Types of emollient
Emollients are available in various different formulations:
Creams, lotions and ointments
Creams are a mixture of water and fat, and tend to be non-greasy and easy to spread. They are appropriate for daytime use. Due to their water content, they often contain preservatives, which some people may become sensitised to. Aqueous cream was once promoted as an effective moisturiser and wash-off soap substitute.
However, reports of skin irritation, particularly in children, mean that it is no longer recommended. Lotions contain more water and less fat than creams. They spread easily on the skin and produce a soothing, cooling effect, but are the least effective for moisturising very dry skin. Lotions are useful for hairy areas of skin or quick application.
Ointments have a thick, greasy consistency and are the most effective emollient at holding water in the skin. They are recommended for very dry and thick skin, and are best applied before bed. However, they are not suitable for weeping eczema and some users find their consistency unpleasant. As ointments don't contain preservatives, users should not put their fingers directly into the pot, but should use a clean spatula instead.
Bath oils
Emollient bath oils coat the skin with a layer of oil that traps water in the skin. Oils can be applied in the shower, but they make surfaces slippery so should be used with caution, particularly when bathing young children.
Soap subsitutes
Conventional soap is very drying, particularly to the hands, and should be avoided by sufferers of atopic or contact dermatitis. Emollient soap substitutes can be used as alternatives to regular soap and, although most don't produce foam, they are effective cleansers.
Emollient tips
- Smooth emollients into the skin gently using downward strokes €“ do not rub continuously
- Apply frequently €“ sufferers of very dry skin may need to apply an emollient every two to three hours on exposed areas
- Between 250g and 600g a week is usually required for the average sufferer, children typically require 250g
- Large amounts of cream, gel or lotion should be dispensed from a pump
- When dispensing from emollient pots, the required amount should be scooped out using a clean spatula
- Wash hands before applying an emollient and keep fingernails short and smooth
- Allow emollients to absorb into the skin before applying any other treatments. If the emollient has not absorbed properly, it may dilute the treatment
- After bathing, dry skin gently, leaving it slightly moist before applying leave-on emollients
- Use emollients of a more greasy consistency, e.g. ointments, before bed
- Use soap substitutes when cleansing
- For complete emollient therapy, use an emollient bath or shower oil before applying a cream, lotion or ointment.