13.2.1.1 Emollient bath and shower preparations

Emollient bath and shower preparations

ChoiceDrugDosage
1st choiceEmulsiderm® (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 paraffin-based emollients. The risk is greater when they are applied to large areas of the body and clothing, or dressings become soaked with the ointment. Following new information, warnings about the risk of severe and fatal burns are being extended to all paraffin-based emollients regardless of paraffin concentration. Data suggest there is also a risk for paraffin-free emollients. 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. For further information see MHRA.
  • 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

ChoiceDrugDosage
1st choiceEmulsiderm® (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 paraffin-based emollients. The risk is greater when they are applied to large areas of the body and clothing, or dressings become soaked with the ointment. Following new information, warnings about the risk of severe and fatal burns are being extended to all paraffin-based emollients regardless of paraffin concentration. Data suggest there is also a risk for paraffin-free emollients. 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. For further information see MHRA.
  • 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.