Eczema and the skin barrier
Eczema is linked to having a defective skin barrier. The bilayer of phospholipid helps to retain the liquid in the skin, at the same time restricting the bacteria and allergens from entering the body.
Creams applied topically on eczematous skin have different compositions of hydrophilic and hydrophobic properties.
The hydrophilic property of creams allows the skin to be moisturized as it has the ability to attract and hold water while its hydrophobic property allows for moisture retention in the skin. Skin creams are fickle and it is often up to the patient to find the best product-skin fit.
Remember that when you buy creams, you should only choose products that are fragrance-free. This is because fragrances are likely to further aggravate sensitive or dry skin.
Ceramides and the skin barrier
Most lotions and moisturizers in the market contain ceramides.
Ceramides are lipids that are found at the epidermal layer of the skin. It acts as a protective layer and cuts down the water loss from the skin and blocks out the bacteria and allergens from the surrounding. In addition it strengthens the skin barrier and moisturizes the skin.
Further research shows how ceramides and other skin lipids reduce transepidermal water loss (TEWL) and improve barrier repair after damage. Research also says that for children with eczema, ceramide use is crucial.
Emulsifying Ointment BP is a classic petrochemical product. This ointment has received somewhat good feedback despite being in-your-face synthetic.
It has been used to good effect for cracks, especially those in the webbings and joints of the hands and fingers. While some patients cannot stand the sticky consistency of ointments, other patients feel calmer with an ointment covering the skin. This is probably because emulsifying ointments seal in moisture to heal areas of cracked and dry skin.
✅Moisturizer and emollient for dry to very dry scaling skin
❌Dressing and clothing in contact with this product burn easily
❌Does not treat inflammation (only for dry but not hot skin)
❌Thick and greasy consistency
Aqueous Cream BP
Aqueous Cream BP has had bad press for being in the market despite a research paper concluding in 2010 that “application of Aqueous Cream BP, containing ∼1% SLS, reduced the SC thickness of healthy skin and increased its permeability to water loss.”
✅For dry skin, scaling skin; soap substitute for removing dirt and grime; or gentle cleanser for removing make-up
✅Also as a baby cleanser or shaving cream
❌Aqueous cream is no longer recommended as a soap substitute or leave-on emollient, as it was for so many years. It is a poor moisturizer and also contains sodium lauryl sulphate (SLS), which irritates the skin and makes eczema worse.
Their products seem to contain everything you need, including filaggrin technology, ceramides, humectant and emollient function. If you suffer from eczema, Cetaphil is definitely worth trying.
Cetaphil Pro AD Derma Restoring Moisturiser
✅All the good stuff, including ceramides, filaggrin technology, humectants like niacinamide and emollients like helianthus annuus seed oil.
❌Contains Cetyl Alcohol, which must never be used near the eyes or on sensitive skin. Potential side effects of Cetyl Alcohol include irritation, stinging, burning and redness.
Cetaphil Eczema Restoraderm Flare-Up Relief Cream
Skin Type: Suitable for those with eczema-prone and sensitive skin.
This luxurious cream has undergone clinical testing, confirming its efficacy in repairing damaged skin barriers and alleviating discomfort associated with eczema flare-ups. Symptoms such as dryness, itchiness, scaling, roughness, and irritation can be relieved by using this cream.
– Clinically proven to initiate skin barrier repair within 24 hours and alleviate eczema symptoms after just one use.
– Demonstrated effectiveness in locking in moisture and hydrating eczema-prone skin for a duration of 48 hours.
– According to 94% of participants, this product delivers instant relief for dry, eczema-prone skin.
– Dermatologist tested and clinically proven to be gentle on sensitive skin.
Here, we will include two better know QV products, one a cream, the other an ointment. Remember that ointments are more greasy and icky, but also help to seal in moisture. It ultimately depends on what consistency of cream of ointment your skin prefers.
