Emollients

There are few dermatology patients who come away from a clinic or an office practice without a prescription for one or other emollient. Emollients have hundreds of clinical uses and are also known as moisturizers especially when employed for their cosmetic uses. They are vital to the cosmetic and toiletry uses. Present day emollients are quite complex in the way that they are formulated.

The main action of emollients is to occlude the skin surface by oily film and to encourage a build up of water within the outermost layer of the skin, consisting of keratinized cells (stratum corneum). Skin becomes dry fro two main reasons: natural moisture within the stratum corneum is lost due to barrier dysfunction; natural lipids (mainly ceramides) that are normally found within the skin become deficient. Because the outer layer of the stratum corneum contains only 10% water, any reduction of this quantity causes the skin to lose its flexibility.

Desquamation, the loss of skin cells from the surface of the skin visible to the naked eye, is also thought to be an important factor in skin dryness. Emollients seem to correct this problem.2

Common emollients include mineral oils, petrolatum, and lanolin and its derivatives. They are divided into oil-in-water and water-in-oil emulsions. While emollients are designed to heal irritated skin, they are not intended to be used on diseased skin because of the irritant properties of many formulations. They should be applied before contact to irritants.3


Atopic dermatitis (AD) is a chronic inflammatory skin disease that has reached epidemic proportions in children worldwide and is on the rise. As one of the most common childhood skin diseases, AD afflicts approximately 17% of children in the United States. Patients with AD frequently develop other forms of atopy. In addition to AD, food allergies are common during the first 2 years of life. AD, allergic rhinitis, and asthma comprise the atopic triad. Recent studies have proven the efficacy of emollients in skin barrier enhancement from birth to reduce the incidence of atopic dermatitis in high-risk babies. Emollient therapy from birth represents a feasible, safe, and effective approach for atopic dermatitis prevention.4,5

References

  1. Sophisticated Emollients. Ronald Marks
  2. Principles of Skin Care: A Guide for Nurses and Health Care Practitioners. Rebecca Penzer, Steven Ersser
  3. Handbook of Occupational Dermatology. L. Kanerva, P. Elsner, J.E. Wahlberg, H.I. Maibach
  4. Emollient enhancement of the skin barrier from birth offers effective atopic dermatitis prevention
  5. Management of Patients with Atopic Dermatitis: The Role of Emollient Therapy