Preservation of normal skin
Moisturizers can be used to prevent the skin from becoming too dry or oily, such as with light, non-greasy water-based moisturizers. Such moisturizers often contain lightweight oils, such as cetyl alcohol, or silicone-derived ingredients, such as cyclomethicone.
For treating skin dryness, the most appropriate moisturizers are heavier, oil-based moisturizers that contain ingredients such as antioxidants, grape seed oil or dimethicone. For very dry, cracked skin, petrolatum-based products are preferable, as they are longer lasting than creams and are more effective in preventing water evaporation.
For oily skin, moisturizers can still be useful after activities causing skin dryness, such as other skin care products and washing. For oily skin, water-based moisturizers that are specifically non-comedogenic are preferable, as there is less risk of comedo formation.
Appropriate moisturizers to keep aging skin soft and well hydrated are oil-based ones that contain petrolatum as the base, along with antioxidants or alpha hydroxy acids against wrinkles.
On sensitive skin (which otherwise is susceptible to skin irritations, redness, itching or rashes), it is preferable to use moisturizers which contain soothing ingredients such as chamomile or aloe, and that minimize potential allergens such as fragrances or dyes, as well as irritants such as acids.
In eczema it is generally best to match thicker ointments to the driest, flakiest skin. Light emollients such as aqueous cream may not have any effect on severely dry skin. Some common emollients for the relief of eczema include Oilatum, Balneum, Medi Oil, Diprobase, bath oils and aqueous cream. Sebexol, Epaderm ointment, Exederm and Eucerin lotion or cream may also be helpful with itching. Lotions or creams may be applied directly to the skin after bathing to lock in moisture. Moisturizing gloves (gloves which keep emollients in contact with skin on the hands) can be worn while sleeping. Generally, twice-daily applications of emollients work best. While creams are easy to apply, they are quickly absorbed into the skin, and therefore need frequent reapplication. Ointments, with less water content, stay on the skin for longer and need fewer applications, but they can be greasy and inconvenient.
Recently, ceramides, which are the major lipid constituent of the stratum corneum, have been used in the treatment of eczema. They are often one of the ingredients of modern moisturizers. These lipids were also successfully produced synthetically in the laboratory.
A randomized control trial in infants found that subjects with atopic dermatitis that were treated with emollients (eg, Eucerin, Cetaphil, Nutraderm) had significantly decreased requirements for topical steroids compared with a control group who were not treated with them. Emollients are best applied immediately after bathing when the skin is well hydrated.
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