CLEANSERS and MOISTURIZERS

Prepared by :SIG, Dermatology Nursing

IADVL

SOAPS and SOAP SUBSTITUTES

• pH of the skin = 5.5 ( acidic); pH of water is 7 ( neutral)

• All soaps are alkaline

• Because of their alkalinity, soaps tend to remove the natural oil film of the skin while removing dirt and grime

• Application of soaps can be both useful and harmful depending on the type of skin ( oily vs dry)

SOAPS

Most commonly used agent for cleansing the skin

May have added agents, mostly antibacterials, for special action on the skin

For antibacterial action, contact time important

pH of soap is alkaline while skin is acidic

Drying effect of soaps on skin can be useful for oily conditions (acne) but harmful for dry conditions (ichthyosis)

SOAP SUBSTITUTES

Act like soaps but pH matched to skin (usually 5.5 to 7)

Because of same pH, do not dry the skin

May have added active ingredients like triclosan

Usually have special additives like lecithin that layer the skin with a protective barrier

MOISTURIZERS

Medical term for it is ‘Emollient’

First line treatment for maintaining effective barrier function

Available as different formulations such as ointments, creams, gels, lotions

Some work as both a skin moisturizer and a soap substitute

Also have some indirect anti inflammatory effect

Help to reduce the requirement of topical steroids (steroid sparing agents)

Action of emollients

EMOLLIENTS

lock water

Lubricate

Reduce scaling

Seal stratum corneum

What do emollients do ?

CREAM

• Both water and fat

OINTMENT

• No water; mostly fat

• Best for very dry skin

EMOLLIENT LOTION

• Liquid formulation

• Best for hairy areas

EMOLLIENTS

WHEN TO APPLY AN EMOLLIENT

• As frequently as possible (atleast 2-3 times a day)

• As liberally as possible (30 - 40gm for whole body per application)

• After bathing ( within 2-3 minutes) while the skin is still moist

Dry skin – loss of barrier

Cracked lips – needs emollient

Scaly palms - Psoriasis

Generalized scaling - whole body moisturisation

Thick scaling – soak and seal

Cracked, dry skin in old age

HOW TO APPLY AN EMOLLIENT

Soon after a bath

Generously but gently

Do not rub vigorously

Apply in the direction of hair

CHOOSING AN EMOLLIENT

• Must be right for the skin condition

• Advise correct amounts and frequency

• Must be cosmetically acceptable

• Appropriate to weather/ environment

• Must be free of preservatives

• No fragrances

Apply enough : at least 30 – 40 gm per application for whole body

SAFETY WITH EMOLLIENT USE

Surfaces can get slippery in the bath specially for children and elderly

Careful while holding babies

Use a spoon to take out emollient from the tub to prevent contamination

THANK YOUTHANK YOU