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Use of Emollients

·     Emollients are an integral part of the treatment of all inflammatory dermatoses. They soothe inflamed skin and give the necessary lubrication to protect against further damage from external agents. They should continue to be applied even when the skin appears to return to normal, as it will still be unstable and easily irritated after the inflammation subsides. 

·  They are particularly important to use regularly in dry skin conditions such as occur in atopic dermatitis and elderly skin, both to reduce itching and protect against environmental irritants.  

 ·  There is no easy way to apply emollients, and they either have to be directly applied, or used in the bath/shower.  It is helpful for patients to be shown how to do this properly by trained staff. 

·      Some emollients contain an antimicrobial agent. These may be useful where the inflammatory condition is at risk of secondary infection e.g. when the skin is broken by scratching. 

·     Emollients work, not by putting moisture into the skin, but by preventing water loss. For this reason, the more occlusive ointment preparations will tend to be more effective. 

·      Emollient effects are short-lived, particularly for cream formulations, so they need to be applied frequently for optimal effect. This is important to bear in mind when considering prescription quantities, as up to 500g per week may be required if treating large areas of skin. 

·      Emollients can be applied at any time of the day, particularly after a bath or shower, and can also be used as a soap substitute for cleansing. 

·     There are a wide variety of emollient preparations available. The cheaper ones are often as effective as the more expensive. It is helpful to give patients a range of emollients to find which suits their skin best, as choice of preparation will vary from person to person. Some patients like to use a cream or gel (non-sticky) during the daytime, and an ointment at night. 

R The best emollient is the one that the patient will use, so be prepared to give a selection to determine  personal preference.  

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