Aqueous cream is bad for eczema

Ten years no eczema (living in healthy London smog). Winter, a move to the country, a few cats, a bit of hard water and some stress later and kaboom the eczema is back. Go to doctor. Doc says, “Get some emulsifying ointment, aqueous cream, oilatum and some hydrocortisone for that eyelid”.  Use all four for a while.  Eczema dies down by the summer and reappears in the winter.  I manage it all along with lots of Aqueous cream.

Sodium lauryl sulfate

Having survived the winter, come April 2011 and the eczema flares up and is horrific.  Itch all night – can’t sleep, itch all day – can’t work. Read National Eczema Society (NES) website FAQ on Aqueous cream.   Aqueous cream thins the skin and increases water loss. Its got 1% Sodium lauryl sulfate (SLS aka Sodium dodecyl sulfate aka sodium laurilsulfate) and SLS is really bad stuff.

I kept telling my better half that Aqueous cream was great and safe.  Its only got a few ingredients, its cheap, there’s no gimmicks or marketing behind it.  Its just paraffin, as long as I don’t light my farts I’ll be fine.

Emollients not moisturisers

So what should I use? Read anything on eczema and they say – you gotta use emollients.  None of these perfumed moisturisers, you want emollients.  Yeah get some emollients.

WTF are emollients?  Emollients are moisturisers (at least so says Wikipedia).  But moisturisers are bad – you can’t use those.  They’re perfumed, they’re bad.

Look at any moisturiser and its got 100 ingredients – and when chemists only get to use four ingredients (as with Aqueous cream) they still mess it up and put in a chemical (just 1%) that does explicity bad things, so what chance have you got with a 100?  Aqueous cream is 30 years old, its been used by millions, it must be safe. Nope.

Just tell me one emollient.  Aqueous cream is an Emollient. Oh… great.

So moisturisers are bad, Emollients are moisturisers and some Emollients are still bad.

I’m confused. I’ll ask again.  WTF are Emollients?

Emollients for Dummies [June 2013]

Update Eventually I found a decent description of Emollients:

Non-cosmetic moisturisers

Those lovely chaps at the National Eczema Society, have a page on Emollients and actually print a pdf list for you that was last updated June 2013. I’m going to re-print it here in a slightly less buried and awkward format than they have it.

Lotions (light preparations)
  • Aveeno
  • Cetaphil
  • Dermal 500 (with anti-microbials)
  • E45
  • Eucerin lotion (3% and 10% urea)
  • Keri
  • Oilatum
  • QV
  • Vaseline Dermacare lotion
Creams (medium preparations)
  • Aderma emollient cream (with oat milk)
  • Aquadrate (10% urea)
  • Aveeno
  • Avene Trixera Crème emollient
  • Balneum (5% urea)
  • Calmurid
  • Cetaphil
  • Decubal
  • Dermol cream (with anti-microbials)
  • Cetraban
  • Dexeryl
  • Diprobase
  • E45 Cream
  • Elave
  • Epaderm Cream
  • Eucerin (5% urea)
  • Eumobase
  • Hewletts Cream (contains peanut oil)
  • Linola Gamma (removed in June 2013)
  • Lipobase
  • Imuderm
  • Neutrogena dermatological cream
  • Nutraplus (10% urea)
  • QV
  • Vaseline Dermacare
  • Zerobase
Ointments (oily preparations)
  • 50/50 white soft paraffin/liquid
  • paraffin
  • Diprobase
  • Emulsifying ointment (related to Aqueous cream see below)
  • Epaderm
  • Hydromol
  • Hydrous ointment (oily cream)
  • Kamillosan
Gels
  • Doublebase emollient
  • Oilatum Gel emollient
Soap Substitutes
  • Aderma oat milk cleansing bar
  • Aquabar
  • Avene cleansing bar
  • Cetaphil wash
  • Cetaphil cleansing bar
  • Cetraben wash
  • Doublebase Wash
  • Dove Pure and Sensitive Bar (added June 2013)
  • E45 wash
  • Eczmol
  • Elave hand wash
  • Emulsifying ointment (related to Aqueous cream see below)
  • Eucerin Dry Skin Relief Wash (5% urea)
  • Imuderm body/hand and face wash
  • Oilatum soap bar
  • Pinetarsol gel (removed June 2013)
  • Pinetarsol cleansing bar (removed June 2013)
  • Ultrabase
Bath Additives
  • Aveeno Colloidal
  • Aveeno (bath oil)
  • Balneum
  • Balneum Plus
  • Cetraban bath oil
  • Dermal 600 (with anti-microbials)
  • Dermalo
  • Diprobath
  • Doublebase Bath
  • E45 Bath
  • Eucerin Bath Therapy
  • Emulsiderm Emollient (with anti-microbials
  • Hydromol Emollient
  • Imuderm therapeutic bath oil
  • Oilatum fragrance-free
  • Oilatum Plus (with anti-microbials)
  • Pinetarsol bath oil (removed June 2013)
Shower Additives
  • QV Shower Products
  • Dermal 200 (with anti-microbials)
  • Doublebase Shower
  • E45 shower
  • Eucerin Shower Therapy
  • Oilatum Shower
  • Imuderm Shower
Other Products
  • Balneum Plus – anti-itch cream
  • E45 – itch relief cream
  • Emollin – emollient spray
Products for Children & Babies
  • Babies (removed June 2013)
  • Infaderm bubble bath (baby bath)
  • Infaderm body lotion
  • Infaderm bath and body oil
  • Children
  • E45 Junior hand & body wash
  • E45 Junior moisturising cream
  • E45 Junior moisturising mousse
  • E45 Junior shower mousse
  • Oilatum Junior bath formula
  • Oilatum Junior cream emollient

