Using leave-on emollients for eczema and side effects

Using leave-on emollients (moisturisers)

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.

Dermatology nurses helped Cat understand how best to use emollients (moisturisers).

Age at interview 24

Gender Female

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Katie-Lauren has to plan ahead about showering because moisturising is so time-consuming.

Age at interview 19

Gender Female

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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.

Shams explains about the difficulties he has when putting treatments on his back, especially when eczema makes it difficult for him to move.

Age at interview 18

Gender Male

Age at diagnosis 7

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Katie-Lauren’s boyfriend sometimes helps her moisturise.

Age at interview 19

Gender Female

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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.

Alice doesn’t like wearing long sleeved tops because of the memory of clothes sticking to moisturisers on her arms.

Age at interview 22

Gender Female

Age at diagnosis 7

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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.

Abid felt more comfortable using a shop-bought moisturiser at work rather than a prescribed one.

Age at interview 24

Gender Male

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Georgia has moisturiser stations’ in the several of the places where she spends her time.

Age at interview 20

Gender Female

Age at diagnosis 4

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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’.

Anissa wasn’t allowed to put her creams on, or check they were rubbed in, at school. Things are different now she’s at university.

Age at interview 20

Gender Female

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Ele took a moisturiser into her school exams but found she couldn’t really use it.

Age at interview 22

Gender Female

Age at diagnosis 2

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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.

George struggled without his emollients on a school trip.

Age at interview 17

Gender Male

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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.

Jessica and her dermatologist think her itchiness might now be an allergic reaction to a cream for vulval eczema.

Age at interview 20

Gender Female

Age at diagnosis 20

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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

Putting on emollients makes Himesh’s skin feel too warm and uncomfortable.

Age at interview 17

Gender Male

Age at diagnosis 10

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Abid talks about the texture and practicalities of some emollients he has tried for his eczema.

Age at interview 24

Gender Male

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Sarah found that some eczema creams blocked her pores, making her more prone to spots and ingrown hairs.

Age at interview 23

Gender Female

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Young people said these downsides drew attention from other people and made them feel self-conscious, including at school and with romantic partners.

Georgia worries that other people will smell her emollients.

Age at interview 20

Gender Female

Age at diagnosis 4

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Himesh feels comfortable putting his creams on at home and leaving them around the house, but others like Katie-Lauren and Aman took the bottles back to their room when sharing bathrooms at university.