Using aqueous cream as a soap substitute for skin washing

Jen Lynch, Clinical and Medicines Information Pharmacist, Midlands and East Medicines Advice Service (East site)Published
Topics: Skin disorders

Aqueous cream is no longer recommended as an emollient, but may considered as a soap substitute. However, adverse effects are possible with any use.

Availability

Aqueous cream may be prescribed by a healthcare professional. It is also widely available to purchase through pharmacies and supermarkets without requiring a prescription, or counselling by a healthcare professional on use of the product.

Use as a soap substitute

Aqueous cream may be used as a soap substitute for skin washing. The preparation is rubbed on the skin before rinsing off completely.

Effectiveness

Aqueous cream is licensed as a soap substitute for skin washing.

Adverse effects

Adverse effects reported with aqueous cream include burning, stinging, itching and redness of skin. These are less likely when aqueous cream is used as a soap substitute than when it is used as a leave-on emollient. The difference in the irritation potential in some patients may be related to the contact time with the skin, as soap substitutes are largely removed in the washing process.

Counselling

Patients and carers should be warned of the risk of adverse skin reactions (burning, stinging, itching or redness) with the use of aqueous cream, but these are less likely when it is being used as a soap substitute. These reactions are generally not serious. If patients get skin irritation after using aqueous cream, they should stop using it and talk to a doctor or a pharmacist.

Use as an emollient

Aqueous cream is licensed for use as an emollient for the symptomatic relief of dry skin conditions; however, its use for this indication is no longer recommended.

Effectiveness

Aqueous cream should not be used as a leave-on emollient as it is likely to exacerbate, rather than improve eczema.

Adverse effects

Aqueous cream may be associated with skin reactions, such as burning, stinging, itching and redness, when used as a leave-on emollient. If a patient reports skin reactions after the use of aqueous cream, they should discontinue treatment. An alternative emollient that does not contain sodium lauryl sulphate should be tried.

Counselling

Patients and carers should be warned of the risk of adverse skin reactions (burning, stinging, itching or redness) if aqueous cream is used as a leave-on emollient. These reactions are often seen within 20 minutes of application and are generally not serious. If a patient experiences skin irritation after using aqueous cream, advise the patient to stop using it and talk to a doctor or a pharmacist.

Counsel patients and their carers on the fire risk associated with the build-up of residue on clothing and bedding. Advise on actions to minimise the risk; not to smoke or go near naked flames because clothing, bedding, dressings, and other fabrics that have been in contact with aqueous cream or skin treated with aqueous cream can rapidly ignite. Washing these materials at a high temperature may reduce emollient build-up but not totally remove it.