What type of ointment is recommended for skin irritations or wounds?

Recommended Ointments for Skin Irritations and Wounds

For most skin irritations and minor wounds, bland petrolatum-based ointments (such as petroleum jelly or white petrolatum) are the first-line recommendation, as they are equally effective as antibiotic ointments while avoiding risks of allergic contact dermatitis and antibiotic resistance. 1, 2, 3

For Minor Wounds and Abrasions

• Apply petroleum jelly or bland ointment after cleansing the wound with water, covering with a clean bandage 1
• Petrolatum-based ointments without antibiotics provide equivalent wound healing to antibiotic ointments for clean surgical wounds and superficial injuries 2, 3
• Antibiotic ointments (such as bacitracin, polymyxin B, or neomycin combinations) may be applied 1-3 times daily for small wounds, but are not superior to plain petrolatum and carry higher risk of contact dermatitis 4, 2
• For small partial-thickness burns managed at home, petrolatum or petrolatum-based antibiotic ointment may be applied after cooling 1

For Inflammatory Skin Conditions and Eczema

• Apply bland, thick emollients (creams or ointments with minimal fragrances or preservatives) at least once daily to the entire affected area 1, 5
• Use oil-in-water creams or ointments rather than alcohol-containing lotions, as alcohol further irritates and dries skin 1, 5
• For acute eczematous flares, add low- to mid-potency topical corticosteroids (such as hydrocortisone 2.5% or prednicarbate cream) twice daily on top of emollients 1, 5
• Tacrolimus 0.03% or 0.1% ointment is recommended as a steroid-sparing anti-inflammatory option for adults with atopic dermatitis 1

For Pruritus (Itching)

• Apply urea- or polidocanol-containing lotions for direct soothing effects 1, 5
• Menthol 0.5% preparations offer symptomatic relief through cooling 5
• If topical therapy is insufficient, add oral H1-antihistamines (cetirizine, loratadine, or fexofenadine) for moderate-to-severe pruritus 1, 5

For Ulcerations and Erosions

• Cleanse with water and apply petroleum jelly or bland ointment with a bandage 1
• Consider hydrocolloid or foam dressings, which are adherent yet gentle on skin 1
• For severe mucosal involvement (such as Stevens-Johnson syndrome), apply white soft paraffin (WSP) ointment or 50/50 WSP/liquid paraffin mixture every 2-4 hours 1

Critical Avoidance Measures

• Do not routinely use topical antibiotic ointments for clean wounds, as they increase resistance risk and sensitization without proven benefit over petrolatum 1, 5, 2
• Avoid topical antihistamines, which increase contact dermatitis risk and lack proven efficacy 1, 5
• Never apply ice directly to burns; it can cause tissue ischemia 1
• Avoid alcohol-containing lotions or gels on irritated skin 1, 5

Common Pitfalls

• While Aquaphor Healing Ointment showed faster healing in some laser wound studies 3, a subsequent study found it caused higher wound redness (52%) compared to plain white petrolatum (12%) 6
• The choice between lotion, cream, gel, or ointment formulation does not affect effectiveness—all are equally effective for eczema, so selection should be based on patient preference and satisfaction 7
• Antibiotic ointments containing neomycin carry particularly high rates of allergic contact dermatitis 2