HYDRATING AGENTS and EMOLIENTS
Place in Therapy
- For atopic dermatitis (AD), they recommend the frequent use of lubricating skin emollients, such as petroleum to help seal moisture onto the dry, cracked skin. Emollients are considered first line for the prevention of flare-ups and treatment for minimal irritation and itch. They can also be used with prescription treatment, applied at least twice daily with 3 minutes of drying time. Plain petroleum jelly is greasy but is highly effective, non-irritating and inexpensive.
- In terms of place of therapy, they are considered nonpharmacological choices and first line for mild skin irritation (i.e. dryness, mild itch, no patches or eczema). If symptoms improve, the emollient should be continued until next flare. For the management of AD during pregnancy and lactation, emollients are considered first line as well.
- Topical therapy by vehicle à Cream, Lotion, Gel, and Ointment
Chronic vs acute management
- Chronic Basic measures (i.e. decrease triggers and anxiety, etc …) + bath product (e.g. oilated oatmeal) + use an o/w or w/o emollient +/- 0.5% HC while skin is still damp.
- Acute Basic measures + wet compress as first line. If ineffective, add 0.5% HC in a drying vehicle base (i.e. lotion or o/w cream) for 1-2 weeks. Avoid ointments and powders.
- If ineffective, substitute emollient with hydrating agent.
- All products should be lanolin free.