QV Dermcare Eczema Daily Cream with Ceramides is best for mild eczema)
✅No harmful ingredients (except maybe seed oil but very little inside)
❌Cannot use for open wounds (no good for people who scratch then bleed a lot)
QV Dermcare Eczema Sting-Free Ointment
✅Helps very cracked skin
❌Contains Isopropyl Myristate (clogs pores, irritating, perfuming)
Initially, Eucerin started promoting itself as the “pH5” cream. This means “more acidic,” which means better for supporting barrier function.
Note that Eucerin’s expanded product range includes a cream containing oatmeal (read up more on oats below), ceramides and licochalcone A. Now it also includes Menthoxypropanediol, which cools the skin and reduces itch.
Eucerin AtopiControl Acute Cream is best for acute stage flare-up and inflammation.
✅Ceramides are included for skin barrier protection.
✅Licochalcone A is anti-inflammatory.
✅Menthoxypropanediol cools skin and reduces itch.
❌Contains a little Cetyl Alcohol.
Eucerin Sun Protect Lotion Extra Light is a sunscreen made for those suffering from mild eczema.
✅Contains Licochalcone A.
❌In reviews, some people said it dried the skin even further and leaves a whitecast.
Suu Balm Rapid Itch Relief Moisturiser contains two main ingredients, menthol and ceramides.
Together with ceramides, it strengthens the skin barrier function and relieves the pain of the patient while providing a cold sensation.
✅Menthol provides a cooling and analgesic effect that disguises skin itch.
❌Contains Cetyl Alcohol.
❌Some other reviews mentioned that the coolness only lasts a few minutes.
❌Need to reapply many times for maintain effect.
Bioderma is range of French skin care products suitable for sensitive skin types. One of the products that is commonly used by eczema patients is the Atovant Intensive Gel Moussant. The gel cleanses and detoxifies the skin without drying it. Because it is able to strengthen the skin barrier (which is the case for many of these products) while being nourishing and gentle, this product is a must try for Eczema patients!
According to alot of research out there, aloe vera is perfect for burns and heals damaged skin. Aloe vera gel contains amino acids which maintain healthy skin. In addition, the moisturizing effect of aloe will help to reduce the dry and itchy skin due to eczema. S
❌Some people just do not respond well to aloe vera.
❌Burning/stinging sensation when applied.
This is a brand which has creams and lotions and boasts of containing Squalene just like QV does. And it adds on a natural ingredient of olive oil, which also contains squalene. Olive oil has historically been used for skin maintenance as well as a carrier oil in a balm or salve.
Physiogel Calming Relief A.I. Face Cream
✅No harmful ingredients.
Physiogel Daily Moisture Therapy Lotion
✅Low Irritant, Hypoallergenic, Fragrance Free & Non-comedogenic.
❌Contains palm oil, coconut oil.
Sebamed moisturizing cream has a low pH5.5 that adds in vitamin E as an antioxidant. As with many of the other products we are featuring here, it sings the hypo-allergenic motto, and so frees itself of certain ingredients.
Their products mostly focus on gentle washes for sensitive skin, not so much moisturisers. For those interested in washes, they can look at Sebamed, but for moisturisers, creams or lotions they can look at other brands more catered towards that like Physiogel, Aveeno or QV.
Adding Oats: Aveeno, A-Derma and Dermaveen
Why Oats? Oats have about 10% lipid content and these provide humectant and emollient qualities a compromised skin barrier requires. More than that, it is rich in beta-glucans, which have strong anti-inflammatory function and also assist in deposition of collagen in the skin. These products reviewed below were probably inspired by the humble oatmeal bath prescribed by naturopaths, but they take it to the cream/ointment level.
Oat Allergy: People with an oat allergy will typically experience red, blotchy spots on the skin called urticaria , or hives. In some cases, an outbreak may occur if a person accidentally touches oats and then other parts of the body.
Aveeno cream is named after Avena Sativa, the botanic name for the common oat. Below as some of their products.
