What is LPC (Liquid Paraffin Cream) 4% emulsifying ointment used for?

LPC 4% Emulsifying Ointment: Definition and Clinical Uses

LPC 4% refers to Liquid Paraffin Cream at 4% concentration in an emulsifying ointment base, which is a high lipid-content emollient used primarily for managing dry skin conditions, particularly in atopic dermatitis, ichthyosis, psoriasis, and other xerotic (dry) skin disorders. 1

What It Is

• Emulsifying ointment is a high lipid-content, ointment-based emollient that contains predominantly lipid (oil/paraffin) with minimal water content, providing superior occlusion and barrier support for severely dry skin 1

• It belongs to the category of paraffin-based emollients, similar to white soft paraffin, yellow soft paraffin, and 50% white soft paraffin/liquid paraffin mixtures, all of which have the highest lipid-to-water ratios 1

• Emulsifying ointment is specifically listed among recommended emollients for managing skin conditions requiring intensive moisturization, alongside products like Ungmentum M, white soft paraffin, and Epaderm cream 2

Primary Clinical Uses

Atopic Dermatitis (Eczema)

• Regular emollient use is the cornerstone of atopic dermatitis management, recommended for application 2-8 times daily to decrease transepidermal water loss (TEWL) and restore skin barrier function 2

• Emollients should be applied liberally and frequently (at least twice daily), with usage estimates of 200-400 grams per week for adults when applied twice daily 2, 3

• Application is most effective immediately after a 10-15 minute lukewarm bath or shower when skin is still slightly damp to maximize hydration 2

Congenital Ichthyoses

• Emollients are recommended 3-8 times daily for neonates and children with ichthyosis to decrease TEWL, with sterile occlusive ointments like white petrolatum commonly used 2

• Water-in-oil emollients (like emulsifying ointment) may be preferred alternatives to pure petrolatum as some authors consider they may reduce infection risk and avoid impairing sweating 2

Psoriasis

• Emollients used in conjunction with topical corticosteroids for 4-8 weeks help reduce itching, desquamation, and total body surface area involvement, and prevent quick relapse when corticosteroids are discontinued 2

• Emollients are recommended as part of the general treatment regimen to help reduce itching and desquamation in psoriasis patients 2

Other Dry Skin Conditions

• High lipid content emollients are specifically recommended for elderly patients with pruritus, as these formulations provide superior occlusion and barrier support 1

• Emulsifying ointment is effective for managing dry skin in various dermatologic disorders including senile xerosis and other conditions associated with severe xerosis 4

Application Guidelines

• For adults, typical usage is 200-400 grams per week when applied twice daily to maintain adequate skin hydration 2, 3, 1

• Specific body area requirements for 2-week supply: face/neck (15-30g), both hands (15-30g), both arms (30-60g), both legs (100g), trunk (100g) 2

• Ointment formulations provide maximum penetration through occlusive dressing effect and are particularly suitable for very dry skin or wintertime use 2

Important Clinical Considerations

Advantages

• Emollients have short- and long-term steroid-sparing effects in mild to moderate atopic dermatitis, reducing the need for topical corticosteroids 2

• High lipid content provides superior barrier protection compared to cream or lotion formulations 1

Limitations and Caveats

• Ointments have a greasy consistency that some patients find cosmetically unacceptable, which can significantly reduce compliance 1

• Patient preference is decisive for long-term adherence, as emollient therapy is time-consuming and demanding 1

• There is a small risk of contact dermatitis with some emollient ingredients, though emollients have no known contraindications unless hypersensitivity to ingredients exists 2

• Some authors suggest occlusive ointments may increase risk of cutaneous infections in certain populations (e.g., neonates with ichthyosis), making water-in-oil emollients potentially preferable 2

Safety Profile

• Emollients are considered safe during pregnancy and lactation 2

• In neonates with congenital ichthyosis, application technique should avoid contamination using latex-free gloves and single-use packets 2

• Active substances like urea, salicylic acid, or silver sulfadiazine must be avoided in neonates due to risk of percutaneous absorption 2