For ingredient comparison and product equivalents use Emollients Quick Reference Guide on our Dermatology webpage

Emollients are flammable
Dressings and clothing that have contact with emollients are easily ignited by a naked flame. Advise patients to keep them away from fire or flames and not smoke when using them. Patients should be counselled to wash bedding/clothing regularly at 60 degrees celcius, to minimise the build-up of impregnated emollient.

Patients on medical oxygen who require an emollient should not use any paraffin based products.

The risk of fire should be considered when using any emollient as there is a risk with all emollients, including paraffin-free emollients.

For more information please refer to MHRA drug safety update.

Further guidance for patients and useful resources can be found on the MHRA website. A useful presentation pack and posters from the MHRA and National Fire Chiefs Council (NFCC) can be found under further advice and resources.

Therapeutic AreaFormulary ChoicesCost for 28
(unless otherwise stated)
Rationale for decision / comments
Creams Aqueous cream is non-formulary: may cause skin irritation, particularly in children with eczema, possibly due to sodium lauryl sulfate content. (MHRA DSU Mar-13)
If the most cost effective choice emollients are not satisfactory for a patient, after a trial, then all other emollients remain on formulary as patient choice is an important factor in the management of eczema and other skin conditions.
First line

1st option
Green crossEpimax Original® - suitable for self-care£2.49 (500g flexi dispenser tube)
Most cost-effective preparation currently available but not available in pump packs. The 500g flexi-dispenser container consists of an airless pump mechanism which prevents contamination.
21% Paraffin
Potential sensitisers: cetyl/cetostesaryl/stearyl alcohol, and phenoxyethanol
2nd optionsGreen crossEpimax ExCetra® - suitable for self-care£2.95 (500g)23.7% paraffin (Light liquid paraffin 10.5%/ WSP 13.2%)
Potential sensitisers: cetyl/cetostesaryl/stearyl alcohol and phenoxyethanol
Cost effective alternative to Cetraben cream
Green crossAquamax® - suitable for self-care£3.99 (500g jar)SLS, Parabens & lanolin free. Not available in pump packs.
28% Paraffin (light liquid paraffin 8% / WSP 20%)
Potential sensitisers: cetyl/cetostesaryl/stearyl alcohol, and phenoxyethanol
Green crossExocream® - suitable for self-care£3.99 (500g pump)
27.1% paraffin (Light Liquid paraffin 12.6% and White Soft Paraffin 14.5%), Anhydrous Lanolin 1.0%
Most cost-effective emollient in a pump dispenser container; can be considered for patients with poor grip strength and who are unable to use other preferred cost-effective options.
ExoCream compares to E45 cream
Potential sensitisers: cetyl/cetostesaryl/stearyl alcohol, lanolin/derivatives and hydroxybenzoates (parabens)
Green crossZeroAQS® suitable for self-care£3.29 (500g jar)21% paraffin (liquid paraffin 6%/ WSP 15%)
Potential sensitisers: cetyl/cetostesaryl/stearyl alcohol and chlorocresol


Second-lineGreen crossOilatum® - suitable for self-care£5.80 (500ml pump)
21% Paraffin (Light liquid paraffin 6%/ WSP 15%)
Potential sensitisers: cetyl/cetostesaryl/stearyl alcohol, propylene glycol , benzyl alcohol and sorbic acid/sorbates
Green crossOilatum Junior® - suitable for self-care£5.28 (500ml pump)
21% Paraffin (Light liquid paraffin 6%/ WSP 15%)
Potential sensitisers: cetyl/cetostesaryl/stearyl alcohol, benzyl alcohol and sorbic acid/sorbates
Green crossZerobase® - suitable for self-care£5.26 (500g pump)

21% paraffin
Zerobase compares to Diprobase cream
Potential sensitisers: cetyl/cetostesaryl/stearyl alcohol and chlorocresol
Green crossZerocream® - suitable for self-care£4.08 (500g pump)

27.1% paraffin (liquid paraffin 12.6%/ WSP 14.5%)
Zerocream compares to Oilatum cream/Epaderm cream/E45 cream
Potential sensitisers: cetyl/cetostesaryl/stearyl alcohol, lanolin/derivatives and phenoxyethanol
Green crossUltrabase® - suitable for self-care£6.96: 500g pump

10% white soft paraffin

Potential sensitisers: fragrances, cetyl/cetostesaryl/stearyl alcohol, hydroxybenzoates (parabens) and disodium edetate
Oatmeal creamGreen crossEpimax Oatmeal Cream® - suitable for self-care£2.99 500gAvena sativa (oat) kernel flour
Potential sensitisers: cetyl/cetostesaryl/stearyl alcohol, phenoxyethanol, benzyl alcohol and isopropyl palmitate
Creams containing ureaUrea is a keratin softener and hydrating agent used in the treatment of dry, scaling conditions (including itchyoisis). Urea can cause stinging and irritation.
First-lineGreen crossimuDERM emollient® - suitable for self-care£6.50 (500g pump)
Usually twice daily as required; add to bath or as soap substitute
Contains both Urea 5% and Glycerine 5%; contains liquid paraffin..
Potential sensitisers: cetyl/cetostesaryl/stearyl alcohol, benzalkonium chloride, phenethyl alcohol and cetrimonium bromide
GlucoRx Allpresan® diabetic foam creamBasic (5% urea):
£5.50 (125ml)
£9.75 (300ml)

