Aqueous cream is recommended as a soap substitute, to be used instead of soap. Soaps including shower gels and bubble baths can irritate and dry out the skin. This can make eczema worse. Although aqueous cream does not lather or foam like regular soap, it cleanses the skin well. It can be used before or during bathing, showering or washing. Be careful : when using aqueous cream in the bath or shower, the floor can become slippery so use a bath mat or shower mat to avoid accidents.
Side effects with aqueous cream are rare. Some people can get signs of sensitivity or an allergic reaction such as red, itchy skin. This may be confused with a flare-up of eczema or dermatitis. If you get these symptoms, tell your doctor or pharmacist.
So what is an aqueous cream? It is a creamy moisturizer used to relieve dry skin conditions such as eczema. When used as a cleanser, instead of that squeaky-clean effect you get from a soap an aqueous cream adds a layer of oil on the surface of the skin, trapping water molecules beneath it hence preventing dryness. You should know that there are two types of aqueous creams. I use the SLS free Johnsons aqueous cream, which comes in a white container covered with a blue lid.
Since it is SLS free, it lacks sulphates, which tend to dry and irritate the skin when left on for a longer time.
The reason why I chose this particular aqueous cream is that I wanted to use it as cleanser and moisturizer. If it contained SLS I would have to rinse it out hence using it as a cleanser but not as a moisturizer. When you first apply the cream — a little goes a long way- you get this rich moisturizing sensation, which makes you doubt that the cream could actually function as a cleanser. However, what you notice later is that it get rids of all the dirt.
And when you wash it off the result is a clean and dewy face. Simply it works like an oil-based cleanser. If your aqueous contains SLS you should be cautious on leaving it on for long. Rather use it as a cleanser, which requires you to rinse it off.
However, there have been reports of skin irritation or allergic contact dermatitis associated with baby wipes in children and the preservative methylisothiazolinone found in wipes and other products. There are still many unanswered questions around skin care practices — how often should children be bathed, what type of cleanser should be used, how often should emollients be used on children, what type of emollient is best, and do additives help or hurt the skin?
Research There is a great deal of interest in research into skin barrier function, and the use of specific products and emollients. The next section provides an overview of some recent research on eczema prevention and products affecting the skin barrier.
Vegetable oils Vegetable oils such as olive oil should not be added to bath water. Studies have shown these can damage the skin barrier in adults.
In one study, adult volunteers either with or without history of atopic eczema applied six drops of olive oil to one forearm and six drops of sunflower oil to the other, twice daily for four weeks. Results showed that the olive oil significantly reduced stratum corneum integrity and induced mild erythema.
Sunflower oil preserved stratum corneum integrity, did not cause erythema and improved hydration. Note that a specially selected sunflower oil was used for the study, with a low oleic acid, high linoleic acid component, and it should not be assumed that supermarket products would have the same effect.
Olive oil therefore has the potential to promote the development of, and exacerbate existing, atopic eczema and it should not be used as a treatment for dry skin or infant massage and cradle cap. The risk of a baby developing eczema is greater in families who already have eczema, asthma or hay fever. There is now a greater emphasis on eczema prevention. Recent work has shown that impairment of skin barrier function at birth and at two months precedes clinical signs of atopic eczema.
This has implications for the optimal timing of interventions for eczema prevention. Recent key findings have demonstrated that intensive emollient therapy in early life and avoiding soaps and detergents, especially in children who carry skin barrier gene mutations and show early signs of skin barrier impairment, may be a way to prevent atopic eczema or at least to reduce disease severity.
Current evidence on skin care in infants is mixed and some studies have received support from commercial companies so there is a potential for bias. Lawton S. Understanding skin care and skin barrier function in infants. Nurs Child Young People. Lio P, et al. Evidence-based selection of skin care options for infants and children. Medscape; Nikolovski J, et al.
Infant skin barrier maturation in the first year of life. J Am Acad Dermatol. Telofski LS, et al. The infant skin barrier: can we preserve, protect, and enhance the barrier?
Dermatol Res Pract. London: NICE; Bathing and cleansing in newborns from day 1 to first year of life: recommendations from a European round table meeting. J Eur Acad Dermatol Venereol. Infant skin-cleansing product versus water: A pilot randomized, assessor-blinded controlled trial. BMC Pediatrics.
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