What I use

Interestingly I’m currently banned by my doctor from using anything (for a couple of weeks, until they can run tests to find what my current allergies are).  I cheat slightly and take salt baths. Two cups of sea salt (about 300g) in a bath every day.  Currently my skin is very dry but it doesn’t itch too much.  And its the itching that knackers everything.

Ask your doctor to test you for allergies (patch test or blood test) – don’t leave until he sends you to a dermatologist.  Its no good if you were tested years ago – things might have changed.

Update October 2014

My blood tests came back with cats as my number one allergen.

When my eczema was bad I tracked everything I took daily in a spreadsheet. I also included a subjective measure from 1-10 of how bad my eczema was – roughly based on what percentage (in 10s, 10%, 20%…) of my body was covered in eczema.

If you’re interested, I’ve published my Medical diary as a Google spreadsheet.

  1. For about two years I regularly used corticosteroids, a weaker one for my face and a stronger one for the rest of my body
    1. Once the skin was red only steroids did any good, so unfortunately I’ve still found nothing beyond steroids to get rid of serious eczema
  2. Once my eczema got slowly better, I switched to Elidel (it has similar properties to corticosteroids with less side-effects)
  3. I use Dexeryl (in the NES list) as my ‘non-cosmetic mosturiser’ aka Emollient 🙂
    1. It was one of the cheapest ones I could get hold of and does help with dry skin
    2. It didn’t help with the eczema if it was red, but does help preventing dry skin getting worse
    3. I have a weekly bath and shave using Dead Sea salt. Where as Atlantic Sea Salt showed no difference, Dead Sea salt definitely did (but not massively). WebMD does recommend this for psoriasis too
  4. I used antihistimines for a while e.g. Citrizine and Rupatall but I didn’t find that they made any difference

Notes

From the Wikipedia moisturiser article, I came across the cosmetics database which has an entire section on Eczema products (not they ever mention Emollients grrr).  That might help when looking for products.

The BBC has an article on Aqueous cream citing the same study that the NES do.

Update

There is a connected cream to this called Emulsifying ointment (its mentioned in the NES list above) , usually mentioned as the base from which Aqueous cream is made. This is a remarkably obtuse name (which I don’t understand why the ingredients of it don’t have to be explained). However Emulsifying ointment is also known as Emulsifying wax. According to the Emulsifying wax wikipedia article is usually made up with a ‘detergent’ sodium dodecyl sulfate i.e. Sodium lauryl sulfate).

