High Lipid Content Emollients
Ointment-based emollients with high lipid content are preferred for dry skin conditions, particularly in elderly patients, and include petrolatum-based products, white/yellow soft paraffin, and emulsifying ointment. 1
Specific Examples of High Lipid Content Emollients
Ointments (Highest Lipid Content)
The following ointment formulations contain the highest lipid-to-water ratios and are most appropriate when high lipid content is desired 1:
- 50% white soft paraffin/liquid paraffin mixture 1
- White soft paraffin (100% lipid base) 1
- Yellow soft paraffin 1
- Emulsifying ointment 1
- Diprobase® ointment 1
- Cetraben® 1
- Hydromol® ointment 1
Clinical Context and Rationale
The British Association of Dermatologists specifically recommends moisturizers with high lipid content for elderly patients with pruritus, as these formulations provide superior occlusion and barrier support. 1
The rationale for high lipid content emollients is based on their mechanism of action 2, 3:
- Lipid-rich formulations restore the stratum corneum lipid bilayers that are depleted in dry skin conditions 2
- They provide occlusion to reduce transepidermal water loss more effectively than lower lipid content products 3
- Ointments are particularly suitable for chronic/remission phases of inflammatory skin conditions like psoriasis and eczema 3
Application Guidance
High lipid content emollients should be applied at least twice daily, ideally after bathing to maximize skin hydration. 1 Usage estimates for twice-daily application are 200-400 grams per week for adults 1.
Important Caveats
- Ointments have a greasy consistency that some patients find cosmetically unacceptable, which can reduce compliance 1
- Patient preference is decisive for long-term adherence, as emollient therapy is time-consuming and demanding 1
- Most emollients are lipid-rich (sometimes oily) and work best when combined with appropriate keratolytics in the initial treatment phase 3