Emollients

Emollients

Emollients are typically the first, and are the mainstay of treatment for all severities of eczema, and are used to provide continual repair of the skin's outer barrier. These treatments soften the skin by providing oils, reducing epidermal water loss and forming a layer to protect against skin exposure to allergens or irritants. Formulations without fragrances or perfumes should be used.1,3 

The choice of a specific emollient is based on you or your child's specific needs - age, body area involved, acute versus chronic lesions, climate and your preferences.1,3-5

  • Creams are best applied to large areas and stable lesions
  • Ointments have a higher oil content, providing more lubrication and protection and are therefore most useful for dry and thickened lesions
  • Lotions have a high water content and can be used to cool or dry highly inflamed and oozing lesions
  • You or your child may require more than one emollient product, depending on lifestyle, time of day, seasonal factors or disease severity 

    • If you are prescribed a leave-on emollient, you should also be prescribed an emollient washing product or bath emollients, as the skin must also be thoroughly but gently cleansed to remove crusts and any bacteria on the skin's surface 
    • Your child should easily be able to use their emollients at nursery or school

  • The use of aqueous cream BP/washing products is not recommended as these contain a known irritant compound 

The "trial and error" approach for finding the right emollient can be difficult and demoralising when they are not effective.6 Talk to your doctor or practice nurse about this. 

You should be clearly shown how to apply emollients correctly, how much to use, and when to use them, as this can lead to improved control of eczema.7 

The order of topical treatment application is important. It has been suggested that emollients should be applied first and then a period of at least 1 hour should be left before the application of corticosteroids or a particular calcineurin inhibitor, tacrolimus. Alternatively, treatments can be applied at different times of the day.

 

References

For a full list of this sections references click here

UK/GEN/16/0051 Date of preparation: October 2016