Aveeno Rescue Relief Cream is another good product for mild acute flare-up and inflammation.
✅Very good for eczema near the eyes and for red angry skin
❌Need to apply sunscreen together with product, if not skin will burn under the sun
Aveeno Eczema Therapy Nighttime Itch
✅Good for rough, flaky patches
❌Super thick and greasy
Aveeno Calm Oat Gel Moisturiser
✅Can also improve wrinkles and crow’s feet?
❌Some reviews said peeling, burning occurred, perhaps due to oat allergy. For people with eczema, skin reactions range from mild to severe.
As if to one-up on Aveeno, we have A-Derma cream, a range of products based on the Rhealba Oat (extracted) as well as another proprietary substance, Filaxerine. Filaxerine is a basically a combination filaggrin (the deficient protein in barrier-compromised ezcemateous skin) and omega-6 fatty acids. The hope is that filaggrin which is slathered on will then crosslink amongst the keratin layer in the epidermis to strengthen skin barrier.
Again, i have only heard good things about A-Derma, so do consider this product is you are looking for topical solutions. It has worked wonders for one of my patients with weepy wounds and intense heat under the skin.
A-Derma Exomega Cream
✅Very gentle, suitable for children with eczema.
❌Super expensive, products can range from $40-$59.
❌Some people found it too greasy.
Robertson’s Skin Repair
Robertson’s is a made-in-Australia product that provides the colloidal oat component as well as cod liver oil, which is rich in omega-3 fatty acids, EPA and DHA.
All these would help moisturize and repair the skin barrier. Note that this is a very natural product compared to the others mentioned. It is not good or bad, because different people respond differently and have their sensory preferences.
Note too that this is an ointment, so it is heavier on the oils, and hence provides a thicker feel when compared to creams, and is often preferred when the skin is very dry.
Dermaveen is a cream like QV or Eucerin, but it contains colloidal oatmeal, which is simply oats that you grind up and throw into a body of water, just like in a a colloidal bath.
Here, you have ground-up oats in a cream with ingredients that provide humectant and emollient support.
Apicare 30% Manuka can be helpful for those with mild eczema in the flexures.
Apicare Manuka Therapy 30 Honey Cream
✅No harmful ingredients.
There’s also Japanese Royal Jelly Manuka Honey Balm that good for sensitive cracked skin, however it is quite expensive and ranges from $60-$90 per small bottle.
Products using Natural Components
Propaira provides an Extra Calming Lotion (note: thin texture) for eczematous skin. Apart from the usual chemical ingredients for humectant and emollient function, it adds on grapeseed extract.
Atopiclair moves further along the ‘natural ingredients’ path, including shea butter to moisturize with hyaluronic acid, while throwing in antioxidants like grapeseed extract and vitamins C and E. Like Aveeno, it is a cream, which is of lighter texture than an ointment.
Derma E Psorzema is a cream highly recommend by one client who has experimented with many ways of managing her Topical Steroid Withdrawal topically. Psorzema combines the two dermatoses Psoriasis and Eczema. This cream is big on natural ingredients and includes an armory of herbs European and Eastern, e.g. Neem, Burduck, Coptis, Barberry, Bearberry. It also contains the ‘skin vitamins’ A and E as well as expensive jojoba oil.
La Roche Posay
This is a product that is mostly made up of minerals, as opposed to chemicals. Chemicals like oxybenzone irritate eczema-prone skin and may even cause contact dermatitis.
La Roche Posay Anthelios
✅Mostly made up of minerals rather than synthetic chemicals
✅SPF rating 50+
La Roche Posay mostly markets products catered towards acne-prone skin and not eczematous skin. However, I recommend the Anthelios XL Sunscreen because it is great for hypersensitive skin that burns easily under the sun. The sun cream also has hydrating properties because it includes the star humectant, hyaluronic acid.
