Aqueous cream worsens eczema: Study

By Dr. Ananya Mandal, MDOct 21 2010

Researchers claim that a cream that is often used in a skin condition called eczema may actually make the condition worse. The research conducted at Bath University found that aqueous cream thinned the skin after a few weeks of use. They found that the cream contains a detergent rather than just moisturizers. The team also said that most GPs seemed unaware of official advice not to prescribe the cream as a moisturizer.

Eczema is an allergic skin condition that is aggravated when the skin gets dry and cracked. This aqueous cream is available over the counter and is an emollient cream. It is recommended by skin doctors as an alternative to soap when washing. However a poll suggested that nine of ten GPs recommended it for childhood eczema for its moisturizing properties.

The study appeared in the British Journal of Dermatology. The study involved volunteers who applied the cream on their forearms every day over a four-week period. The team compared skin samples taken before and after. They found the thickness of the stratum corneum, the outermost skin layer, was reduced by about 10% over the period of application of the cream.

Lead researcher Professor Richard Guy who supervised the study that was undertaken as a PhD work by researcher Manda Tsang said the sodium lauryl sulphate detergent in the cream was affecting a thin layer of fats lying on top of the skin. “Our study has found that rubbing aqueous cream containing sodium lauryl sulphate into the skin thins this protective barrier, making the skin more susceptible to irritation by chemicals… So to use this cream on eczematous skin, which is already thin and vulnerable to irritation, is likely to make the condition even worse,” he explained.

Manda Tsang, also said, “Eczema affects around 30% of the population, an increase from around 5% a generation ago…This is due to a combination of genetic and environmental factors, such as central heating and carpets that can encourage dust mites, and using more creams and cosmetics that can thin the skin if used too frequently…Our study suggests that it might be better for eczema patients to use oil-based ointments on damaged skin.”

The National Eczema Society recommends alternatives such as white soft paraffin or even other types of emollient without such high sodium laurel sulphate content. Margaret Cox, chief executive of the society said, “Aqueous cream contains sodium lauryl sulphate, which is a fairly heavy duty detergent. Sadly it is widely used - one it's cheap and two, it's prescribing habit.”

According to Professor Michael Cork, an academic dermatologist from the University of Sheffield this practice of prescribing the cream was against the National Institute of Health and Clinical Excellence in England and Wales guidelines. “This layer of skin will grow back over time, but if you're using aqueous cream on it every day, it simply won't get the chance,” he said to patients of eczema.