What are the recommended moisturizers for treating dermatitis?

Recommended Moisturizers for Dermatitis

For treating dermatitis, moisturizers in tubes rather than jars are strongly recommended to prevent contamination, with immediate application after hand washing being essential for maintaining skin barrier function. 1, 2

Types of Moisturizers and Their Applications

• Moisturizers are integral to nearly all dermatitis management plans and can be used as monotherapy in mild cases or as part of a comprehensive regimen with pharmacologic treatments 1
• Various types are available including emollients, occlusive agents, and humectants, each with unique mechanisms for improving skin hydration 1
• Water-based moisturizers are safe under all gloves, while oil-based moisturizers should be avoided as they can break down latex and rubber materials 1, 2
• Pocket-sized moisturizers are recommended for frequent reapplication throughout the day 1

Application Techniques

• Apply moisturizer immediately after hand washing when skin is still slightly damp for better absorption 1, 2
• For severe dryness, use the "soak and smear" technique: soak hands in plain water for 20 minutes and immediately apply moisturizer to damp skin nightly for up to 2 weeks 1
• At night, consider applying moisturizer followed by cotton or loose plastic gloves to create an occlusive barrier that enhances penetration 1
• For healthcare workers, apply water-based moisturizer before wearing gloves 1, 2

Evidence for Moisturizer Effectiveness

• Moisturizers reduce signs, symptoms, and inflammation in dermatitis, improve disease severity, and increase time between flares 1
• Studies show a small but significant reduction in dermatitis severity with regular moisturizer use 1
• Moisturizers containing glycyrrhetinic acid, urea, and glycerol have demonstrated better efficacy than vehicle or placebo controls 3
• Adding moisturizers to topical anti-inflammatory treatment is more effective than anti-inflammatory treatment alone and results in fewer flares 3

Selection Considerations

• No specific moisturizer or active ingredient can be definitively recommended over others based on current evidence 1, 4
• Important considerations include allergenic potential, patient preference, formulation, and cost 1
• Be aware that only 12% of best-selling moisturizer products are free of common allergens from the North American Contact Dermatitis Group 5
• The most common allergens in moisturizers are fragrance mix, paraben mix, and tocopherol 5
• Products labeled "fragrance-free" may still contain fragrance cross-reactors or botanical ingredients that can cause reactions 5

Special Considerations for Different Types of Dermatitis

For Irritant Contact Dermatitis (ICD)

• Use barrier creams (humectants) which may help protect against irritants, though their effectiveness is similar to regular moisturizers 1, 2
• Switch to less-irritating products and avoid identified irritants 1

For Allergic Contact Dermatitis (ACD)

• Identify allergens through patch testing and avoid them in moisturizer formulations 1, 2
• For glove-related ACD, apply moisturizer after washing hands and before wearing gloves 1

For Atopic Dermatitis

• Regular moisturizer use reduces the need for topical corticosteroids over 6-8 weeks 3
• Moisturizers are particularly important for preventing flares in atopic dermatitis 3, 4

Common Pitfalls to Avoid

• Avoid moisturizers in jars due to contamination risk from double-dipping 1
• Don't use products with known allergens or irritants (fragrances, preservatives) if you have sensitive skin 2, 6
• Avoid applying moisturizers with dirty hands or contaminating the product 1
• Be cautious with products labeled "dermatologist recommended" as these tend to be more expensive without necessarily being more effective or less allergenic 5
• Don't assume "hypoallergenic" or "fragrance-free" products are truly free of potential allergens 5