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39 thoughts on “Aqueous cream is bad for eczema

  1. Bob Algee says:

    Ian,
    I saw all the products you have listed fro eczema. You must not have Ceravee available in UK. It contains ceride(an ingrediant to hold moisture in) It has been a Godsend for my wife and me. I do not use steroid ointment but about 1/10 of the time as before. It is a little more expensive, but to us, well worth it. You can find 3 or $4.00 off coupons. I suggest you give it a try. Ithought they were all alike, but have had excellent results from this. It may not be available in UK?

    Bob

    Like

  2. Janice Hoyle says:

    Hi Ian, thanks for the info. I’ve been using aqueous cream for about a year as a body wash to prevent itching.(I’m in my 60’s). Recently a friend told me that it can thin the skin so I’m grateful for the comprehensive info you provide. I’ll buy one of the products from your list in future. Thank you for sharing your experience and research. Santosh.

    Like

      • I sent an email to Arbonne asking them about Carrageenan and SLS and got this excellent response from them:

        From: Arbonne Customer Service
        To: Ian Channing
        Subject: Other/Ingredient Query (#8661-313010236-2835)
        Date: 11 September 2012 18:22

        Hello Ian,

        Thanks for your e-mail. Please see the e-mail we have received regarding you enquiry from our Product Specialist team

        Carrageenan(scientific name: Chondrus Crispus Extract) is found in the following products:
        – Arbonne Aromassentials Awaken Body Lotion
        – Arbonne Aromassentials Unwind Body Lotion
        – Mandarin Pomegranate Body Lotion
        – RE9 Advanced For Men Exfoliating Wash
        – RE9 Advanced for Men Shave Gel
        – RE9 Advanced Instant Lift Gel
        – SeaSource Detox Spa Fortifying Hair Mask
        – SKY for Men Shave Gel

        Sodium Lauroyl Sarcosinate is found in the following products:

        – Ginger Citrus Shampoo
        – Pampermint Body Wash

        Arbonne does not use the ingredients mineral oil, sodium lauryl sulfate, or sodium laureth sulfate in any of its products.

        Kind Regards

        Customer Service

        Like

  3. stumpylovesstinky says:

    quick question: will there be “Sodium lauryl sulfate” written in the ingredient list of the aqueous cream? mine only says “emulsifying wax, white soft paraffin and liquid paraffin.” the brand is “Aqua Cream”. tq!

    Like

  4. Hello Ian,

    I found your links quite interesting. Just out of curiosity, have you found anything yet that works for you?

    Last year my sebhorric dermatitis (I know it’s not the same as eczema) had gotten to a point that commercial shampoos, creams, makeup – pretty much everything that people buy and use – started literally stripping me of my skin and resulted in yellow scales once dry. My skin took a turn for the worst. Having tried everything including prescriptions and over the counters since the age of 12 until now, I was fed up and proceeded to look for all-natural products to deal with this serious skin condition.

    I came across MooGoo, an Australian all-natural (100% natural – yup, that’s right! They don’t use SLS or parabens at all!) company that creates products solely for problem skin. They have products for sensitive skin types and for eczema, psoriasis, sebhorric dermatitis, rosacea and acne, etc. Ever since I have started using their products, my skin has been amazing.

    Check them out online and honestly give them a go. I was very reluctant in ordering from them at first, but their products are the only ones I use now. Washing my face or taking a shower is not painful anymore. 🙂 I live in Canada and order online from Australia. The MooGoo crew is very prompt in responses, knowledgeable, and excellent in customer service. They are wonderful. They even have a facebook page, so you can even check them out there. Their eczema cream and some other products, like the shampoo and MSM cream may help for eczema.

    Things I use from MooGoo :

    Milk Wash – for face (reduces redness and itchiness. Also, no dryness at all!)
    MSM Cream – for face (reduces redness *great for rosacea and irritated skin*)
    Scalp Cream – for sebhorric dermatitis on my scalp, hairline, eyebrows, sides of noses (and sometimes as an all-around moisturizer)
    Milk Shampoo & Milk Conditioner – for dandruff on scalp

    These were such a life-saver for me! Amazing stuff – no more redness and itchiness, no more yellow scales, no more burning skin!

