Types Of Emollients For Eczema

Whats The Best Way To Use Emollients

Emollients absorb better when skin is damp. To get the most out of your emollient:

Eczema Symptoms & Signs

Eczema is an inflammatory condition of the skin that is very common. There are different types of eczema, including atopic dermatitis, contact eczema, neurodermatitis, allergic contact eczema, and others.

Symptoms, signs, and severity can depend upon the exact type of eczema that is present. The location of the skin inflammation also varies according to the type and cause of eczema. Signs and symptoms associated with eczema include patches of chronically itchy, dry, thickened skin, usually on the hands, neck, face, and legs, inner creases of the knees and elbows. If the irritated areas are scratched, dry patches of skin and open sores with crusts may develop and may become infected.

Almost all patients with eczema complain of itching. Since the appearance of most types of eczema is similar, elevated plaques of red, bumpy skin, the distribution of the eruption can be of great help in distinguishing one type from another. For example, stasis dermatitis occurs most often on the lower leg while atopic dermatitis occurs in the front of the elbow and behind the knee.

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Bath Additives And Shower Gels

Various emollient preparations come as bath additives and shower gels. These may be considered in people with extensive areas of dry skin. However, there is some debate as to how well these work, or even if they should be used. The amount of emollient deposited on the skin during bathing or showering is likely to be far lower than with directly applied emollient creams, ointments or lotions. So, one concern is that some people may under-treat their skin if they rely on bath or shower emollients only. Therefore, If you do use them you should use them in addition to, not instead of, creams, ointments or lotions that you rub directly on to the skin.

Note: bath additive emollients will coat the bath and make it greasy and slippery. It is best to use a mat and/or grab rails to reduce the risk of slipping. Warn anybody else who may use the bath that it will be very slippery.

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Emollients For Adults With Eczema

This video has been developed to help you understand more about emollient therapy and how it can help in controlling the symptoms of eczema.

Eczema is a dry, itchy inflammatory skin condition.

Maintaining a good skin care regime that involves cleansing and moisturising, can help manage the dry skin and itch of eczema, and prevent infection.

How emollients work?

To understand how emollients can help reduce the symptoms of eczema, lets look at what happens in the skin.

In skin where there is no eczema or dryness, the surface of the skin, which is called the skin barrier, is intact. This means that there are no breaks in the skins surface. The surface of the skin acts as a barrier to prevent bacteria, allergens or irritants getting through.

The cells of the skin bind together, like a well cemented brick wall with no gaps, and there is no excess loss of moisture from the skin.

In skin with eczema, the skin is dry and the skin barrier is weakened or broken. This weakened or broken skin barrier is like an old crumbling brick wall with gaps. This means that moisture can escape and bacteria, allergens and irritants can travel deeper into the skin layers, causing inflammation and itch, and increasing the risk of infection and allergic sensitisation.

Emollient therapy

Why is emollient therapy important in the management of eczema?

Regular emollient therapy is essential to try to restore the broken skin barrier. Emollients work to provide a protective layer to the skin.

Ointments

Tips To Prevent Eczema On Your Face

• Avoid scratching your face if its the affected area. It can cause or worsen the inflammation
• Drink lots of water daily 2 lighters of water. It will keep your skin hydrated.
• Eat balanced diet and make sure the food is healthy
• Wash your bed sheets, towel, quilts, and pillowcases regularly with proper soap or detergents.
• When feeling that your face is getting dryer try using a moisturizing cream. You can apply moisturizer at night before sleep and make sure its alcohol free moisturizer
• Try dealing with the situation if there are any sing on other parts of the body because most likely it will affect your face sooner. So try to treat eczema as soon as flare-ups begin
• Do not use loofahs or showers pumps while bathing unless advised otherwise by a doctor.
• Avoid being stressed all the time. Stress full situations brings negative effects to eczema prevention

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How To Use A Moisturizer

Itâll work best if you apply it after a bath or shower. Use lukewarm — not hot — water. Bathe for just about 10 minutes.

Pat your skin dry. Leave it slightly damp. That way you donât remove all the moisture you got from bathing.

Apply moisturizer within 3 minutes after you get out of the water. Wait longer and your skin will start to dry out.

Soften the moisturizer by rubbing it between your hands. Use your palms to smear a thick layer all over your skin. Apply it gently in simple downward strokes. Try not to rub it in circles or up and down.

It may feel sticky at first, but that’s OK. Don’t try to take off the extra. Your skin will absorb it.

Each time your wash your hands or get them wet, moisturize them, too. Keep moisturizer by each sink in the house so you don’t forget.

If you use a prescription skin medicine, put it on before you moisturize.

What Are The Benefits Of Using Emollients

Using emollients regularly may help you manage dry or itchy skin and can be a helpful addition to prescription skin creams. Emollients can make your skin feel more comfortable, relieving itching and pain from dryness or irritation. Daily use can help prevent skin cracks, helping you avoid infections.

