CLEANSERS and MOISTURIZERS Prepared by : SIG, Dermatology Nursing IADVL

pH of the skin = 5.5 ( acidic); pH of water is 7 ( neutral) SOAPS and SOAP SUBSTITUTES pH of the skin = 5.5 ( acidic); pH of water is 7 ( neutral) All soaps are alkaline Because of their alkalinity, soaps tend to remove the natural oil film of the skin while removing dirt and grime Application of soaps can be both useful and harmful depending on the type of skin ( oily vs dry)

SOAPS Most commonly used agent for cleansing the skin May have added agents, mostly antibacterials, for special action on the skin For antibacterial action, contact time important pH of soap is alkaline while skin is acidic Drying effect of soaps on skin can be useful for oily conditions (acne) but harmful for dry conditions (ichthyosis)

SOAP SUBSTITUTES Because of same pH, do not dry the skin Act like soaps but pH matched to skin (usually 5.5 to 7) Because of same pH, do not dry the skin May have added active ingredients like triclosan Usually have special additives like lecithin that layer the skin with a protective barrier

MOISTURIZERS Medical term for it is ‘Emollient’ First line treatment for maintaining effective barrier function Available as different formulations such as ointments, creams, gels, lotions Some work as both a skin moisturizer and a soap substitute Also have some indirect anti inflammatory effect Help to reduce the requirement of topical steroids (steroid sparing agents)

Action of emollients

What do emollients do ? EMOLLIENTS lock water Lubricate Reduce scaling Seal stratum corneum

CREAM Both water and fat OINTMENT No water; mostly fat EMOLLIENTS CREAM Both water and fat OINTMENT No water; mostly fat Best for very dry skin EMOLLIENT LOTION Liquid formulation Best for hairy areas

As liberally as possible (30 - 40gm for whole body per application) WHEN TO APPLY AN EMOLLIENT As frequently as possible (atleast 2-3 times a day) As liberally as possible (30 - 40gm for whole body per application) After bathing ( within 2-3 minutes) while the skin is still moist

Dry skin – loss of barrier

Cracked lips – needs emollient

Scaly palms - Psoriasis

Generalized scaling - whole body moisturisation

Thick scaling – soak and seal

Cracked, dry skin in old age

HOW TO APPLY AN EMOLLIENT Soon after a bath Generously but gently Do not rub vigorously Apply in the direction of hair

CHOOSING AN EMOLLIENT Advise correct amounts and frequency Must be right for the skin condition Advise correct amounts and frequency Must be cosmetically acceptable Appropriate to weather/ environment Must be free of preservatives No fragrances

Apply enough : at least 30 – 40 gm per application for whole body

Careful while holding babies SAFETY WITH EMOLLIENT USE Surfaces can get slippery in the bath specially for children and elderly Careful while holding babies Use a spoon to take out emollient from the tub to prevent contamination

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