    P.S. I have not been paid to advertise. Haha. I just honestly love their stuff and have told a lot of my friends about them.

    Sarah

    Like

    • Hi Sarah,

      Thanks for you comment – MooGoo looks really good.

      For me, the only thing that I’ve found that ever properly worked was cortisone. Other creams might help with dry skin, but once the skin was inflamed nothing else actually worked. I keep the number of products I use to an absolute minimum so I can figure out what is working / not working.

      The emollient I use is Dexeryl, it definitely doesn’t have any SLS and isn’t too expensive. I get it from the pharmacist here, but it looks like its readily available via the internet.

      The only company I still trust with their products is Neal’s Yard Remedies from London, UK (If you’re ever in London Neal’s Yard is a great place to go). I still don’t use much of their stuff either though – just the Shampoo and Conditioner.

      Other than that I take salt baths every other day. They might not work for you, indeed a suggestion I was given for having starch baths made my skin much worse, so salt could have a similar effect for you. But if you haven’t tried salt or starch baths you should definitely experiment. The starch bath is created by just sticking some porridge oats in a sock and leaving it in the bath. I’m pretty certain that salt baths do definitely help. I’m tracking the severity of my eczema each day and when I take salt baths to look for a correlation.

      Finally the only other thing of note I take is gallons (3-4 cups :)) of Clipper Tea’s Green Tea with Lemon per day. I read on a site (can’t find it now) that both Green Tea and Vitamin C are good for eczema. I find that this is perfect, because green tea alone isn’t very tasty but combined with lemon makes it highly drinkable. So whatever happens green tea is good for you – certainly better than regular tea or coffee and it might do something to help with the dermatitis, but I expect it will be marginal.

      [Update] Sarah – after looking at an earlier comment from inovaczekrene novaczek you could try Carrageenan from Irish Moss that interestingly for you is produced by a Canadian company Arbonne. I can’t actually find which products they use Carrageenan in, but they certainly have a stong ingredients policy, such as not using Parabens or Mineral Oil (I understand from a MooGoo article that Mineral Oil is the same as Parafin oil which is the bad stuff containing SLS in Aqueous cream).

      Ian

      Like

  5. Kirsten says:

    In a few weeks, I’m going to put my family (4 kids, husband and me) on the Elimination Diet in an effort to discover what foods we are all reacting to. We have all sort of symptoms including mouth ulcers, difficulty sleeping, behavioural issues etc. I’ve just been reading some of the comments re eczema and there is apparently a strong link between it and diet. The website to refer to is fedup.com [Ian edit: I think its actually fedup.com.au] and once you’ve been on the elimination diet for 3-6 weeks you can start reintroducing various food groups to see which ones you are reacting to. There are all sorts of interesting stories of symptoms dramatically improving or disappearing altogether with a change in diet!! All the best ….

    Like

    • Hi Kristen,

      The National Eczema Society also recommends trying an exclusion diet for Atopic Eczema (see the Diet section in their Atopic Eczema page), they do note that there’s little evidence of much change except for children under 3, but I’d certainly agree that if you can stick to the regime its worth trying to exclude foods you have suspicions of causing problems.

      Like

  6. Dorothy Moore says:

    Hello Ian,

    many thanks for this in-depth information.

    I have Asteototic eczema – after telling me my skin was in a dreadful state, thin and was dying; I didn’t think in time to ask “will it see me out” ; the skin specialist prescribed Aqueous plus 10% olive oil.

    This eczema causes skin splitting (like several paper cuts at a time all over the body) and the Aqueous stings like hell !!

    I now need to print off, study and follow the links.

    thanks everyone for your input.
    Dorothy

    Like

  7. Toolz says:

    Please help me I have a terrible rash in my skin a doctor oncesaid its eczema and it doesn’t end its itching so badly and it leaves my skin with black spots I’m desperate to have this faded, I’m currently using E45 cream and Aqua Base Opintment to bath but its not helping, help me… And please advise if I can get the product in South Africa where I am..

