Emollients are widely used to treat skin conditions. They are creams, ointments or lotions that are applied to the skin to keep it moist. They soften the skin and form a barrier against sources of irritation. They are often prescribed for skin conditions such as eczema and psoriasis.
There are many different types of emollient in use at Great Ormond Street Hospital (GOSH). Ointments are greasy and form the best barrier against water and irritants. Creams are a mixture of oil and water and are thinner than ointments. Lotions are thinner still and easier to apply to hairy areas. Gels have a high water content so are easier to apply to the face.
The type your child is prescribed depends on his or her skin problem.
How are emollients used?
Emollients should be spread evenly on the skin. Your clinical nurse specialist may also draw up a schedule so that you know which cream should be applied at which time of day.
Emollients may come in a pump dispenser, tube or tub. If the emollient comes in a tub, to avoid spreading germs when you dip your fingers in, we advise that you put the amount of emollient needed for each application into a separate bowl using a spoon. Apply the emollient from the bowl, washing it and the spoon afterwards in warm soapy water ready for the next application. After you have applied emollient to your child’s skin, wash your hands thoroughly with soap to remove any excess oiliness.
As well as applying emollient directly to your child’s skin, the doctor may prescribe emollient bath products, such as bath oil or shower cream. These should be used instead of your child’s regular washing products, such as soap or bubble bath. They will lock in moisture from the bath or shower, reducing dryness further. Some need to be diluted in the bath water but others can be applied directly to the skin like a liquid soap.
The effects of emollients do not last long so you will need to apply them to your child’s skin frequently, sometimes several times a day, according to the instructions on the label.
What are the side effects of skin emollients?
Some ingredients in emollients can cause a rash. If this occurs, tell your doctor. Your child may need to try other types of emollient to find one that suits.
The moisturising effect of emollients can make the bath or shower tray very slippery. We advise you to use a non-slip bath mat and clean it and the bath thoroughly after each use. Your child’s skin and your hands will also be very slippery after using an emollient so take care when picking him or her up. Wash your hands thoroughly before handling anything hot or sharp.
- Some emollients, particular those containing white soft paraffin or petroleum jelly can catch fire if used near a naked flame. Never apply emollients to your child by candlelight, near an open fire or while smoking a cigarette. Once the emollients have been applied to your child’s skin, he or she should also avoid naked flames, such as candles or open fires. Store the emollients in a cool, dry place away from any naked flames or heat sources such as radiators.
- Use the emollient only as you have been instructed.
- When your child stops treatment, please return the medicine to your pharmacist for disposal. Do not throw it away.
- Keep all medicines out of the reach of children.
Please read this information sheet from GOSH alongside the patient information leaflet (PIL) provided by the manufacturer. If you do not have a copy of the manufacturer’s patient information leaflet please talk to your pharmacist. A few products do not have a marketing authorisation (licence) as a medicine and therefore there is no PIL.
For children in particular, there may be conflicts of information between the manufacturer’s patient information leaflet (PIL) and guidance provided by GOSH and other healthcare providers. For example, some manufacturers may recommend, in the patient information leaflet, that a medicine is not given to children aged under 12 years. In most cases, this is because the manufacturer will recruit adults to clinical trials in the first instance and therefore the initial marketing authorisation (licence) only covers adults and older children.
For new medicines, the manufacturer then has to recruit children and newborns into trials (unless the medicine is not going to be used in children and newborns) and subsequently amend the PIL with the approved information. Older medicines may have been used effectively for many years in children without problems but the manufacturer has not been required to collect data and amend the licence. This does not mean that it is unsafe for children and young people to be prescribed such a medicine ‘off-licence/off-label’. However, if you are concerned about any conflicts of information, please discuss with your doctor, nurse or pharmacist.