What Can I Do About It
You should still be able to get sufficient quantities of leave-on emollient on prescription to treat your eczema effectively, even if its not your preferred brand. If youve been refused emollient on prescription altogether, or the alternative youve been prescribed isnt working well for you, or you havent been prescribed enough, please , and show it to your GP or pharmacist. You could also present the evidence below to your GP or pharmacist.
The NHS England Clinical Working Group that was responsible for the development of the CCG prescribing guidance on OTC medicines has confirmed that:
- It did not intend for this guidance to be a blanket ban on the prescribing of emollients.
- People should still be able to receive emollients on prescription for long-term skin conditions like eczema.
- The prescribing guidance applies only to people with mild dry skin.
- The guidance does not prevent GPs from prescribing emollients based on clinical need, in accordance with their professional duties.
The Dermatology Council for England has the content of a letter on their website written by the Deputy Chief Pharmaceutical Officer at NHS England & NHS Improvement, in response to a letter from the DCE. The letter from NHS England states, among other things:
What Ingredients To Avoid In Eczema Creams
Of course, there are ingredients youll want to avoid too, Dendy Engelman, M.D., a board-certified dermatologist at Medical Dermatology and Cosmetic Surgery, tells SELF. Ingredients to watch out for include fragrances, exfoliating acids , harsh soaps, and retinol, she says: These can further irritate the skin by drying them out.
Dr. Nada Elbuluk, M.D., director of the Skin of Color Center and Pigmentary Program at USC, also notes to look at ingredients lists for anything you might be allergic to, because that will also cause a flare-up. I also recommend avoiding physical exfoliants and even certain fabrics such as wool, which can make eczema worse, she says.
So what are the absolute best eczema creams to hydrate, strengthen, and protect against flare-ups? We asked dermatologists to tell us what moisturizers they commonly recommend to their eczema patients. Heres what they suggest.
All products featured on SELF are independently selected by our editors. However, when you buy something through our retail links, we may earn an affiliate commission.
Emollients And Sensory Differences
This Ask the Expert article was published in Exchange 180, June 2021.
Q My five-year-old son has always been very sensitive and has recently been diagnosed with autistic spectrum disorder . He has atopic eczema and very dry skin but he has increasingly found the feel and smell of emollients difficult to cope with. He is starting to refuse all emollients, which is gradually making his skin drier and, in turn, flaring his eczema. Were finding it a real struggle any suggestions?
, Dermatology Nurse Adviser to NES, says: For people on the autistic spectrum or with sensory processing issues, managing eczema can be a real challenge. It is not uncommon for children and adults alike to have heightened or reduced sensitivity to sights, sounds, taste, smells, textures and touch. Adults with sensory issues have said that even a gentle touch can feel like fire or barbed wire, so its important to find the best solution.
Bath oils are not often prescribed, but this is one situation where a bath oil could really help restore the skin barrier without physical touch. Once your son is comfortable in an emollient bath, you could introduce a leave-on emollient as a soap substitute. This may be a good option for a formulation with a comfortable texture for your son. Over time, you might help him get into a routine of applying his own emollients perhaps with a reward system if he finds this motivating.
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What Products Should I Avoid If I Have Eczema
You should avoid any ingredients that you have a known allergy to and anything that has irritated your skin previously, Dr. Chan said. Common products that can do this are acne products with benzoyl peroxide or salicylic acid. I also would avoid high percentage AHAs.
Be sure to note that developing a skin allergy is higher when you have atopic dermatitis, so avoiding fragrance when you can is a good idea, especially during an active flare.
Review Of Studies And Patient Preferences
As reported by van Zuuren and colleagues in 2017, the mean duration of clinical studies on emollients was 6.7 weeks and mean age of patients 18.6 years . The clinical studies ranged from comparing studied product with vehicle or no treatment. Study participants considered the studied product to be more effective in reducing eczema and symptoms of itch compared to control. In addition, participants applying the studied product reported reduced disease severity and flares compared to placebo, vehicle or no moisturizer as assessed by the investigator. Most moisturizers showed some beneficial effects, namely prolonging time to flare, and reducing the number of flares and amount of topical corticosteroids needed to achieve similar reductions in eczema severity. However, the authors found no evidence that one moisturizer is better than the other . Moisturizers themselves were found to have beneficial effects, and combining moisturizers with active topical treatment produced better results when compared to active topical treatment alone .
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What Are Emollients And Moisturisers Used For
Uses of moisturisers include:
- Reducing skin dryness and scaling
- Reducing transepithelial water loss
- Maintenance of skin integrity, flexibility, and barrier function
- Relieving skin symptoms such as itch
- Treatment of skin conditions such as atopicdermatitis and prevention of flare-ups
- Disguising fine lines and wrinkles
- Forming a base for other cosmetic products such as make-up.
