Moisturisers
Moisturisers help protect the outermost layer of skin known as the stratum corneum or skin barrier. People living with eczema have a damaged skin barrier, which makes their skin more sensitive to irritants, allergens, bacteria and other invaders. A damaged skin barrier also makes it harder for the skin to retain water, leading to chronic dry, itchy skin, which can cause eczema and other skin conditions to flare-up or get worse.
What is a moisturiser?
Whilst moisturisers seem to contain an endless list of ingredients, there are essentially three main components:
- an occlusive to prevent the loss of water from the skin
- a humectant to attract moisture towards the skin
- an emollient which soothes dry skin and improves its appearance.
Even when prescription medicine is required, moisturisers must continue to be used to obtain maximum benefit.
Good eczema management is not possible without regular use of moisturiser, which, when applied correctly, can soothe, hydrate, protect the skin and relieve the itch.
What’s the difference between lotions, creams, ointments, gels and oils?
Moisturisers are not all the same. When choosing a moisturiser, it is essential that you understand the differences between an ointment/cream/lotion/gel and the way each works to repair the skin barrier. You need to find one that best suits your skin and also your lifestyle. You’ll be using it every day, so you need to like the way it looks, feels and smells, too.
As well as formulation it is also important to think about the actions of moisturisers. All leave-on moisturisers are ‘occlusive’, which means they seal the skin barrier, enabling skin repair by preventing trans-epidermal water loss and treating and preventing dry skin.
The different formulations available
Lotions contain more water and fewer oils than creams and so they spread easily when applied. They act quickly and are useful for hairy areas of skin, weeping eczema or for quick absorption if time is short but overall they are not as effective in moisturising dry skin.
Creams contain a mixture of water and oils and like lotions feel light and spread easily when applied to the skin. They too need to be reapplied often, as they do not penetrate very dry skin readily. Creams are ideal for weeping eczema and daytime use. They are also great to refrigerate and numb itchy skin quickly.
Ointments do not contain water (or only a very small amount) and as a result tend to be thick and greasy. Some people find them cosmetically unacceptable. They are ideal for very dry and thickened skin and are ideal for night-time use. Ointments contain less water than other moisturisers, so they require fewer preservatives, making them ideal for people who react to preservatives. They should be applied every 6-8 hours and not used on weeping eczema.
Gels Chemically speaking, gels are formed from molecules that make a three-dimensional network, which then traps other molecules in the spaces of the network, which then traps other molecules in the spaces of the network. They are relatively light and non-greasy, despite having a reasonably high oil content. They should be applied every 3-4 hours, unless they contain humectants, in which case, they only need to be applied every 6-8 hours.
Oils These mostly comprise bath and/or shower oils, for washing. Some disperse and add moisturiser to the water while other are semi-dispersing and leave a coat of moisturiser on the body.
When and how to apply moisturiser
Moisturiser treatment is not just about products but understanding how and when to use them to get maximum benefit.
- Use liberally and frequently, at least two to three times a day.
- It is best to apply moisturiser after bathing or showering whilst skin is still damp (within 5 minutes) and while water is still trapped in the skin which helps lock in the moisture.
What are the key features I should look for when choosing a moisturiser?
- Avoid “cosmetic moisturisers” which may contain sunscreen, fragrance, antioxidants, anti-aging ingredients etc
- “Hypoallergenic” products are least likely to irritate
- If possible, test the moisturiser on a small area of skin first for a few days to make sure it does not sting, burn or irritate the skin
- It should be affordable because you need to use it several times a day
- It should be comfortable to apply and doesn’t irritate the skin
- It treats dry skin and repairs the skin barrier
- It fits in with your lifestyle, feels and
- looks pleasant, is easy to use and available in adequate quantities.
Active ingredients
- Some moisturiser lotions and creams contain additional active ingredients:
- Antimicrobials destroy bacteria and are found in some leave-on creams, lotions and wash products. Some people becomes sensitised to the leave-on forms if they use them over a long period.
- Anti-itch ingredients are found in a couple of creams in the form of lauromacrogols, a local anaesthetic.
- Ceramides are used in some leave-on creams and lotions. They may re-establish the balance of fats necessary for the appropriate functioning of the skin barrier.
- Oatmeal is found in cream and lotion. It has anti-itch properties.
How to obtain your chosen moisturiser?
You have finally found the moisturiser that suits, only to find it is not available locally or is really expensive. Stock up when it’s on special (all Pharmacists have specials from time to time on most products). Buying online nowadays is also available.
Information contained in this article was obtained from the NES & NEA
It is not the policy of the Eczema Association of Australasia Inc to recommend or endorse any product or treatment. It is part of the role of the Association to provide information on a wide range of products and treatments to keep those involved with eczema as fully informed as possible as to all options available. For medical advice, consult your health professional.
