Topical formulations (things to put on your skin) are split into different categories depending on the base type of product and its characteristics. Creams, gels, solutions, lotions and ointments can all be applied to the skin to treat certain conditions. Ointment describes a smooth and oily substance, making it greasy to put on, compared to creams, lotions and gels, which have an increasingly high water content, rather than oil. This makes ointment a doctor's favourite choice for eczema, as it moisturises the skin and reduces inflammation, and an ointment can also carry other medications within it.
Creams and lotions are often preferred by parents and patients as they are less messy and absorb more quickly. But they are less moisturising, and often contain preservatives and antibacterials to protect against any bugs growing in their water content, and this may be irritating on sensitive eczema-prone skin.
Here we will talk you through some of the ointments available for eczema.
Emollients are moisturising treatments applied directly to the skin to soothe and hydrate the skin. They cover the skin with a protective film to trap in moisture and protect the skin against bacteria and other pathogens or impurities. Emollients are often used to help manage dry, itchy or scaly skin conditions such as eczema, psoriasis and ichthyosis.
They are available as ointments but can also come as creams, lotions, gels and sprays. Some emollients can also be used as soap substitutes in the bath or shower. All emollients are safe for babies, the elderly, pregnant women and breast-feeding women.
Steroid medications can come in many different forms like emollients too. You can buy the mildest steroid over-the-counter such as hydrocortisone cream, but for long-term use you should discuss any steroid creams or ointments with your doctor and figuring out the best treatment for your condition. They will use the steroid ladder to assess the next best ointment for you.
Steroid ointments can be stronger than creams, even for the same formulation, as they are "occlusive". The strength of any steroid cream or ointment also increases if you occlude the skin with clothing, gloves or socks, clingfilm, or even the crook of your elbow, as it's sandwiched in a skin fold. Your doctor can discuss steroid strengths with you.
Always make sure you apply emollient ointments at least two to three times a day. If you are applying a steroid ointment too, be sure to apply the emollient first to make the skin supple before applying steroid medication second. Make sure you apply in the direction of hair growth, as this reduces the risk of folliculitis (blocked hair follicles).
If you are buying an emollient over-the-counter, ointments are great for keeping moisture in although they are a bit messier. The thing that makes them great, the fact they sit on top of the skin to keep moisture in the skin and keep bacteria out – is what makes them messy and can get all over clothes and bed sheets.
With medications prescribed by your doctor, they will discuss with you what they think is the best topical formulation and treatment for you. If the medication needs to be absorbed well, a cream may be the best way forward. If the aim is to treat dryness with eczema, then an ointment may be the best way forward.
But as you're signing up for the long-term in yours or your child's eczema treatment, your doctor will want to know what works best for you - applying a cream regularly is likely to be more beneficial to your eczema than applying an ointment every once in a while.
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