13.2 Emollients and Barrier Preparations

See section 13.5.1 for treatment recommendations for atopic eczema

13.2.1 Emollients (moisturisers)

Ointments 100% oil

1st        EPADERM ointment (preservative-free) 
        WHITE SOFT PARAFFIN 50% / LIQUID PARAFFIN 50% (preservative-free)
      DIPROBASE ointment
      DERMAMIST (WSP 10%) spray application

Occlusive Cream (30-70% oil)

1st     DOUBLEBASE (gel and Dayleve gel)
1st       UNGUENTUM M
        HYDROUS OINTMENT BP (oily cream)

Emollient Cream (11-30% oil)

1st       AVEENO cream
1st       EPADERM cream
        CETRABEN cream
      DIPROBASE cream
      DERMOL cream (with antiseptic)

Lotion (5-14% oil)

        DERMOL 500 lotion (with antiseptic) 
        AVEENO lotion

Preparations containing Urea

        CALMURID cream (10% urea) 
      BALNEUM cream (5% urea)

Emollients soothe, smooth and hydrate the skin and are indicated for all dry scaling disorders.

Emollients should be applied regularly to maintain improvement; most are best applied after a shower or bath.

These products, apart from white soft paraffin 50% / liquid paraffin 50%, may be used as soap substitutes by firstly wetting the skin, washing with the cream or ointment, then rinsing off.

If emollients are being applied to the whole body twice daily, children may need 250g per week and adults 500g per week. Emollient bath additives

Emollient bath/shower products without antiseptic

1st       AQUEOUS cream BP 
      OILATUM shower emollient gel
      BALNEUM bath oil
      BALNEUM PLUS bath oil
      DOUBLEBASE bath additive or shower gel
        AVEENO bath oil

Emollient bath/shower products with antiseptic

Bath additives with antiseptic should be used to reduce staphylococcal carriage in eczematous patients

1st        OILATUM PLUS
      EMULSIDERM liquid emulsion
        DERMOL 500 lotion (use as soap substitute) 
        DERMOL 600 bath emollient

13.2.2 Barrier preparations

If the barrier preparation is to be used for continence related problems, then zinc and castor oil is not recommended.  This is because it has a high mineral oil content, and as such blocks the absorbency of the pad.  Urinary (nappy) rash may clear if skin is left exposed to air; if associated with yeast (candida) infection, an antifungal cream such as clotrimazole cream is useful.

1st        ZINC AND CASTOR OIL ointment (contains peanut oil) 
        CAVILON spray (for stoma use only in primary care)


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