How Is Eczema Treated What Medications Are Used
Treating eczema can be difficult if the cause is something you cant control, like genetics. Fortunately, you may have some influence over your environment and stress levels. Do your best to figure out what triggers or worsens your eczema, and then avoid it. The goal is to reduce itching and discomfort and prevent infection and additional flare-ups.
Consider these treatment tips:
If your child has skin problems, such as eczema, you can:
- Avoid long, hot baths, which can dry the skin. Use lukewarm water instead and give your child sponge baths.
- Apply lotion immediately after bathing while the skin is still moist. This will help trap moisture in the skin.
- Keep the room temperature as regular as possible. Changes in room temperature and humidity can dry the skin.
- Keep your child dressed in cotton. Wool, silk and manmade fabrics such as polyester can irritate the skin.
- Use mild laundry soap and make sure that clothes are well rinsed.
- Watch for skin infections. Contact your healthcare provider if you notice an infection.
- Help them avoid rubbing or scratching the rash.
- Use moisturizers several times daily. In infants with eczema, moisturizing on a regular basis is extremely helpful.
- Make lifestyle changes that prevent flare-ups.
- Avoid skin products that have fragrances and dyes
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Although Many People Think An Emollient And A Moisturiser Are The Same Thing They Arent An Emollient Is One Of The Ingredients In A Moisturiser The Other Ingredients In A Moisturiser Bring Water Into Your Skin Emollients Are The Part Of A Moisturiser That Keep Your Skin Soft And Smooth
Emollients have been used for over 5,000 years and they form an essential part of the therapy for all dry skin conditions, including atopic and contact eczema.
Emollients are safe and effective and, in the majority of cases, mild to moderate eczema can be successfully treated by using emollient therapy alone.
The Right Moisturiser For Children With Eczema Is The One That They Like To Use Study Finds
Press release issued: 24 May 2022
The Best Emollients for Eczema trial has found that no one type of moisturiser is better than another. This study, the first in the world to directly compare different types of moisturisers, highlights the importance of patient education and choice when deciding which moisturisers to use for children with eczema. The results from the National Institute for Health and Care Research funded study are published in The Lancet Child & Adolescent Health and British Journal of General Practice today .
Moisturisers are recommended for the one in five children who have eczema , which causes dry and itchy skin. Over 100 different moisturisers are prescribed in the NHS, costing over £100 million a year. Lack of research in this area means NHS guidelines vary widely in what is recommended, which leads to confusion and waste.
In the study, led by the universities of Bristol, Nottingham and Southampton, 550 children with eczema aged under 12 years were randomised to use one of four types of moisturiser as their main moisturiser for 16 weeks. Parents completed diaries about their child’s eczema for a year, and some were interviewed to gain an in-depth understanding of how they used the moisturisers and what they thought of them. All children also had an independent examination of their skin.
Further work is needed to determine if these findings apply to adolescents and adults with eczema, and people with other dry skin conditions.
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How Should Eczema Cream Be Used
Different eczema creams are used in different ways. How and when you apply your eczema cream will depend upon whether youre going through a flare-up, how bad your symptoms are, and where on your body the affected areas are.
If youre not going through a flare-up of symptoms, or if your eczema is very mild, you should simply use emollients. Emollients should be used every day at least twice, but ideally more often, especially if you have very dry skin. You should use a large amount and apply it all over your skin, smoothing it in the same direction your hair grows.
If you are experiencing a flare-up, you should use emollients and topical corticosteroids. Apply a layer of emollient first, wait for it to soak into the skin, and then use your corticosteroid cream or lotion. This should be applied only to the affected areas, as directed in the products patient information leaflet. Typically, you will have to apply corticosteroids once or twice a day.
Other things to consider include the following:
You should always speak to a pharmacist or doctor before you start using eczema creams, to make sure youre using the right kind at the right strength.
How To Use Emollients
You should apply an adequate amount of emollient frequently to obtain the best results. Use it between two to four times a day. The worse your symptoms are, the more often you should apply it.
Along with the regular applications, reapply it every time you get the affected area wet. If your hands are affected, apply the emollient every time you wash them. If you go swimming or exercise, apply the emollient afterwards.
According to the National Eczema Association, you should apply an emollient, or any moisturizer, within three minutes of washing your hands or getting out of the shower or bathtub while your skin is still moist. Gently pat yourself dry, then apply the emollient before the water can evaporate.
Apply the emollient by dabbing some on your skin, then gently rubbing it in. You dont need to rub it in completely. You should always rub it downward in the direction of hair growth to avoid clogging your hair follicles.
During times of the year when you know your skin gets dry, or when a flare of a skin condition has cleared up, you should continue to consistently and regularly use the emollient to help keep your skin hydrated and prevent a recurrence of the flare.