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What You Need To Know

• Although emollients alone can help reduce the symptoms of eczema and prevent flares, most people will need to use anti-inflammatory treatments such as topical corticosteroids of an appropriate strength and duration as well

• Effectiveness and acceptability of emollients varies according to disease severity, body site, climate, container, and patient or carer preferences and beliefs

• Based on current evidence, the best emollient is the one that the individual prefers after a period of testing

Atopic eczema or dermatitis, commonly referred to as eczema, is characterised by dry, itchy skin. Although mainly a childhood condition, this disease commonly persists into or develops in adulthood.1 Patients are advised to use leave-on emollients or moisturisers, applied directly to the skin which add or help retain moisture.23 While evidence of their clinical effectiveness is limited, their use is ingrained in clinical practice and guidelines.2

Older, cheaper emollients may be as effective as newer, more expensive ones,6 and the advantages of products that claim dermatologically tested, fragrance-free, and hypoallergenic are dubious.7 Through a process of trial

What Are The Types Of Emollients

Emollients vary in their water and oil contents. High oil/low water mixtures are generally recommended for skin hydration and barrier repair .

Emollients can be classified into two categories based on their ingredients: hydrophilic or hydrophobic . Water-based, hydrophilic emollients exert a hydration effect by attracting water to the skins outer layer . Hydrophobic emollients reduce the loss of water through the skin by forming a protective barrier that prevents the evaporation of moisture .

Although an emollient is often considered the same as a moisturiser, it can also be described as a specific ingredient of moisturiser. Moisturisers can be categorised into groups based on their mechanism of skin hydration.

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Public And Patient Involvement

In 2013, the James Lind Alliance published the eczema research priorities for patients and healthcare professionals and Which emollients are the most effective and safe in treating eczema? emerged as one of the highest ranked uncertainties.27

Co-author AR is mother of children with eczema and a member of Nottingham Support Group for Carers of Children with Eczema. We have established a group of parents of children with eczema, who helped develop the study and want to support our ongoing work through meetings and email communication. A patient and public involvement member sits on the trial steering committee. We will use the internet and social media to promote wider patient engagement.

PPI has helped us to frame the research question around, Which emollient to prescribe first? for childhood eczema, acknowledging that individuals differ in their experiences of effectiveness and tolerability of different emollients. It has also gave us a clear steer that including a non-emollient group would be unacceptable to many families, favoured POEM as the primary outcome and highlighted how emollient use may be a trade off between effectiveness and acceptability.

Ongoing PPI involvement has informed both qualitative and quantitative data collection and helps ensure that the study continues to focus on delivering clinically important outcomes that are meaningful to patients.28

Surprising Ways Parents Make Eczema Itchier

Some itch-relieving techniques that people use can make eczema itchier. To prevent this, dermatologists recommend that you avoid:

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How To Spread On Your Cream Effectively

You need to apply a sufficient amount, so feel free to take what you need in your hand and to apply more as you go. The goal is to prevent feelings of skin tightness from coming back too quickly, but without applying so much that you feel sticky and uncomfortable when getting dressed. Apply in large circular motions, without rubbing.

Monitoring Safety And Audit

As the randomised treatments within this study do not differ from common usual clinical practice, risk-based monitoring will be implemented in line with a risk-assessment. Data on adverse events will be collected by parent self-report. No interim analyses are planned.

An independent Data Monitoring Committee has been established and terms of reference have been drawn up and agreed. The committee will meet at least annually, and its role is to safeguard the interests of the trials participants, potential participants, investigators and sponsor to assess the safety and efficacy of the trials interventions, and to monitor the trials overall conduct, and protect its validity and credibility.

The sponsor organisation is the University of Bristol. Adverse event reporting will be in accordance with local procedures.

The trial may be prematurely discontinued due to lack of recruitment or by the sponsor, chief investigator, regulatory authority or funder based on new safety information or for other reasons given by the trial steering committee or data monitoring committee, regulatory authority or ethics committee concerned.

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Appendix 1 Medline Search Strategy

1. randomized controlled trial.pt. 2. controlled clinical trial.pt. 3. randomized.ab. 4. placebo.ab. 5. clinical trials as topic.sh. 6. randomly.ab. 7. trial.ti. 8. 1 or 2 or 3 or 4 or 5 or 6 or 7 9. humans.sh. 10. 8 and 9 11. atopic dermatitis.mp. or exp Dermatitis, Atopic/ 12. atopic eczema.mp. 13. 11 or 12 14. emollient.mp. or exp Emollients/ 15. moisturiser.mp. 16. moisturizer.mp. 17. lubricant.mp. or exp Lubrication/ or exp Lubricants/ 18. ointment$.mp. or exp Ointments/ 19. cream$.mp. 20. exp Oils/ or oil$.mp. 21. corticosteroid$.mp. 22. exp Steroids/ or steroid$.mp. 23. 14 or 15 or 16 or 17 or 18 or 19 or 20 or 21 or 22 24. 10 and 13 and 23

Dissemination And Data Sharing

A series of stakeholder meetings will raise study awareness among and share progress and findings with policymakers, voluntary groups, clinicians, patients, families. Study progress, outputs and a summary of findings will be made available via a study website and Twitter account and summaries distributed to participating families and GP surgeries. Findings will be submitted for presentation at conferences and written up for publication in a peer-reviewed journal, which may include integration of the quantitative and qualitative findings. The International Committee of Medical Journal Editors has criteria for authorship will be observed and no professional writers will be employed.

