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Eczema 'made worse by aqueous cream'

People with eczema who use moisturising cream can end up making their condition worse, researchers have reported.

Famous brands bought in high street shops can actually irritate the skin, according to scientists at Bath University.

Eczema should instead be treated with oil-based ointments, they added.

Commonly prescribed aqueous cream BP, for example, was found to significantly reduce the thickness of healthy skin over a four-week period and cause irritation because it contains the detergent sodium lauryl sulphate.

The cream, originally used to wash the skin, is used as a moisturiser to make the skin more flexible and to stop the protective outer layer from cracking.

Healthy volunteers applied aqueous cream to their forearms every day for four weeks. The scientists found that the thickness of the stratum corneum was down by at least 10%, adding that this damage is likely to be more pronounced in people with already unhealthy skin.

Manda Tsang, who worked on the study, said: “Eczema affects around 30% of the population, an increase from around 5% a generation ago.

“This is due to a combination of genetic and environmental factors, such as central heating and carpets that can encourage dust mites, and using more creams and cosmetics that can thin the skin if used too frequently.

“Our study suggests that it might be better for eczema patients to use oil-based ointments on damaged skin.”

The study findings appeared in the British Journal of Dermatology.

Readers' comments (8)

  • At last some back up to what I have claimed for years.

    I do have eczema and found that Aqueous irritated my skin and caused me problems. This has been the same for my children. I also noticed it with my patients and therefore I used to use olive oil on their limbs. This worked well and had the benefit of vitamin e. Not to mention it was cheaper than aqueous. However I often found myself at odds with other staff and doctors who swore by aqueous and would often ignore the negative comments from the patients.

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  • I read the article in the British Journal of Dermatology and also looked up the ingredients of a few of the emollients I use with my eczema, such as E45, Vaseline intensive rescue and Simple Derma intensive relief. None of these contain sodium lauryl sulphate, so it leaves me wondering how the researchers can so confidently say here that we should ditch creams for ointments (which they don't say in the article), when their research appeared to have a comparatively narrow focus. Surely the main finding is that SLS is harmful, not creams per se?

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  • My daughter has eczema and used to scream as a toddler if I used aqueous. I told my sceptical GP who prescribed an alternative. I looked into it myself and found aqueous was wrongly being used as a moisturiser and was meant to be a soap substitute. Since then, I have always passed this information on to patients. At last there is some recognition of this even if it is nearly 20 years after I discovered it.......often the way.

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  • My daughter has had exczema since babyhood (now 22) and has always used aqueous as a soap substitute and moisturises with soft white parrafin or olive oil.
    We found that many of the brands that you buy over the counter for eczema irritated her skin and it was only the products such as olive oil which gave her any relief.

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  • I sometimes have Psoriasis on my scalp and have found that the only thing that really works is warm olive oil (the cheapest) - massaged into the scalp, cover head with a towel and place a plastic cover on your pillow - go to sleep and wash in the morning - lovely soft skin, no irritation and shinny hair!

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  • Finally, some research back up (evidence base) about aqueous cream! My son suffered from eczema from when he was just a few weeks old. We were prescribed aqueous cream and his eczema seemed to get worse. On telling other healthcare professionals, it was like i was fabricating my observations and it was put down to worry of a new mother.' I like other cemmentors switched to olive oil and non-perfumed oil-based ointments. These seemed to work though he also needed steroids from time to time as it would get worse at certain periods (which we later found out that he had certain food allergies too).

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  • My son suffered terribly from eczema at an early age. He was prescribed Aqueous cream and it appeared to make the condition worse. It would cause his skin to become bright red and looked worse than before the cream was applied. He would say that it felt as if it was 'burning' so I stopped using it. The only relief he had from the condition was by using Hydrocortisone.

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  • hi, i totally agree,it should be made very clear that aqueous cream is a soap substitute, used for cleansing, i find that most of teh emmolient creams such as aqueous .diprobase etc irritate if used a a mosituriser as my son perscribed these also from yong age i found that epaderm.hydraderm, used regularly keep his excema at bay but i must used oilatum and aqueous cream to bath. recently on holidays the chemist did not have the epaderma and in desperation i used aqueous to mosturise my son after 3 days he had a terrible bout of excema after been free for almost a year. when using my usual regeime. i think that laurel sulphate shouls be clearly labelled on all the creams as a possible irritant as with most branded creams etc its difficult to know which ingredients may cause irritation . thank you and i am so glad that the nursing times has clarified my long held idea.

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