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Author: Dr Mark Duffill, Dermatologist, Hamilton, New Zealand, 1998. Updated by A/Prof Amanda Oakley, February 2016.
Emollients are products used to soften skin. Moisturisers are products used to add moisture to the skin. There are numerous emollients and moisturisers on sale at general stores and pharmacies. Options include:
Emollients and moisturisers are most effective when applied immediately after bathing but can also be applied at other times.
Uses of emollients and moisturisers include:
Occlusives are oils of non-human origin, often mixed with water and an emulsifier to form a lotion or cream. They provide a layer of oil on the surface of the skin to reduce water loss from the stratum corneum.
The choice of occlusive emollient depends upon the area of the body and the degree of dryness and scaling of the skin.
Sorbolene and glycerine cream is a general-purpose moisturiser that is non-greasy, cheap and available in bulk without prescription.
The minimum quantity for an occlusive emollient is 250 g (or ml) and often 500 g or 1 kg is needed: liberal and regular usage is to be encouraged. How frequently it is applied depends on how dry the skin is: very dry skin may benefit from a greasy emollient every couple of hours, but slightly dry skin may only need a light moisturiser at night.
Humectants increase the water holding capacity of the stratum corneum. They include:
Urea and the acidic preparations often sting if applied to scratched or fissured skin. They are also keratolytic, ie they have a descaling or peeling effect, important in the management of ichthyosis.
Creams and lotions are prone to microbial contamination and preservatives are added to improve shelf life. Preservatives in moisturisers can lead to contact allergic dermatitis in sensitive individuals.
Many additional agents may be added to a moisturiser to appeal to the consumer. Be aware that marketing claims for the effectiveness of many of these ingredients in reducing the signs of skin ageing can be misleading. Large molecules such as peptides and collagen cannot penetrate through the stratum corneum.
People with sensitive skin associated with atopic dermatitis or rosacea often describe irritant reactions to emollients and moisturisers such as burning and stinging. If irritation is transient, the product can continue to be used. It should be discontinued if contact dermatitis appears.
Thermal burns from paraffin-containing ointments on clothing or bedding can be dangerous and may occur if exposed to cigarettes or a lighted fire.
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