No later than 3 years after the completion of the study, we will deposit a de-identified data set in an appropriate data archive.

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Creams Ointments And Lotions

Whenever you use an emollient, apply it liberally to the affected area of skin. Emollients should be applied by smoothing them into the skin along the line of hair growth, rather than rubbing them in. You cannot overdose, as emollients do not contain active medicines which pass through the skin. If you wash, or have a bath or shower, apply an emollient to washed areas as soon as possible afterwards in addition to any other times that you use emollients. Also, apply after swimming.

Many people mix and match different emollients to suit their needs and daily routine. For example:

• Many people use a thick ointment as a soap substitute, as normal soap tends to dry the skin.
• Some people use an ointment at bedtime for the night but prefer a less messy cream during the day.
• Some people use an ointment on some areas of the body which are particularly dry and use a cream on the rest of the body.
• Some people use an ointment when their skin is particularly dry but switch to a cream when their skin is not too bad.

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• Some users said it blocked pores, causing acne

• Remains tacky on skin after applying

Cetaphil is another dermatologist-endorsed brand that uses non-irritating ingredients to formulate effective, hydrating products for people suffering from skin issues. This ultra-hydrating lotion is made with moisturizing shea butter and glycerin to keep dryness at bay, macadamia nut oil, and vitamins E and B5. It is a great budget-friendly option for people who prefer a lighter texture than an ointment or cream, as it goes on thin, spreads easily, and will leave skin silky smooth without any stickiness or oily residue.

Active Ingredients: Glycerin, Macadamia Nut Oil, Shea Butter | Uses: Hydrates, restores and protects dry skin.

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Confidentiality And Access To Data

The database and randomisation system will protect patient information in line with the data protection legislation. Trial staff will ensure that participants anonymity is maintained through protective and secure handling and storage of patient information at the lead centre. The chief investigator will have access to and act as custodian of the full data set.

What Are The Contraindications To Emollient Use

Emollient ingredients may irritate the skin or cause contact dermatitis in some people. Stinging or burning can result in reduced use, which may decrease their therapeutic effect . The application of an emollient can also be time-consuming and leave residues on clothes and furniture . Clothing soaked with paraffin-containing emollients is flammable and a fire hazard.

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What Are The Benefits Of Emollient Use

Emollient therapy may be sufficient to control mild eczema and to eliminate symptoms .

Regular, liberal use of emollients can significantly reduce the severity of established eczema. Multiple studies have demonstrated that emollient therapy has a role in reducing the frequency and rate of flare-ups and the need for topical steroids while at the same time improving disease control by improving skin-barrier defects .

For optimal results, it is best to apply emollients to damp skin after bathing, but they can also be applied to dry skin at any time . Regular application 23 per day is recommended . The amount applied averages from 150200 g per week in young children to 500 g in adults . The therapeutic effects of emollients are reduced 6 hours after their application .

What Types Of Eczema Cream Are There

If you have eczema, you probably manage your condition using a combination of emollients and topical corticosteroids. Emollients should be used daily, while topical corticosteroids should be used during a flare-up of symptoms.

Emollients are cleansers and moisturisers tailored towards dry skin. They create a protective barrier, trapping water in the skin and reducing inflammation and itching. They should be applied liberally across the body at least twice a day.

Emollients are not the same as cosmetic moisturisers, as they arent fragranced and arent designed to treat any other skin complaints, such as acne or wrinkles.

Emollients come as:

• Cleansers
• Bath/shower oils

If your eczema symptoms are mild, you may only need to use lotions and creams. These emollients contain a lot of water, which means they are quickly absorbed and non-greasy.

If your eczema is more severe, and you have very dry, itchy and thick patches of skin, you should use ointments, as these contain a high fat content.

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What Types Of Moisturiser Are There

There are many types and brands of emollients, ranging from runny lotions to thick ointments. The difference between lotions, creams and ointments is the proportion of oil to water. The lipid content is lowest in lotions, intermediate in creams and highest in ointments. The higher the lipid content, the greasier and stickier it feels and the shinier it looks on the skin. As a general rule, the higher the lipid content , the better and longer it works but the messier it is to use.