Avène is a French skincare brand that is known for its soothing and calming products for sensitive skin. Avène Thermal Spring Water is the key ingredient in many of their products, and it is known for its anti-inflammatory and hydrating properties. Avène also has a line of products specifically for eczema-prone skin, including the XeraCalm A.D Lipid-Replenishing Cream.
The XeraCalm A.D Lipid-Replenishing Cream is a fragrance-free, paraben-free, and hypoallergenic cream that is designed to soothe and hydrate skin that is prone to eczema. It contains I-modulia®, a patented ingredient that helps to reduce itching and inflammation. The cream also contains evening primrose oil, which is a natural moisturizer that helps to restore the skin’s barrier function.
Grahams Natural Eczema Cream
Grahams Natural Eczema Cream is a natural and effective treatment for eczema and dermatitis. It is formulated with a blend of natural ingredients that have been shown to be effective in reducing the symptoms of eczema, including itching, dryness, redness, and inflammation. This product are not available in Guardian, NTUC, or Watsons but can be bought on shopee for around less than $30 for a 120g tube.
Key ingredients in Grahams Natural Eczema Cream:
- Manuka honey: Manuka honey is a type of honey that is produced in New Zealand. It has been shown to have antibacterial and anti-inflammatory properties.
- Calendula: Calendula is a flowering plant that has been used for centuries to treat skin conditions. It is known for its anti-inflammatory, antiseptic, and healing properties.
- Gotu kola: Gotu kola is a plant that is native to Southeast Asia. It has been used in traditional Chinese medicine for centuries to treat a variety of skin conditions, including eczema.
Noreva Xerocontrol A.I Triple Action Cream is a fragrance-free, paraben-free, and hypoallergenic cream that is designed to soothe, hydrate, and protect eczema-prone skin. It contains a patented ingredient called I-modulia®, which helps to reduce inflammation and itching. The cream also contains evening primrose oil, which is a natural moisturizer that helps to restore the skin’s barrier function. Shea butter is another ingredient in the cream that helps to soothe and protect the skin.
Noreva Xerocontrol A.I Triple Action Cream is a safe and effective treatment for eczema-prone skin. It is suitable for use on all ages, including infants and children.
Choice of ointment/cream/lotion often depends most on symptomatic relief. It is of upmost importance that the topical application feels right on you, whatever the product boasts of. Yes, we would like a maximum of anti-inflammation and skin protecting qualities, but it also has to ‘feel good’, so that the itch factor is reduced somewhat, or the pain from cracks is alleviated. Some people respond better to thicker occulent ointments (e.g. petroleum-based or even thicker oils), because thinner creams/lotion leave the skin feeling ‘dry’.
Note too that you can be using different products on different parts of your body. e.g. thick ointment on cracked fingers and toes and a lighter cream on the rest of the body. Also, some creams that worked before may not work now. Other creams that disagreed a year ago may actually work when your skin is drier.
These are the key ingredients that you may want to look out for when searching for relevant products for their skin.
- Humectants including hyaluronic acid, honey, aloe vera, niacinamide, glycerin and squalane
- Emollients like glycerol, beeswax, allantoin
- Centella Asiatica Extract
- Ceramides (EOS, NP and AP)
- Antioxidants like Vitamin E
- Anti-inflammatory (aloe vera, licorice root, calendula, green tea, witch hazel)
Also, these are the ingredient that you would want to avoid in your products:
- Alcohols: will increase dryness
- Parabens: If parabens come into contact with open scratched wound, this may cause allergic reaction.
- Essential Oils: may make skin more sensitive. Because they are lipophilic and can penetrate into the skin barrier, and certain oils have allergens that can cause contact dermatitis
- Sulphates: the most common would be sodium lauryl sulphate (SLS) that dries out your skin.
- Fragrances: skin may react negatively
Additionally, some patients like to use multiple creams together and layer them. Different areas of the body may suit different products. Ultimately it is all about picking and choosing what works best for each individual patient.
This is a very useful website for checking out skincare ingredients. Check it our here! https://incidecoder.com/