Emollients soothe, smooth and hydrate the skin and are used for all dry or scaling disorders. Their effects are short-lived and they should be applied frequently, even after improvement occurs. They are useful in dry and eczematous disorders; less so for psoriasis, although they can help with reducing itchiness and removing scale. Light emollients are suitable for many patients with dry skin but a wide range of more greasy preparations are available, including white soft paraffin, emulsifying ointment, and liquid and white soft paraffin ointment. The severity of the condition, patient preference and the location of the psoriasis outbreak will often guide the choice of emollient.
Emollients should be applied in the direction of hair growth. Some ingredients on rare occasions may cause sensitisation, so if an eczematous reaction occurs, it’s best to stop using the emollient.
Preparations such as aqueous cream and emulsifying ointment can be used as soap substitutes for hand-washing and in the bath; the preparation is rubbed onto the skin before being rinsed off completely. The addition of a bath oil product may also be helpful. Aqueous cream, however, is not recommended for treating atopic eczema as it has been shown that the sodium lauryl sulphate (a caustic detergent), which helps to de-scale the skin, also damages the skin barrier. Preparations containing an antibacterial should be avoided unless infection is present or is a frequent complication.
Urea is employed as a hydrating agent within moisturisers. It is used in scaling conditions and may be useful in elderly patients. It is occasionally used with other topical agents such as corticosteroids to enhance penetration. See our Emollients and Psoriasis leaflet.
WARNING: Emollients that contain liquid paraffin should be handled with care (see product specification). Smoking or a naked flame could cause the clothing, dressings or any material that has come into contact with liquid paraffin products to catch fire. There have been reported incidents where injury caused by the ignition of material which has come in contact with liquid paraffin has led to serious and life-threatening situations and even death.