Choosing the right emollient

Prescribing note

Aqueous cream was developed as a soap substitute rather than as a leave-on emollient. It has been shown to produce immediate cutaneous reactions in more than 56% of patients.6

A large number of emollients are available on the market each made with different ingredients, however several include common sensitisers such as lanolin, parabens, perfumes and sodium lauryl sulphate, which can be irritants or allergens for some people. NICE recommends that you offer your paediatric patients a choice of unperfumed emollients, from which they can choose the one they prefer.1

If someone has an unpleasant reaction to an emollient, you should review its ingredients for potential sensitisers or irritants and select an alternative product which does not contain the identified ingredients.

Some brands, like Diprobase4, are particularly low in sensitisers making them more likely to be well-tolerated by a wide range of patients; starting patients on one of these may avoid the need for them to try several brands before finding one that works for them.

Helping your patients to adhere to emollient therapy is essential; many people with mild to moderate eczema are able control their condition using emollients alone.5

References:
  1. 1.NICE (2007) Atopic eczema in children. Management of atopic eczema in children from birth up to the age of 12 years. Clinical Guideline 57, London, December 2007
  2. 4.Manufacturers SPC
  3. 5.Cork MJ (1997) The Importance of Skin Barrier Function. J Dermatol Treat, 8, S7-S13
  4. 6.Cork MJ et al (2003) An audit of adverse drug reactions to aqueous cream in children with atopic eczema. Pharm J 2003, 271, 747-748

Date of preparation: May 2009 / Code: E&D 09-003