Emollient creams and ointments, antimicrobial-containing

How it works

The emollient base occludes and rehydrates the skin to restore the barrier, while the added antimicrobial reduces surface bacterial load, including staphylococcal colonisation that can drive eczema flares.

Prescribing in practice

• The antiseptic component can cause irritant or allergic contact reactions, so the product should be stopped if the eczema worsens or the skin becomes more inflamed after application.
• These products are for skin prone to infection and are not a substitute for systemic antibiotics in established, spreading skin infection.
• As with all paraffin-based emollients, residue on fabrics and dressings is flammable and fire-safety advice must be given.

Monitoring

No laboratory monitoring is needed; review for local tolerability, signs of contact sensitisation and adequacy of infection control at follow-up.

Counselling the patient

• Apply liberally and frequently to dry skin in the direction of hair growth.
• Stop and seek advice if the skin becomes more red, itchy or sore, which may indicate a reaction to the antiseptic.
• Keep away from naked flames and do not smoke, as the product on skin and fabric is flammable.

Evidence & guidelines

Emollients are a cornerstone of eczema management in NICE guidance, and antimicrobial-containing emollients are used where recurrent bacterial colonisation contributes to flares.