun-damaged skin. Solar keratoses are also known as actinic keratoses. Solar keratoses usually develop on areas of skin which have received a lot of sun exposure. They are usually harmless, but there is a small risk that they may eventually turn into skin cancer. In themselves, solar keratoses are not cancerous.

Topical treatments (meaning you apply them to the skin) are useful if you have a lot of small solar keratoses. Ingenol mebutate is one of the treatments that are available. It kills the abnormal skin cells and fresh normal skin grows back. The brand name for ingenol mebutate gel is Picato®. There are two strengths of gel: the lower strength (150 micrograms/gram) is used for keratoses on the face or scalp, and the higher strength (500 micrograms/gram) is used for keratoses on other areas of the body.

To make sure this is the right treatment for you, before you start using ingenol mebutate gel it is important that your doctor knows:

  • Si estás embarazada o amamantando.

  • Si alguna vez has tenido una reacción alérgica a una preparación para la piel.

  • If you are taking or using any other medicines. This includes any medicines you buy without a prescription, as well as herbal and complementary medicines.

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  • Before you start this treatment, read the manufacturer's printed information leaflet from inside your pack. The manufacturer's leaflet will give you more information about ingenol mebutate and a full list of the side-effects which you may experience from using it.

  • Use ingenol mebutate exactly as your doctor tells you to. Each tube is used for one application only, so open a new tube each time you use the gel. Find a convenient time in your day to apply it - do not use it straight after you have had a shower or bath, and do not use it less than two hours before you go to bed. Gently rub the gel on to the area to be treated and allow it to dry for about 15 minutes:

    • If you are using the 150 micrograms/gram strength on your face or scalp, apply the gel once a day for three days in a row.

    • If you are using the 500 micrograms/gram strength on your body or arms/legs, apply the gel once a day for two days in a row.

  • Once you have used the gel, wash your hands well (unless they are the treated area) and try to avoid touching the area for the next six hours. Do not wash the treated area during this six hours.

  • Only use ingenol mebutate on your skin - you must avoid it coming into contact with your eyes and mouth. If this does happen, wash the area with plenty of warm water straightaway.

  • As you use the gel, the area of skin you are treating is likely to become red and swollen. After a week it may blister and peel, but then it will begin to heal. Expect this reaction to happen, but if it becomes severe or if you are concerned about it, speak again with your doctor.

  • Intenta mantener cualquier cita regular con tu médico. Esto es para que tu médico pueda verificar tu progreso.

  • Some people find it helps to apply a moisturising cream to the skin around the damaged areas to help soften the skin.

  • When you have had a lot of sun exposure, your risk of developing skin cancer on some other part of your skin is increased. Check your skin regularly and tell a doctor if you notice any changes, such as new moles, small dark patches developing, or a change in an existing mole.

  • There is some general advice which will help prevent any further sun damage to your skin. Avoid being out in the sun between 11 am and 3 pm. Always use a broad-spectrum sunscreen with an SPF of 30 or higher, and which protects against both UVB and UVA light. Apply plenty of the sunscreen, and re-apply it regularly, particularly after swimming and if you are sweating a lot.

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Local irritation including redness, itching, pain, swelling and peeling can all occur. These effects are normal and show that the gel is working. If the discomfort becomes severe or troublesome, or if you think the area may have become infected, you should contact your doctor for further advice. Also, up to 1 in 10 people using the gel have experienced headache as a side-effect of treatment. If this happens to you, ask your pharmacist to recommend a suitable painkiller.

If you experience any other symptoms which you think may be due to the gel, speak with your doctor or pharmacist.

  • Mantenga todos los medicamentos fuera del alcance y la vista de los niños.

  • Store the gel in a refrigerator.

  • The tubes are for single use only - do not store opened tubes to use later.

Información importante sobre todos los medicamentos

This preparation is for use on the skin only. If someone swallows some of it, go to the accident and emergency department of your local hospital. Take the container with you, even if it is empty.

Si compras algún medicamento, consulta con un farmacéutico que sea seguro tomarlo junto con tus otros medicamentos.

If you are having an operation or any dental treatment, tell the person carrying out the treatment which medicines you are taking or using.

Este medicamento es para ti. Nunca lo des a otras personas, incluso si su condición parece ser la misma que la tuya.

No guardes medicamentos caducados o no deseados. Llévalos a tu farmacia local, que se encargará de desecharlos por ti.

Si tienes alguna pregunta sobre este medicamento, consulta a tu farmacéutico.

Informar efectos secundarios de un medicamento o vacuna

Si experimenta efectos secundarios, puede reportarlos en línea a través de Yellow Card website.

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Preguntas frecuentes

What is a solar keratosis and why is it treated?

A solar keratosis is a small, scaly, thickened growth on the skin, often caused by sun exposure. While usually harmless, there's a small risk they could become skin cancer, which is why treatment with ingenol mebutate gel is given. These growths are not cancerous in themselves.

How does ingenol mebutate gel work to treat solar keratosis?

Ingenol mebutate gel works by killing the abnormal skin cells that make up the solar keratosis. Once these cells are eliminated, fresh, normal skin is able to grow back in their place.

Can I use ingenol mebutate gel immediately after showing or bathing?

No, you should not use ingenol mebutate gel immediately after a shower or bath. You should also not use it less than two hours before you go to bed.

What should I do if the treated skin area becomes red, swollen, or peels?

Redness, swelling, blistering, and peeling are expected reactions when using ingenol mebutate gel and are signs that the treatment is working. Generally, the skin begins to heal after about a week. However, if these symptoms become severe or if you are concerned, you should contact your doctor.

What kind of moisturising cream can I use around the treated area, and why is it helpful?

The article suggests that some people find it helpful to apply a moisturising cream to the skin around the damaged areas. This can help to soften the surrounding skin.

Are there different strengths of ingenol mebutate gel, and how do I know which one to use?

Yes, there are two strengths: 150 micrograms/gram and 500 micrograms/gram. The lower strength is for solar keratoses on the face or scalp, while the higher strength is for treated areas on other parts of the body. Your doctor will tell you which strength to use.

What precautions should I take to prevent further sun damage to my skin after treatment?

After treatment, it's important to protect your skin from the sun. Avoid being in direct sunlight between 11 am and 3 pm. Always use a broad-spectrum sunscreen with an SPF of 30 or higher that protects against both UVB and UVA light. Apply plenty of sunscreen and re-apply it frequently, especially after swimming or if you are sweating a lot.

Lecturas adicionales y referencias

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About the authorView full bio

Author image

Michael Stewart, MRPharmS

Medicine Leaflet Review Manager – Contractor, Pharmacist

BPharm (Hons), MRPharmS

Michael is a community pharmacist practicing in the Midlands and South Yorkshire with more than 20 years’ experience advising on medicines and medical conditions. He has a strong background in healthcare training, having produced and delivered training courses for pharmacy teams and staff of residential care settings, including nurses. He has also contributed to pharmacy advisory boards for the management of low acuity conditions in the community.

About the reviewer

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Sid Dajani

Sultan Dajani qualified at the London School of Pharmacy in 1994 and became the youngest elected member of the Royal Pharmaceutical Society council since its founding in 1842.

Historial del artículo

La información en esta página está escrita y revisada por pares por clínicos calificados.

  • Próxima revisión: 4 de noviembre de 2027
  • 9 de mayo de 2023 | Última versión

    Última actualización por

    Michael Stewart, MRPharmS

    Revisado por pares por

    Sid Dajani
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