Galaxal-Based Moisturizers for Eczema
Moisturizers, including those containing glycerol (galaxal), are strongly recommended for eczema management and should be used regularly as part of comprehensive treatment. 1
Evidence for Moisturizer Use in Eczema
The American Academy of Dermatology provides a strong recommendation for moisturizer use in atopic dermatitis based on moderate certainty evidence. 1 Moisturizers reduce disease severity, decrease flares, and extend time between flares by minimizing transepidermal water loss and improving stratum corneum hydration. 1
Glycerol-Containing Moisturizers Specifically
Glycerol-containing moisturizers demonstrate significant improvement in patient-reported skin symptoms (RR 1.22,95% CI 1.01 to 1.48) and investigator-assessed SCORAD scores (MD -2.20,95% CI -3.44 to -0.96), though the minimal important difference was not met. 2
The safety profile is favorable, with no statistically significant difference in adverse events compared to vehicle or placebo (RR 0.90,95% CI 0.68 to 1.19). 2
Glycerol functions as a humectant, drawing water into the stratum corneum and maintaining epidermal hydration, directly counteracting the transepidermal water loss characteristic of eczema. 3
Comparative Effectiveness
While glycerol-containing moisturizers are effective, urea-glycerol combination creams demonstrate superior barrier-strengthening properties. 3, 4 A 2022 study found that urea-glycerol cream significantly reduced skin sensitivity to irritants (TEWL reduction of -9.0 g/m²/h compared to control) and improved natural moisturizing factor levels, whereas simple paraffin-based emollients showed no barrier improvement. 4
No particular moisturizer or active ingredient can be definitively recommended over others based on limited available evidence, though moisturizers with active ingredients (urea, glycerol) generally outperform simple vehicles. 1
Practical Application Guidelines
Apply moisturizers immediately after bathing to maximize absorption and hydration, as this is when the skin is most receptive. 1, 3
Use dispersible cream as a soap substitute rather than traditional soaps and detergents, which remove natural lipids and worsen xerosis. 1
Apply at least once daily to the whole body, with more frequent application during flares or in areas of severe dryness. 1
Avoid alcohol-containing lotions or gels in favor of oil-in-water creams or ointments, particularly for inflammatory conditions. 1
Integration with Anti-Inflammatory Treatment
Combining moisturizers with topical corticosteroids is more effective than corticosteroids alone, reducing disease severity, flares, and the total amount of corticosteroid needed. 3, 2, 5 Moisturizer use reduced topical corticosteroid requirements by 9.30g over 6-8 weeks (95% CI -15.3 to -3.27). 2, 5
Moisturizers significantly reduce flare frequency (RR 0.40,95% CI 0.23-0.70) and prolong time to flare (median 180 vs 30 days without moisturizer). 2
Important Caveats
Consider allergenic potential, as many moisturizers contain known contact allergens and numerous ingredients that may trigger reactions in sensitive individuals. 1
Choose fragrance-free formulations to minimize contact dermatitis risk, particularly in patients with established sensitivities. 3
Ointment bases provide superior occlusion and are preferred for very dry, scaly eczema, while creams may be more cosmetically acceptable for daily use. 3
Adverse events are generally mild and cutaneous, occurring in 34.3% of treatment arms versus 22.1% of controls (RR 1.32,95% CI 1.01-1.74), with withdrawal due to adverse events being uncommon. 1