1. CLEANSERS and MOISTURIZERS
Prepared by :
SIG, Dermatology Nursing
IADVL

2. pH of the skin = 5.5 ( acidic); pH of water is 7 ( neutral)
SOAPS and SOAP SUBSTITUTES
pH of the skin = ( 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)

3. 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)

4. SOAP SUBSTITUTES Because of same pH, do not dry the skin
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

5. 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)

6. Action of emollients

7. What do emollients do ? EMOLLIENTS lock water Lubricate
Reduce scaling
Seal stratum corneum

8. CREAM Both water and fat OINTMENT No water; mostly fat
EMOLLIENTS
CREAM
Both water and fat
OINTMENT
No water; mostly fat
Best for very dry skin
EMOLLIENT LOTION
Liquid formulation
Best for hairy areas

9. As liberally as possible (30 - 40gm for whole body per application)
WHEN TO APPLY AN EMOLLIENT
As frequently as possible (atleast 2-3 times a day)
As liberally as possible ( gm for whole body per application)
After bathing ( within 2-3 minutes) while the skin is still moist

10. Dry skin – loss of barrier

11. Cracked lips – needs emollient

12. Scaly palms - Psoriasis

13. Generalized scaling - whole body moisturisation

14. Thick scaling – soak and seal

15. Cracked, dry skin in old age

16. HOW TO APPLY AN EMOLLIENT
Soon after a bath
Generously but gently
Do not rub vigorously
Apply in the direction of hair

17. CHOOSING AN EMOLLIENT Advise correct amounts and frequency
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

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

19. Careful while holding babies
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

20. THANK YOU
THANK YOU