Intensive (10% urea):
£5.50 (125ml)
£9.75 (300ml)
Basic is Indicated for dry, sensitive foot skin in diabetic patients

Intensive is Indicated for very dry to chapped foot skin in diabetic patients

Apply twice daily.
Can be used on
entire foot
including
between toes
Second-line
1st option

Green crossClearZal® Hard Skin Remover - suitable for self-care£4.30 (100g tube)

Once daily
Urea 7%, salicylic acid 4%, trichloroacetic acid 2%
Other ingredients: aloe barbadensis (organic aloe), mineral oil, petrolatum, stearyl alcohol, cetyl alcohol, propylene glycol, hydroxypropyl starch phosphate, glyceryl stearate, PEG-100 stearate, ceteth-20, hydroxyethylcellulose, disodium EDTA, methylisothiazolinone, phenoxyethanol
Potential sensitisers: cetyl/cetostesaryl/stearyl alcohol, propylene glycol, phenoxyethanol

2nd optionsGreen crossDermatonics® Once Heel Balm - suitable for self-care£8.50 (200ml tube)Once daily
Contains 25% urea
Ingredients: Aqua, Urea, lanolin, Petrolatum, C12-15 Alkyl Benzoate, Acrylates, Copolymer, Cera Alba, Dimethicone, Glycerin, Phenoxyethanol, Ethyhexylglycerin, Triethanolamine, Parfum
Potential sensitisers: beeswax, lanolin/derivatives and phenoxyethanol
Green crossFlexitol® 10% Urea Cream - suitable for self-care£11.77 (500g pump)Two or three times daily.
Contains 10% urea.
Ingredients: Purified Water, urea, Lanolin, Cetostearyl, Alcohol, Glycerine, Dimeticone, Paraffin Oil Light, Glyceryl Monostearate, Decyl Oleate, PEG-20 Stearate, Phenoxyethanol, Sodium PCA, Shea Butter, Panthenol, Tocopheryl Acetate, Benzyl Alcohol, Butylated Hydroxytoluene, Perfume.
Potential sensitisers: fragrances, cetyl/cetostesaryl/stearyl alcohol, lanolin/derivatives, benzyl alcohol and phenoxyethanol
Udrate® cream£9.89 (100g)10% urea 5% lactic acid
Gels
First-lineGreen crossEpimax Isomol Gel® - suitable for self-care£2.92 (500g flexi-dispenser tube)
Liquid paraffin 15%, isopropyl myristate 15%. Potential sensitiser: triethanolamine

Not available in pump packs - the 500g flexi-dispenser container consists of an airless pump mechanism which prevents contamination.
Second-lineGreen crossMyribase Gel® - suitable for self-care£4.66 (500g pump)Isopropyl myristate 15% / Liquid paraffin 15% equivalent to Doublebase Gel. Potential sensitisers: triethanolamine and phenoxyethanol
LotionsLotions have a higher water content than creams, which makes them easier to spread but less effective as emollients.
First-lineGreen crossE45® Lotion - suitable for self-care£4.50 (500ml pump)14% Paraffin (Light Liquid Paraffin 4%/ WSP 10%)
Potential sensitisers: lanolin/derivatives, benzyl alcohol and hydroxybenzoates (parabens)
Second-line:Green crossQV® skin lotion - suitable for self-care£5.24(500ml pump)White soft paraffin 5%, glycerin 5%
Potential sensitisers: cetyl/cetostesaryl/stearyl alcohol and hydroxybenzoates (parabens)
Ointments
First-line

1st option
Green crossEmulsifying ointment BP - suitable for self-care£2.47 (500g jar)50% paraffin WSP 30 % Emulsifying wax 20% Liquid paraffin
2nd optionGreen crossEpimax ointment - suitable for self-care£2.99 (500g)Yellow soft paraffin 30%, liquid paraffin 40%, emulsifying wax 30%
Green crossWhite soft paraffin BP - suitable for self-care£3.23 (500g jar)100% WSP
Second line

1st option
Green crossFifty:50 - suitable for self-care£3.66 (500g jar)White soft paraffin 50%, liquid paraffin 50%
2nd optionGreen crossZeroderm® - suitable for self-care£4.10 (500g jar)Liquid paraffin 40%w/w, white soft paraffin 30%w/w
Zeroderm compares to Epaderm or Hydromol ointment.
Potential sensitiser: cetyl/cetostesaryl/stearyl alcohol
Aerosols: Sprays and mousseShould only be used where application without touching the skin is necessary.
Green crossDermamist® - suitable for self-care£5.97 (250ml spray)white soft paraffin 10%
Potential sensitisers: none listed
Emollients containing antimicrobialsUse preparations with antimicrobials only if infection present or strongly suspected. Routine use should be avoided.
Dermol 500 lotion®£6.04 (500ml pump)benzalkonium chloride 0.1%, chlorhexidine hydrochloride 0.1%, liquid paraffin 2.5%
Potential sensitisers: cetyl/cetostesaryl/stearyl alcohol, benzalkonium chloride, and phenoxyethanol
Paraffin-free emollientsGreen crossEpimax paraffin-free® - suitable for self-careCream £3.99 (500g)
Ointment £4.99 (500g)
May be more suitable where flammability is an issue. Patients on medical oxygen who require an emollient should not use any paraffin based products.

The risk of fire should be considered when using any emollient as there is a risk with all emollients, including paraffin-free emollients.