Moisturizers (Humectants, Emollients and Occlusives)

Moisturizers are one of the most important elements in good skin care for people with atopic dermatitis (AD), regardless of the severity of their disease. Moisturizers may be the main treatment for mild AD and should be a part of therapy for moderate to severe AD. AD damages the barrier of the skin, which leads to increased water lost through the surface of the skin and an increased irritation due to allergens, chemicals, and fibers. The damaged skin barrier also puts people with AD at a higher risk for skin infections.1,2

Types of moisturizers

Moisturizers may be called by several different terms, such as ointments, creams, lotions, or emollients. All of these products are mixtures of lipid (fat) and water. Ointments have the highest proportion of lipid and likewise feel “greasy.” An example of an ointment is petroleum jelly, which is 100% lipid. Creams are emulsions of water in lipid and contain stabilizers to keep the ingredients from separating. Although creams can be less greasy than ointments, some contain other ingredients that may sting or irritate AD skin. Lotions contain a higher percentage of water to lipids, and lotions will need to be applied more frequently to maintain skin hydration.1

There are different types of moisturizers that may be used by people with AD, including:

  • Humectants, which attract and bind water from deeper layers of the skin
  • Emollients, which contain lipids (fats) naturally found on the skin and smooth skin by lubricating the skin
  • Occlusives, which form a hydrophobic film to reduce the loss of water from the skin3

Examples of Moisturizers by Type3

Humectants
Emollients
Occlusives
Glycerin
Collagen
Carnauba wax
Alpha hydroxy acids
Colloidal oatmeal
Lanolin
Hyaluronic acid
Elastin
Mineral oils
Sorbitol
Glyceryl state
Olive oil
Urea
Isopropyl palmitate
Petrolatum
Shea butter
Silicone
Stearic acid

Benefits of moisturizers

Moisturizers play an important role in the treatment and maintenance of AD and provide several benefits, including:

  • Helping repair the skin barrier
  • Combat the water lost through the skin
  • Increasing the hydration of the skin
  • Treating and preventing dry skin
  • Helping control itchiness, redness, cracking, and thickening of the skin (lichenification)2

Choosing a moisturizer

There have been few clinical studies comparing moisturizers to determine which is the best, and the trials that have been performed have not demonstrated one moisturizer as superior to others. Due to their high lipid content, ointments tend to have the greatest moisturizing effect, followed by creams, then lotions. However, the best moisturizer is usually individually determined by a number of factors, including individual preference, safety, effectiveness, cost, and the absence of fragrances or other chemicals that may cause sensitivity. Regardless of which product is used, the regular application of moisturizers to the skin is an important part of the therapy for AD.1,2

Frequency of application

While there is not an official recommendation for frequency of application, it is generally believed that moisturizers should be applied often enough that dry skin (xerosis) is minimal. It is especially important to apply moisturizers after bathing when the skin is still damp. This helps seal the water into the skin.2

Emily Downward | June 2017
View References