    Like

    • Hi Toolz, I’m no qualified doctor, so you have to get doctors advice to confirm that it is eczema. I especially have never heard of black spots from eczema. Typically if you do have eczema you will be alergic to something e.g. animals, dust mites – so you should get yourself tested for allergies too – which can be done through a ‘patch test‘ or I’ve also had it done here in Belgium through a blood test.

      The only thing that I feel relatively confident in telling you is that the only thing that actually improved my eczema was cortisone (also known as corticosteroids / or hydrocortisone) – but you should get your doctor to prescribe you some. E45 is good as far as I know and is at least a proper emollient, but the only thing I’ve seen emollients treat is dry skin, not any rash.

      If you’re struggling with your doctor, one thing I might suggest is try emailing (helpline@eczema.org) or calling (+44800 089 1122) the National Eczema Helpline that’s based in the UK.

      Like

  8. miss lee says:

    Well yes aqueous cream it can thin the skin because its watery in a way.

    My baby he has eczema n shame his only two months of age. I get frustrated though cuz this aqua bar- soap seems to burn him in a way. I dont know because he crys wen i wash him with it sooooo now am clueless what should i do? Continue with it just buy a green bar soap sunlight!

    Like

    • Hi miss lee, if there’s a problem with it you have to stop using it. Its not listed in the Babies and Children section of the list above, so you might try looking in there. I have a baby of 6 months and we firstly don’t give her many baths – one per week based on doctors advice. We also don’t give use any kind of soap – just water. We use some Weleda baby oil to keep her skin moist when changing nappies and after a bath but nothing in the bath.

      Like

    • Hi Karen,

      I’ve never come across Perioral Dermatitis, but looking at the Wikipedia page (https://en.wikipedia.org/wiki/Perioral_dermatitis), these certainly shouldn’t cause any harm as they’re not corticosteroids, but it also looks like they probably won’t do anything for the perioral dermatitis. These products are for repairing the skin barrier, where as it sounds like perioral dermatitis is a reaction to corticosteroids. If your perioral dermatitis is caused by using corticosteroids, these will help with any eczema you may have been treating with the corticosteroids.

      Like

  9. Joanna Dem says:

    Hi, your post was very very helpful for me. What do you think about Oilatum Natural Repair Face Cream? I’m asking because it isn’t in the list of creams…

    Like

  10. Hi,

    I’m trying to find a SLS-free shampoo. I currently use E45 Dry Scalp Shampoo but two of its ingredients are Laureth 6 and Laureth 2. Does this explain why the product is not helping reduce the itchiness of my scalp? Can anyone recommend a chemical free light shampoo that is available in pharmacies?

    Many thanks
    Jon

    P.S – I’ve started to use Dead Sea Salt and it certainly seems to be helping calm my skin down.

    Like

    • Hi @Jon, I’m a big fan of Dead Sea salt. I use it just as a face wash by filling a basin and disolving a small amount of the water in there. It uses a lot less salt and seems to still help – I doubt there’s any studies on the amount of time you actually need to spend soaking the skin in the salt water.

      As far as I know the study was only specific to SLS and not to any other chemical combinations, so it wouldn’t explain your problem.

      Like

    • I found out by trial and error what was causing me rashes which was thought to be eczema on my feet.When i was using Oilatum my rash was worse and itchy so i stopped using it.I found that potassium sorbate that is in most cosmetic and food and drinks was the common denominator.So now i avoid chemical 202 potassium sorbate like the plague.

      Like

      • What my doctor told me was that if you have actual eczema i.e. the skin is red and inflamed then all the emollients won’t help – only cortisone will do something. I kept a daily spreadsheet of what I took and this certainly agreed – only cortisone definitively helps.

        I also did find that using Dead Sea salt (see this Web MD article) helped with the inflammation but not as much.

        If you’ve got dry skin then the emollients help to restore the skin barrier before it turns to eczema.

