Emollients soothe, smooth and hydrate the skin and are indicated for all dry or scaling disorders. Effects are short lived and thus frequent application is advised. Emollients should be applied immediately after washing or bathing to maximise the effect of skin hydration. They are useful in dry and eczematous disorders, and to a lesser extent in psoriasis. The choice of an appropriate emollient will depend on the severity of the condtion, patient preference and the site of application. The least expensive emollient that is effective, cosmetically acceptable and that the patient is prepared to use regularly should be prescribed.
Generally, 'greasy' preparations provide the best emollient effect, however, for cosmetic reasons, patients may prefer a less oily preparation for daytime use or for use on an exposed area such as the face.
Emollients should be applied liberally and as frequently as possible, intensive use may reduce the need for topical steroids.
Careful explanation of how to use emollients, as well as how much to use may encourage compliance.

Fire hazard with paraffin-based emollients: Emulsifying ointment or 50% Liquid Paraffin and 50% White Soft Paraffin Ointment in contact with dressings and clothing is easily ignited by a naked flame. The risk is greater when these preparations are applied to large areas of the body, and clothing or dressings become soaked with the ointment. Patients should be told to keep away from fire or flames, and not to smoke when using these preparations. The risk of fire should be considered when using large quantities of any parafin based emollient.
Rapid Response Report - Fire hazard with paraffin-based skin products.

DO NOT supply 500g pots to the wards routinely where a smaller pot is available, check area to be treated.

In dry skin conditions soap should be avoided. Emollient bath additives should be added to bath water; hydration can be improved by soaking in the bath for 10-20 minutes. Some bath emollients can be applied to wet skin undiluted and rinsed off.
Aqueous cream used as a soap substitute may also suffice as a bath additive. It is best whisked in a jug of hot water before adding it to the bath water.
The preparations make skin and surfaces slippery - particular care is needed when bathing. The use of anti-slip bath mats/handles especially for the young and elderly should be encouraged.

GPs can be asked to prescribe bath additives/wash - DO NOT prescribe from outpatients unless really urgent. Patients may be asked to purchase these products in the community.