Why are emollients needed?

The fact that babies have thinner and softer skin than adults can be seen with the naked eye. Due to this feature, it is more susceptible to irritation and the influence of environmental factors, which leads to diaper rash, seborrheic crusts, atopic dermatitis and other unpleasant phenomena.

At the moment, it is known that babies with atopic dermatitis, among other things, have a disrupted skin barrier function due to a lack of lipids and filaggrin protein. The skin of such children is prone to dryness (which in itself is an unpleasant sensation – tightness, itching, peeling), the appearance of microcracks and the development of bacteria, since whole colonies of various microorganisms live on the skin of any person and as soon as the barrier functions of the skin fail, they begin active reproduction, which leads to an exacerbation of atopic dermatitis.

Thus, if the protective layer of the baby’s skin is constantly maintained in a normal state, it is possible to significantly reduce (and sometimes completely eliminate) the manifestations of atopic dermatitis. One of the main agents that have such a supportive effect are emollients – substances that soften the skin. They artificially create a lipid film, restoring the damaged surface of the epidermis and, as a result, its barrier function, which significantly reduces dry skin and eliminates itching. It should be remembered that emollients are not a substitute for anti-inflammatory treatment for atopic dermatitis, but they are a necessary addition to it.

Since there is currently a huge selection of emollients on the market (the most popular series: Emolium, Mustela Stelatopia, Lipikar AP +, Lokobase Ripea, Lipobase, AVÈNE, Topicrem), let’s try to figure out how they differ, how to choose the right one and how to use it correctly to achieve maximum effect.

Types of emollients

Natural (plant and animal)

These products are usually based on oils and / or wax of natural origin. The most commonly used components are:

  • Peach and olive oil: contain many biologically active substances that have a positive effect on the skin, in particular,  soften it,  increase elasticity,  protect against external negative factors,  and also  eliminate dryness. It should be noted that these components, like all natural oils, leave a greasy film.
  • Jojoba Oil: Chemically, it is not an oil at all, but a natural liquid wax derived from the Simmondsia chinensis plant. It spreads very easily over the skin, moisturizing it and forming a protective film that retains moisture.
  • Lanolin: An  animal wax obtained from the digestion of sheep’s wool. It  forms a fatty film on the skin that retains moisture,  perfectly  relieves symptoms of dryness and nourishes the epidermis. Currently, lanolin derivatives are more common – lanolin oil and lanolin alcohol.
  • Squalene: A  liquid hydrocarbon found in sebum, shark liver and olive oil. It perfectly softens the skin and also has protective properties.

It should be noted that preparations on a natural basis are considered the safest for the body, however, they are quite allergenic, so before using them, you should make sure that they do not cause unpleasant reactions.

Synthetic

These funds are based on fatty acids, esters and other components obtained synthetically. As a result of chemical reactions, biologically inert substances are formed , which remain on the surface of the skin, without irritating it, but forming a protective film. The likelihood of an allergic reaction to such products is much lower than to natural ones. Another “plus” is that they practically do not leave behind a greasy effect.

Chemical

This category includes products based on paraffin, petroleum jelly and / or mineral oils, which are considered chemically and biologically neutral – they are not absorbed into the skin, are not absorbed by its cells, but at the same time are capable of creating a protective film that prevents moisture evaporation and  limits the negative impact of the environment on the skin.

Emollients of chemical origin are considered to be something between natural and synthetic products.

Forms of release of emollients

When choosing an emollient, first of all, you need to decide on its shape, since it is different for each stage.

Ointments and creams restore the damaged hydrolipid layer of the epidermis most effectively  

Ointments are the densest in texture, consist of mineral oils and practically do not contain water, while perfectly softening the skin and creating a protective film on it. It is  preferable to use them on very dry, cracked, thickened areas of the skin (an emulsion will not cope with this task). 

Ointments should not be used in the acute stage of atopic dermatitis, as well as applied to the area of ​​folds, since a “greenhouse effect” can occur with the formation of diaper rash and weeping.

Creams are also quite strong emollients, but they contain significantly less fat than ointments, so they are easier to apply and faster absorbed.

