Using leave-on emollients for eczema and side effects
People said they use emollients one or two times a day, but sometimes more. Usually this was in the morning (such as after a shower) and in the evening before bed. Some thought it was important to also use an emollient before putting on steroid creams. Some people like that there are no limits on how often they can moisturise. Lizzie and Sarah find that emollients soothe the skin. Anissa found it helped to put the cream in the fridge. Alice says she uses moisturiser “constantly” and Lizzie described it as “just part of your daily routine”. Some people put thin layers of their moisturisers on frequently, others preferred to put a thicker layer on and wait a bit longer for it to absorb.
Many people felt strongly that using emollients is an important part of looking after their skin and helped limit flare-ups. Yet, it can be time-consuming having to moisturise so much – Aisha says it’s “hard work having to do that all the time”. It sometimes left her feeling like she should always be moisturising and that even then it wouldn’t be enough. Some said it can feel like a lot of time and effort to put in, especially if they were unsure how much of a difference it made. Forgetting to use an emollient could be a problem. Hazel said there have been times when she’s “let it slide” and Aisha said this missing moisturising just once can “wreak havoc”. Molly thought that getting into the routine was easier when she can see a flare-up but a “battle” to remember at other times. She found it supportive when friends reminded her to put on the creams. Remembering can be especially difficult when there’s a lot going on in your personal life. Sometimes people also felt they were missing out on doing fun things with their friends because they tried to stick to a routine with using eczema treatments.
The seasons can make a difference how emollients are used. In dry and cold weather, some people said they use more and thicker creams. Anissa and Molly also moisturise more often if they’ve been in contact with triggers such as washing detergent or damp in a house.
It can be tricky to put emollient on some parts of the body or when the eczema is very painful. Parents often helped younger children but it could be embarrassing having parents help when they got older. It can be difficult to do things after applying emollient. Ele and Aadam have had to ask for help with activities, like opening jars, because their hands were slippery. People found it annoying having to wait until the emollient dries before putting on their clothes or getting into bed at night. One thing that both Vicky and Himesh found worked well for shaving was to use either one of their emollients instead of a shaving gel product.
Taking creams to out and about with you
People said they had to take their emollients everywhere they go. This includes school or university classes and at work. Some thought it could be embarrassing being seen by others using prescribed creams, such as at work or in lectures, but that shop-bought moisturisers would be okay. George never took any creams into school and Shams put his emollients into another pot to disguise them. Anissa also put her creams into smaller pots because the tub of emollient was too big and heavy to carry about. Himesh’s dermatology doctors and nurses gave him smaller sample-size moisturisers to carry with him. The opportunity to use creams and feeling comfortable to do so varied in different settings. Himesh’s secondary school had a medical treatment room. He could leave his creams there and quickly put some more on during class breaks. Himesh also got extra time in exams so he could top up on the creams. Trying to quickly put on emollients in public/shared toilets between lectures is difficult, especially for eczema on areas usually hidden under clothes. Some jobs were seen as more suitable for using creams during the working day, such as those which are desk based. In contrast, waitressing and being on check-outs were tricky if you couldn’t fit moisturisers into uniform pockets or were always ‘customer facing’. Some people were worried about taking their emollients with them if they went abroad. Having to plan ahead to take enough (but not too much) and packing them in luggage could be a stressful. A few people had lived abroad and had struggled to get similar emollients for managing their eczema. Downsides and side effects with emollients
Some people had side effects from emollients they’d used. Ele had a bad reaction to E45 and Gary remembers one cream which burnt when he put it on. Aisha and Shams both found that heavy emollients irritated their skins. Some side effects went away with time. Himesh noticed that often his skin would get red for a little while when he first used a new emollient. Most complaints about emollients were about how they smell and what they feel like:
- oily, greasy, slimy, sweaty – makes the skin shiny
- sticky, gooey, too thick
- smelly, stinky – like petrol, gas, “medicated”, like a "laboratory"
- dries too quickly or comes off with sweating so has to be reapplied
- messy – gets on clothes and bedsheets, picks up pet fur, gets in eyes and hair
- crusty and sharp when dried
- difficult to rub in – leaves a residue and rolls of cream on skin
- putting on creams “heats up” the skin which makes it itchier
- Age at interview:
- Age at diagnosis:
- Himesh is 17 and a sixth form student. He is single and lives at home with his family. His ethnicity is British Indian.
When I’m applying a cream I feel really like heated up so then obviously then I would have to wait until it soaks in and then put my clothes on and I remember when I used to do it about probably about two years ago, usually put it, no yeh two years ago, used to our it day and night when I wake up and like I would get heated up especially when it was school time I would have to put my cream on and then put my clothes on and I feel really uncomfortable especially when you have to wear a shirt, blazer, tie all day, so yeh I’d feel uncomfortable basically.
- Age at interview:
- Abid, aged 24, is of British-Bangladeshi descent.
I think there’s one which is quite common which is called Epaderm which is like I can’t, I’m trying to think of a, of a texture to, to give you a an idea of it but it’s almost like pâté almost and you're supposed to rub that in your skin and it’s, it’s not, it’s not really practical. And it’s not even from that point of view and like you have to be super conscious of this, so if you want it to, if you want to try to rub this in, this incredibly greasy thing, you’re not gonna feel comfortable putting clothes on after, so you need, let’s say you start your work at 9 ‘o’ clock which is a normal, normal time to work. I wake up and let’s say it’s a half an hour commute, normally you would wake about maybe 7 ‘o’ clock have a shower, have your breakfast and go to work kind of thing. In this situation you’ll have a shower and you, strangely saying you can’t put your clothes on after because you’ve just applied this, this so called cream.
And then you're there, kind of stuck in this kind of limbo, where you’re pretty much magnetic man which everything will stick to you.
- Age at interview:
- Sarah is 23 years old and a charity/youth worker. Her ethnic background is White British.
When the eczema’s bad I don’t really, I don’t get spots really when my eczema’s bad. And I just like moisturise everywhere. But then when it’s kind of like an average point you kind of like have to moisturise. And then obviously the bits where you’ve got eczema, you have to moisturise a lot. And then the bits where you’ve got spots, you’re like, ‘oh, I don’t really wanna put the moisturiser on there.’ So I end up like not moisturising my forehead at all and then putting like eczema cream like on my eyes and like the bottom of my face. And then where, wherever you don’t have eczema but you’ve used eczema cream, you get clogged pores, cos it really clogs and it builds up on your skin.