Emollient creams and ointments, hydrogenated castor oil-containing

How it works

Hydrogenated castor oil acts as an occlusive and emollient lipid that coats the skin, reducing transepidermal water loss and helping repair the skin barrier.

Prescribing in practice

• Paraffin and oil-based emollients leave a flammable residue on clothing, bedding and dressings, so patients must be warned to keep away from naked flames and not to smoke.
• Occasional contact irritation or sensitisation can occur, so review if the skin worsens with use.
• Apply liberally and frequently as a leave-on emollient to maintain skin hydration.

Monitoring

No laboratory monitoring is required; review skin condition, tolerability and adherence to fire-safety advice at follow-up.

Counselling the patient

• Apply generously and often, smoothing in the direction of hair growth.
• Avoid naked flames and smoking, as the product on skin and fabrics is flammable.
• Report any increase in redness or irritation.

Evidence & guidelines

Emollients are a mainstay of managing dry skin and eczema in NICE guidance, and the MHRA has highlighted the fire risk associated with emollient residues on fabric.