Emollients

Key examples

• Aqueous cream
• Liquid paraffin

 

Common indications

• As a topical treatment for all dry or scaling skin disorders. Specifically, they are used alone or in combination with topical corticosteroids in the treatment of eczema. They can reduce skin dryness and cracking in psoriasis, where, depending on severity, they are used alone or in combination with other therapies.

 

Mechanisms of action

• Emollients help to replace water content in dry skin. They contain oils or paraffin-based products that help to soften the skin and can reduce water loss by protecting against evaporation from the skin surface. Many preparations can be used as a soap substitute (as soap is drying to the skin) and there are also specific bath or shower emollient preparations available.

 

Important adverse effects

• Emollients have few adverse effects. The main tolerability issue is that they cause greasiness of the skin, but this is integral to their therapeutic effect. Emollient ointments can exacerbate acne vulgaris and folliculitis by blocking pores and hair follicles.

 

Warnings

• While these drugs are usually very safe to use, paraffin-based emollients are a significant fire hazard when the oil content is high (>50).

 

Important interactions

• There are no significant interactions with other medications. However, when using more than one topical product, applications should be spaced out. This ensures that small volumes of topical drugs (e.g. topical corticosteroids) are not prevented from reaching the affected skin by large quantities of emollient.