Emollients

NHSL Medicines Guidance
NHS Lanarkshire

General Notes

Emollients should be applied regularly to maintain improvement. Apply after a bath or a shower when the skin is still damp. Where emollients are being applied to the whole body twice daily, children may need 250g per week and adults 500g per week.

Oatmeal-containing products (e.g. Aveeno®) show no superior action, are not routinely recommended and are non-formulary in NHS Lanarkshire.

Risk of severe and fatal burns

The MHRA published a Drug Safety Update in December 2018 about the risk of severe and fatal burns with both paraffin-containing and paraffin-free emollients. 

Patients should be advised to:

  • Avoid smoking
  • Change and wash clothes and bedding frequently
  • Keep cream off furniture
  • Tell relatives and carers about their treatment and ask how they can help to reduce risk
  • Tell their healthcare professional if they normally smoke, as they can offer help and advice to stop smoking.

Downloadable digital resources (including a leaflet, poster and PowerPoint presentation) are available from the MHRA website.

Emollients for mild to moderate dry skin

Preferred list (P)

EXOCREAM®

  • Excipients: cetostearyl alcohol, lanolin and hydroxybenzoates

EPIMAX ISOMOL® gel

  • Does not contain cetostearyl alcohol. For use in patients where cetostearyl alcohol has had an irritant effect.
  • Previously named Isomol® gel.

Total list (T)

CETRABEN® cream

  • Excipients: cetostearyl alcohol, phenoxyethanol, hydroxybenzoates (parabens)

OILATUM® cream

  • Excipients: cetostearyl alcohol

Emollients for severe dry skin

Preferred list (P)

WHITE SOFT PARAFFIN AND LIQUID PARAFFIN ointment

  • White soft paraffin 50%/liquid paraffin 50%
  • Low risk of sensitivity

EMULSIFYING OINTMENT

  • Excipients: cetostearyl alcohol

Total list (T)

YELLOW SOFT PARAFFIN

HYDROMOL® ointment

  • Excipients: cetostearyl alcohol

Emollients for severe dry skin: preparations containing urea

Preferred list (P)

HYDROMOL® INTENSIVE cream

Total list (T)

BALNEUM® PLUS cream

  • Use when an antipruritic effect is required.

Calmurid cream

  • Product discontinued – replacement expected in due course.

Prescribing notes:

  • Preparations containing urea are useful where a keratolytic is required e.g. hyperkeratosis, ichthyosis, extremely dry and/or fissured skin on hands and feet.

Emollients with antimicrobials

Preferred list (P)

DERMOL® 500 lotion

  • Excipients: cetostearyl alcohol, phenoxyethanol

Total list (T)

DERMOL® cream

  • Excipients: cetostearyl alcohol, phenoxyethanol

Prescribing Notes:

  • For short-term use to wash and/or as a leave on emollient during skin infection only.

NHSL Joint Adult Formulary Key

To indicate the category of a formulary medicine, updated sections adopt the following key:

Preferred list (P): First-line formulary choices.

Total list (T): Alternative choices when preferred list options not effective/not tolerated, or not indicated.

Specialist initiation (S1): Specialist initiation, or on the advice of a Consultant or Specialist Practitioner in this therapeutic area. Continuation in primary care is acceptable.

Specialist use only (S2): Supply via hospital, Homecare Service or a hospital based prescription (HBP) for dispensing by community pharmacy. Not prescribed in primary care setting.

Editorial Information

Last reviewed: 31/01/2022

Next review date: 31/01/2025

Author(s): NHSL.

Version: Please refer to the introduction section for an explanation of the review dates above.

Approved By: ADTC

Reviewer name(s): ADTC.