In the period of remission (or with a little dryness), on the scalp, as well as in the hot season, it is worth using an emulsion or milk. Due to their light texture, they allow the skin to breathe.

How to choose an emollient?

The first thing to decide when choosing an emollient is its form, which depends, as already discussed above, on the stage of the disease and localization.

Further, the situation is more complicated, since the emollient can only be selected empirically. Sometimes even the most expensive and seemingly the best remedies are not suitable (ineffective or even worsen the skin condition) for a particular child. In this regard, it seems irrational to buy a large package at once. Better to take different probes and experiment. Despite the manufacturer’s assurances about the hypoallergenicity of such funds, individual reactions cannot be ruled out either. Therefore, before applying the emollient to the whole body, a skin reaction test should be carried out: apply the product to a small area and wait at least a day, observing the reaction.

When choosing emollients, it should also be remembered that they must be developed and manufactured using modern high technologies, taking into account the special requirements for care products for baby’s delicate skin. In addition to the usual checking of the expiration date of the drug, you should pay attention to what stage of atopic dermatitis it is used for, as well as age restrictions on its use.

In order for the  chemical composition of hygiene and subsequent skin care products to be compatible, it is advisable to  use products of the same brand.

Why won’t baby cream replace emollients?

Since emollients are not cheap, mothers often try to replace them with regular baby cream. However, it is worth remembering that many modern baby creams contain stabilizers, fragrances and alcohol, which are able to dissolve lipids (with which atopics already have problems) and, as a result, lead to new exacerbations.

At the same time, emollients developed specifically for the care of atopic skin (as well as skin prone to dryness) contain physiological lipid mixtures in the correct ratio, are hypoallergenic, and  do not contain preservatives and fragrances.

Before purchasing special products, Bepanten or another good cream with panthenol will help soften the skin, but this will not be a full replacement for the emollient.

How to apply emollients correctly?

Usually, the first time atopic dermatitis is noticed only at the stage of exacerbation. However, after the symptoms of inflammation are removed, the baby’s skin remains dry and easily inflamed over and over again. This is often due to the fact that parents do not use emollients during remission, or they use them incorrectly.

To increase the time between exacerbations (and possibly avoid them altogether), you should know the following rules for using emollients:

  1. With atopic dermatitis, dry skin is observed throughout the body, and not only in the inflamed areas, therefore, the emollient should be applied to the entire body. We apply ointments / creams to especially problematic areas, and emulsion / milk to everything else.
  2. Not all emollients are moisturizing properties. Their main purpose is to saturate the skin with lipids and retain moisture. Accordingly, the emollients should be applied to damp skin:  within three minutes  after  bathing or irrigation with thermal / mineral / filtered water, the skin was soaked with a soft cotton diaper or napkin and the emollient was applied .
  3. Emollients should be applied in a thick, greasy layer so that the skin is saturated with it as much as possible. Previously it was recommended to apply in a thin layer, but the emollients change – the recommendations also change.
  4. Emollients should be used even during periods when there are no symptoms of the disease. Only the form of the emollient and its quantity change.
  5. It is necessary to apply emollients as the skin is dry. The instructions, as a rule, indicate the frequency of application 1-3 times a day. However, this frequency is suitable only for the period of remission: in the morning, after bathing and before bedtime (if bathing and sleep are separated by a long time interval, respectively, 3 times a day; if sleep follows bathing – 2 times). However, during the exacerbation period (and immediately after it), the skin (especially on damaged areas), as a rule, needs more frequent care (the first couple of days (and sometimes a week) it dries up 2-3 hours after applying the emollient), therefore, determine the frequency of application is possible only empirically: touched the skin – dry – moistened, soaked, applied an emollient. Also, in case of redness of the cheeks, it makes sense to process them before each feeding so that they do not get irritated from contact with food.
  6. Previously, it was recommended to change emollients every month and a half, so that there was no addiction to them. This recommendation has now been changed. If the emollient performs its function well, then there is no need to change it.
  7. Cancellation of emollients should be gradual and only after reaching a stable remission. First, we switch to lighter forms (milk / emulsion), then we reduce the number of applications. It is better to do this outside the heating season.

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