        @kittyway – Thanks for the information. The avoidance principal is always the best. The emollient I’m using is Elidel. These are the ingredients it contains:

        1. Glycerol
        2. White soft paraffin
        3. Liquid paraffin
        4. glycerol monosterate
        5. stearic acid
        6. polydimethylcyclo-siloxane
        7. silicone oil
        8. macrogol 600
        9. trolamin
        10. propyl parahydroxybenzoate (E216)
        11. purified water

        Like

  11. Hello Ian,
    Thank you for your blog, it is very interesting. I am doing research for a client of mine who is using e45. That’s how I came across your article.

    8 Years ago, my friend Helen’s baby boy suffered from terrible eczema. He even ended up in hospital as his skin became badly infected. She was given all kind of medication but it only made it worse until someone recommended she used Arbonne’s products and in particular the ABC Baby’s range. Arbonne is Swiss heritage company now based in the States founded 35 years.

    His condition completely cleared in the matter of a couple of weeks. I am so impressed I have decided to join the company as a rep. If any of you needs more info. I would be most delighted to send you samples and talk further about it.

    Best regards,

    Fabien

    Liked by 1 person

  12. Sonia says:

    The dark marks someone talked about are scars from scratching the rash. I get that too and it is distressing. The dermologist I saw. Just said it will take about two years of not scat hing to go! The oilatum repair is great it is really the only thing that doesn’t irritate when my face is inflamed and red.
    Sonia

    Like

  13. Vin says:

    Hi – I am a pharmacist in the UK and have seen over my 18 years in the industry how confusing all these creams/lotions/ointments etc are.

    From my professional point of view all I can say to you is what helps my patients – every one of us will react differently to these substances and the only way to find out which suits best is a self documented rotation through them all until you find the best combination.

    Much to your distress I am sure – but I have many patients over the years who find aqueous cream is a perfect fit for them and their condition ( usually advise a few drops of lavender oil into the mix as this also helps with itch-scratch cycle).

    I am sure that if each person visited the local pharmacy and asked to have a sit down chat with the pharmacist you could begin to find help.

    The use of any of the simple creams you list is a good starting point in the morning (Aveeno/aqueous/oilatum creams perhaps) then reapply 2/6 times daily depending on your lifestyle and it fitting in.

    At night the use of an ointment which is often better as it adheres to the skin although it can be messy so you can use stretch bandage over it (tubifast here in UK).

    agree that most people will find use from OIlatum products or Doublebase as an emollient/moisturiser (clinically speaking same thing just with or without fragrance – some oilatum products have fragrance!! so look for the fragrance-free bottles.

    Check with your own pharmacist due to need for careful use but when a flareup has occurred then a steroid product should be used (lightly and for only a few days) to clear. One trick is when you apply your steroid to red areas only give it 10 mins then apply your cream or ointment OVER the same area because clinical trials have shown an increase in steroid effectiveness with the cover over it (also try the tubifast at this point).

    Sorry for going on. I find it frustrating when there is so much help out there if all pharmacists and doctors got the time to go into each persons treatment In detail to help them but time and money don’t allow us as much time with individuals in todays fast world.

    Good luck all who are suffering
    Vin

    Liked by 1 person

    • Hi Vin,

      Thank you for your comments! The September 2014 edition of the National Eczema Society magazine had a section on when and how to apply cortisone and emollients. They recommended leaving 15-20 mins for lotion and 30 mins for ointment however that is only because of ‘raised concerns’ of diluting the cortisone – your suggestion of 10 minutes seems more plausible. Would you have any links to the clinical trials?

      I used aqueous cream as a child and my mother swore by it, but anecdotal evidence never helps when it’s a long term problem as people have forgotten what they used by the time any problems set in.

      I definitely agree with your point about documentation. The one thing it proved for me (in the spreadsheet in my article) was the effectiveness of Dead Sea salt when it dramatically improved my eczema between Nov – Dec 2012.

      It’s also interesting that you mention up to 6 times a day – given that all other advice I’ve received has been maximum three and I usually only ever remember two.

      Like

  14. Hi All,
    When talk about Aqeous cream,most of products contain SLS and i finally found Aqeous cream without SLS which manufactured in India its call Parasoft Cream plus Aloe Vera works good for eczema and dry skin..
    Its work preety well ….i would like to recommend this to all

    Like

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