Scientists have found that aqueous cream used to treat eczema thinned the skin after a few weeks of use. This is because it contains a detergent rather than just moisturisers.
"Aqueous Cream BP" is widely prescribed to British patients with eczema to relieve skin dryness. The formulation contains sodium lauryl sulphate (SLS), a chemical that is a known skin irritant and a commonly used excipient in personal care and household products.
The University of Bath study, published in the British Journal of Dermatology looked directly at its effects on the skin when used regularly. Volunteers, none of whom had eczema, rubbed it into their forearms every day over a four-week period. They found the thickness of the stratum corneum (SC), the outermost skin layer, was reduced by about 10% in this time.
The application of "Aqueous Cream BP", containing ∼1% SLS, reduced the SC thickness of healthy skin and increased its permeability to water loss. These observations call into question the continued use of this emollient on the already compromised barrier of eczematous skin.
Sodium lauryl sulphate detergent in the cream was affecting a thin layer of fats lying on top of the skin.
According to BBC, "To use this cream on eczematous skin, which is already thin and vulnerable to irritation, is likely to make the condition even worse. "Aqueous cream contains sodium lauryl sulphate, which is a fairly heavy duty detergent. Sadly it is widely used - one it's cheap and two, it's prescribing habit. This layer of skin will grow back over time, but if you're using aqueous cream on it every day, it simply won't get the chance."
The UK National Eczema Society recommends alternatives such as white soft paraffin or even other types of emollient without such a high sodium laurel sulphate content.
The moisturizer creams that I typically recommend for use in atopic dermatitis (Eucerin and Aquaphor) do not contain sodium lauryl sulphate. The ingredients can be verified on the manufacturer's website.
Atopic Dermatitis Treatment - Illustrated (click here for full size image).
Barrier creams and emollients for AD include CeraVe (http://cerave.com), Mimyx, EpiCeram (http://epiceram-us.com), Eletone, Theraplex (http:/theraplex.com), Eucerin and Aquaphor.
Effect of Aqueous Cream BP on human stratum corneum in vivo. M. Tsang, R.H. Guy. British Journal of Dermatology, Volume 163, Issue 5, pages 954–958, November 2010.
Aqueous cream 'aggravates eczema'. BBC.
50% of school children with eczema (atopic dermatitis) may actually have allergic contact dermatitis (study) http://goo.gl/Bq3ZB
Prescription barrier creams include Atopiclair, EpiCeram, or Hylatopic Plus.
Image source: Skin layers. Wikipedia, public domain.
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