Emollient bath and shower preparations
| Choice | Drug | Dosage |
|---|---|---|
| 1st choice | Hydromol® bath and shower emollient (isopropyl myristate 13%, light liquid paraffin 37.8%) | Dose: Add 1-3 capfuls to the bath or apply to wet skin and rinse |
| or | ||
| Oilatum® emollient bath additive (light Liquid paraffin 63.4%) | Dose: Add 1-3 capfuls to the bath or apply to wet skin and rinse | |
| or | ||
| Cetraben® emollient bath additive (light liquid paraffin 82.8%) | Dose: Add 1-2 capfuls to the bath or apply to wet skin and rinse |
Prescribing Notes
- CAUTION – there is a fire hazard associated with emollients. The risk is greater when they are applied to large areas of the body and clothing, or dressings become soaked with the emollient. Following new information, warnings about the risk of severe and fatal burns are being extended to all emollients whether they contain paraffin or not. Advise patients who use these products not to smoke or go near naked flames, and warn about the easy ignition of clothing, bedding, dressings, and other fabric that have dried residue of an emollient product on them. Resources available to support safe use include MHRA Drug Safety Update Dec 2018 and MHRA Safe Use of Emollient Guidance July 2020.
- Evidence is lacking on the clinical effectiveness of bath emollients. They should not be used as substitutes for emollients applied directly to the skin. Many emollient products can be used for triple purpose: dissolved in hot water, used for washing and as an emollient after drying.
- With the exception of white soft paraffin 50%/liquid paraffin 50%, emollients may be used as soap substitutes by firstly wetting the skin, washing with the cream or ointment, then rinsing off.
- Care must be taken with bath emollients as they make skin and surfaces slippery.
Emollient bath and shower preparations with antimicrobial
| Choice | Drug | Dosage |
|---|---|---|
| 1st choice | Emulsiderm® (benzalkonium chloride 0.5%, liquid paraffin 25%, isopropyl myristate 25%) | Dose: Add 7-30ml/bath or rub into dry skin until absorbed |
| Or | ||
| Dermol 600® bath emollient (benzalkonium chloride 0.5%, liquid paraffin 25%, isopropyl myristate 25%) | Dose: Add up to 30ml/bath; do not use undiluted | |
| Or | ||
| Dermol® 200 shower emollient (benzalkonium chloride 0.1%, chlorhexidine dihydrochloride 0.1%, liquid paraffin 2.5%, isopropyl myristate 2.5% | Dose: Apply to skin or use as a soap substitute |
Prescribing Notes
- CAUTION – there is a fire hazard associated with emollients. The risk is greater when they are applied to large areas of the body and clothing, or dressings become soaked with the emollient. Following new information, warnings about the risk of severe and fatal burns are being extended to all emollients whether they contain paraffin or not. Advise patients who use these products not to smoke or go near naked flames, and warn about the easy ignition of clothing, bedding, dressings, and other fabric that have dried residue of an emollient product on them. Resources available to support safe use include MHRA Drug Safety Update Dec 2018 and MHRA Safe Use of Emollient Guidance July 2020.
- Preparations containing benzalkonium chloride can cause skin irritation with continued use.
- The addition of an antimicrobial to a bath emollient may reduce bacterial infection and colonization but should not be used regularly unless the infection is widespread or recurrent to minimize the risk of resistance.
- There is a potential for anaphylactic reaction to chlorhexidine e.g. ingredient in Dermol® 200 shower emollient. Healthcare professionals should ensure that all known allergies are recorded in patient notes and that any reactions are reported to the MHRA.