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What Creams Are Best For Eczema
In terms of what dermatologists recommend and what the reviews reveal, Diprobase comes out top for the best eczema cream. Its an emollient-based moisturising and protective cream that relieves and soothes red, inflamed, dry and chapped skin. Sounds like an all-round winner.
Eucerins Body Creme is a steroid free formula that is clinically proven to reduce eczema flare ups. One Amazon review read: I have been using it for 1.5 months and eczema is almost invisible. I had to wear cotton gloves before as my hand was red and itchy, now I can make it without.
Elsewhere, La Roche Posays Lipikar Moisturising Body Balm AP+M has singing reviews. Dermatologically tested, the formula calms irritated and sensitive skin with its gentle and hydrating balm-like finish. Locking in hydration for up to 48 hours, its perfect for eczema-prone skin as it encourages the skins barrier to restore itself.
For more from GLAMOUR UKs Associate Commerce Writer Georgia Trodd, follow her on Instagram@georgiatrodd.
Best Natural: Wild Naturals Eczema & Psoriasis Cream
Courtesy of Wild Naturals
Contains manuka honey for moisturizing and soothing properties
pH balanced at 5.5 to support skin’s natural barrier function
Not endorsed by the National Eczema Society
While some dermatologists will only recommend products formulated with well-studied ingredients, some people with eczema want an all-natural option to relieve some of their symptoms, such as dry skin and redness. Wild Naturals Eczema & Psoriasis is not endorsed by the National Eczema Association, but it does contain manuka honey, which studies have found to have antibacterial benefits. It also contains aloe vera, which can help soothe irritated skin.
This moisturizing cream has a lightweight, non-greasy texture, and users report that they only need a little product to target affected areas.
Price at time of publish: $22
Active Ingredients: Aloe vera, manuka honey | Scent: Fragrance-free, but users report a slight scent of honey | Usage: Patch test on skin before applying to all affected areas or as recommended by doctor
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What Are The Benefits Of An Emollient
Most people get dry, irritated skin from time to time, especially during the winter when the air is cold and dry. You can also get dry skin from washing your hands often, or from working with harsh chemicals. Emollients are effective for soothing and healing dry skin due to almost any cause, including:
Other actions that cause you to have dry skin that can be treated with emollients include:
- using very hot water when you bathe or shower
- taking frequent or long baths or showers
- exposing your hands to water for a long time when you clean or wash the dishes
- positioning your skin close to a strong heat source like a space heater for a long time
- using soaps or cleansing products that are harsh or drying
- excessive sun exposure
No matter what the cause, dry, itchy, irritated, cracked skin is uncomfortable. Even worse, openings in your skin due to scratching or cracking can bleed or become infected.
Emollients can help improve and control your symptoms and heal your skin.
Comparison With Existing Literature
There is a body of qualitative childhood eczema research22 focused on the lived experience of eczema for children and families,2325 beliefs around eczema and its causes,26,27 and the management and treatment of eczema.2428 Studies have highlighted confusion about different emollient types and concern about different emollient constituents.22 However, only Santer et al29 looked at perceptions of emollients among patients or carers. Their study used interview data with carers of children with eczema aged 5 years. They identified similar trade-offs around acceptability and effectiveness as were observed in the present study. The present results add to these findings because it assesses experiences across the main four types of emollients in greater depth, and includes the views of children.
There has been limited qualitative work directly with children3032 and adolescents/young adults with eczema.3335 Teasdale et al36 interviewed 14 children aged 612 years. They found that applying creams was helpful in relieving eczema symptoms. As in the present interviews, participants had mixed views about the texture, viscosity, and odour of some topical treatments, yet reported using topical treatments even if they disliked its texture or odour, supporting the trade-off favouring effectiveness over acceptability.
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If I Start To Feel Unwell Or I Have A Concern What Should I Do
Because methotrexate is an immunosuppressant medication, people taking it can be more susceptible to infection. Therefore, you should inform your doctor or specialist nurse if you experience a fever, sore throat, any infection or unexplained bleeding/bruising. Patients who have not had chickenpox or the chickenpox vaccination and who come into contact with either chickenpox or shingles should inform their doctor immediately.
If you have any other concerns , you should contact your doctor or specialist nurse. Contact details for your doctor or specialist nurse should be in your methotrexate booklet.
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When And How To Apply Emollients
When the skin is very dry, using a combination of the three types of emollients helps to give the best hydration and restore the skins barrier function to normal. Emollients can be used in combination with other treatments which your doctor may prescribe, such as topical steroids.
There are no standard rules regarding whether to apply a topical steroid preparation after or before using an emollient. Some people are happiest using an emollient first to prepare the skin, followed by the steroid.
However, whichever order of care you choose it is important that you leave as long a period as practical, approximately 1/2 to 1 hour, between the two treatments to avoid diluting the strength of the topical steroid preparation, and to prevent the spread of topical steroids to areas not affected by eczema.
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