How to use Moisturisers

What are moisturisers (emollients)?

A moisturiser is more commonly referred to as an emollient. Emollients help soothe the skin and provide relief from itching and dryness. Their use can prevent conditions like eczema ‘flaring up’.

There are many different types of emollients, and they are classified according to how GREASY they are.

Ointments

These are the greasiest. They are usually made of white soft paraffin or liquid paraffin and are ideal for very dry or thickened skin and night-time application. They do not usually contain preservatives (ingredients that help to protect the product from bacteria/germs and increase its shelf-life) and are therefore less likely to cause skin reactions.

Creams

These contain a mixture of oil and water and are less greasy, and therefore easier to spread on the skin than ointments. They must be used frequently and applied liberally to prevent the skin from drying out. Creams usually come in a container with a pump dispenser and are good for day-time application.

Lotions

These contain the least oil and most water so are the least effective in moisturising the skin. They normally contain preservatives so may cause skin irritation. Lotions are useful for hairy areas such as scalps and areas of weepy skin.

How do emollients work?

Emollients trap moisture in the skin and form a protective oily layer on the outer skin surface which helps skin repair and improves skin hydration. You may wish to use different types of emollients at different times of the day, on different areas of the body or when severity of your condition varies. For example, use a cream in the morning if dressing to go to work or school and an ointment in the evening when wearing pyjamas.

Most emollients (except white soft paraffin alone) can be used instead of soap as well. This is referred to as a soap substitute.

Which emollient is best?

There is no one ‘best emollient’. The type (or types) to use depends on the dryness of the skin, the area of skin involved, and what is comfortable and acceptable to you.

More than one emollient may be required for use at different times of the day or for when the skin condition is more active.

How much emollient should I apply?

The quantity of emollient required will vary depending on the size of the person, the extent and severity of the skin condition, and whether the emollient is also being used as a soap substitute. As a general guide, if you needed to treat the whole body, the recommended quantities used are:

  • 600 g per week for an adult.

  • 250-500 g per week for a child.

How should I apply my emollient treatment?

Step 1:

Wash your hands to remove invisible bacteria.

Step 2:

Do not put fingers into tubs to scoop out the ointment as you may introduce bacteria into the ointment. To reduce the risk of infection, transfer some emollient onto a clean plate using a clean dessert spoon. If you have a cream in a tub with a pump top, you can pump directly onto your hand.

Step 3:

Emollients should be applied to the skin in a downward direction of hair growth and left in a thin layer to soak in – this may take 10 minutes. Do not rub emollients in as you risk pushing it down into the hair follicle. This can cause infected hair follicles in some people.

How often should I apply my emollient treatment?

  • Apply emollients whenever the skin feels dry and as often as you need. This may be two to four times a day or more.

  • Apply emollients immediately after washing or bathing when skin has been dabbed dry.

  • Emollients can and should be applied at other times during the day, for example in extreme weather to provide a barrier from the cold.

  • You should continue to use emollients after your skin condition has cleared if the clinical condition justifies it.

What if I have also been prescribed a topical steroid?

  • If a topical steroid is required, emollients should be applied at least 30 minutes before or after the steroid.

  • Intensive use of emollients can reduce the need for topical corticosteroids. The quantity and frequency of applying emollients should be far greater than that of topical steroids.

What precautions should I take with emollients?

! Paraffin-based emollients are flammable so please take care near any open flames or potential causes of ignition, such as cigarettes.

! Ointments and creams used in the bath and shower can make the surface slippery so take extra care.

! If you find an emollient is making your skin sore and/or very itchy, you may be allergic to one of the ingredients and you should discuss this with your doctor.

Bath emollients

A tablespoon of any ointment (except 50:50) can be dissolved in some hot water and added to the bath water. Any cream emollient can be used as a soap substitute. Take care though, as the bath will be slippery.

Summary Do’s & Don’ts

DOs

  • Apply emollients as regularly and as frequently as you can.

  • Carry emollients with you when on the go.

  • Keep fingernails short and smooth.

DON’Ts

  • Rub into the skin.
  • Put fingers in tubs.
  • Smoke or be near fire or flames after applying paraffin-based emollients