What is an emollient and how does it work?
Emollients are a type of moisturizer that works to soothe, soften, and hydrate the skin by creating a protective, oily film on the outermost layer. This barrier helps to prevent water loss from the epidermis, repairing a damaged or defective skin barrier common in many dry skin conditions. Emollients are classified based on their primary mechanism, though many products combine these actions for maximum effect:
- Occlusives: These are oil-based agents that create a physical barrier on the skin's surface to reduce transepidermal water loss. Thick, greasy ointments are typically the most occlusive.
- Humectants: These ingredients attract and bind water to the skin, increasing its moisture content. Common examples include glycerin and urea.
Unlike cosmetic moisturizers, medical emollients are typically unperfumed and free from additives that can irritate sensitive skin. They are often available in various forms, from light lotions to heavy ointments, to suit different needs and severities of dry skin.
Key skin conditions treated by emollients
Emollients are a cornerstone of treatment for many dermatological conditions characterized by a compromised skin barrier and excessive dryness. Their regular and liberal use is vital for managing symptoms and preventing flare-ups.
Eczema and atopic dermatitis
Eczema, or atopic dermatitis, is a chronic skin condition causing inflamed, itchy, cracked, and rough skin. The dry skin associated with eczema is caused by a genetically defective skin barrier, which allows irritants and allergens to penetrate more easily. Emollients help by:
- Restoring the skin barrier: By forming a protective film, emollients reduce water loss and help repair the damaged barrier, making it more resilient to irritants.
- Breaking the itch-scratch cycle: Emollients soothe and relieve the intense itching that is a major symptom of eczema. This reduces the urge to scratch, which can further damage the skin.
- Reducing flares: Consistent emollient use can significantly decrease the frequency and severity of eczema flare-ups.
Psoriasis
Psoriasis is an autoimmune disease that causes the overgrowth and rapid shedding of skin cells, leading to thick, scaly plaques. Emollients are a critical part of a psoriasis treatment plan. They help by:
- Softening plaques: Greasier ointments are particularly effective at softening and smoothing the thick, scaly areas associated with psoriasis.
- Reducing scaling and itching: By hydrating the skin, emollients help reduce the characteristic flaking and relieve the associated itch.
- Enhancing treatment: When used alongside other topical medications, emollients can improve the absorption and efficacy of those active ingredients.
Ichthyosis
Ichthyosis is a group of genetic skin disorders characterized by extremely dry, thickened, and scaly skin. Emollients, especially thicker, more occlusive formulations, are essential for managing this condition. They provide the intensive, long-lasting hydration needed to control the scaling and cracking.
General and environmental dry skin
Beyond chronic conditions, emollients effectively treat everyday dry skin caused by factors such as:
- Weather: Cold, dry air in winter or hot weather can strip the skin of its natural moisture.
- Frequent washing: Over-washing with hot water and harsh soaps can remove the skin's protective oils, a problem that can be counteracted with emollient-based products.
- Medications: Certain medications, including diuretics and statins, can cause dry skin as a side effect.
Comparison of emollient forms
Choosing the right emollient formulation is important for effective treatment, with different types better suited for different skin areas and severities.
Feature | Ointments | Creams | Lotions |
---|---|---|---|
Composition | High oil content (~80%) with minimal water. | Balanced mix of oil and water. | High water content with less oil. |
Feel/Texture | Thick, greasy, and heavy. | Lighter and easier to spread than ointments. | Thin, light, and absorbs quickly. |
Occlusive Effect | Most occlusive; locks in moisture for long periods. | Moderately occlusive; needs more frequent application. | Least occlusive; provides short-term relief. |
Best For | Very dry, thick, and scaly areas; overnight use; less likely to irritate rashes due to fewer preservatives. | Broad areas of the body; sore or weeping skin; daytime use. | Hairy areas like the scalp; mild dryness. |
Using emollients effectively
To maximize the benefits of emollients, follow these application best practices:
- Apply frequently: For dry skin conditions, apply emollients at least twice daily, or more often as needed.
- Post-bathing application: The best time to apply an emollient is immediately after a warm bath or shower while the skin is still damp. This helps to lock in moisture effectively.
- Proper technique: Gently smooth the emollient into the skin in a downward, circular motion. Avoid vigorous rubbing, which can irritate sensitive skin.
- Use as a soap substitute: Many regular soaps and cleansers are alkaline and contain detergents that can worsen dryness. Using an emollient wash or soap substitute can help cleanse the skin without stripping its natural oils.
- Don't share pots: If using an emollient from a pot, use a clean utensil or pump to avoid introducing bacteria.
Conclusion
Emollients are a fundamental component of managing and treating a wide range of dry and sensitive skin conditions, from chronic illnesses like eczema and psoriasis to everyday irritation. By repairing the skin's natural barrier and locking in moisture, they effectively reduce itching, scaling, and inflammation, improving both skin health and comfort. Selecting the right type and ensuring consistent application are key to harnessing their therapeutic power. While cosmetic moisturizers offer hydration, emollients provide targeted, medical-grade relief for compromised skin. If you have a persistent or severe skin condition, consulting a healthcare provider to determine the best emollient for your needs is always recommended.
Learn more about emollient use and management of eczema from the National Eczema Society.