Related guidance:
British Association of Dermatologists
- MHRA published a Field Safety Notice linking cetostearyl alcohol (an excipient of some Epimax products and a number of other emollients) to eye-related toxicity and corneal epithelial loss.
- Please ensure patients using emollients containing cetostearyl alcohol are aware to avoid contact of these products with their eyes and wash their hands after use.
- If patients experience any side effects from their medication, please encourage them to seek clinical advice and report to the MHRA via the Yellow Card Scheme.
(cetostearyl alcohol/cetearyl alcohol = cetyl alcohol and stearyl alcohol)
- Advise patients who use these products not to smoke or go near naked flames, and warn about the easy ignition of clothing, bedding, dressings, and other fabric that have dried residue of an emollient product on them.
- Washing clothing or fabric at a high temperature may reduce emollient build-up but not totally remove it.
- Report any fire incidents with emollients or other skin care products to the Yellow Card scheme.
- A toolkit of resources is now available for health and social care professionals to support the safe use of emollients.
If the most cost effective choice emollients are not satisfactory after a trial, then all other emollients remain on formulary as choice is an important factor in the management of eczema and other skin conditions and includes presentation with full list of ingredients.
Emollient bath and shower products are non-formulary, based on evidence they offer little or no benefit.
| Therapeutic Area | Formulary Choices | Cost for 28 (unless otherwise stated) | Rationale for decision / comments |
|---|---|---|---|
| Eye-related injuries following the use of Epimax on or around the skin of the eyes. See MHRA (January 2023) for Epimax ointment, Epimax paraffin free ointment and Epimax original cream. MHRA published a Field Safety Notice linking cetostearyl alcohol (an excipient of some Epimax products and a number of other emollients) to eye-related toxicity and corneal epithelial loss. Please ensure patients using emollients containing cetostearyl alcohol are aware to avoid contact of these products with their eyes and wash their hands after use. If patients experience any side effects from their medication, please encourage them to seek clinical advice and report to the MHRA via the Yellow Card Scheme. (cetostearyl alcohol/cetearyl alcohol = cetyl alcohol and stearyl alcohol) |
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| Emollient creams and ointments, colloidal oatmeal-containing | |||
 Epimax®Oatmeal - suitable for self-care | Cream: £3.10 (500g) | Tottle. Contains water, glycerol, distearyldimonium chloride, isopropyl palmitate, liquid paraffin 3.5%, dimethicone, avena sativa (oat), kernel flour, allantoin, white soft paraffin 0.75%, isopropanol, octyldodecanol, phenoxyethanol, ethylhexylglycerin, sodium chloride, benzyl alcohol and cetostearyl alcohol. | |
| Miclaro®Oat - suitable for self-care | Cream: £3.99 (500ml) | Pump. Contains avena sativa kernel flour (1%), glycerol, distearyldimonium chloride, isopropyl palmitate, cetyl alcohol, liquid paraffin, white soft paraffin, dimethicone, microcrystalline wax, benzyl alcohol, allantoin, dehydroacetic acid, sodium chloride and purified water. | |
| Lotion: £3.99 (500ml) | Pump. Contains avena sativa kernel flour (1%), glycerol, Isopropyl palmitate, distearyldimonium chloride, cetyl alcohol, white soft paraffin, dimethicone, benzyl alcohol, sodium chloride and purified water. | ||
| Zeroveen® - suitable for self-care | Cream: £6.13 (500g) | Pump. Contains purified water, glycerol 12.6%, liquid paraffin 5%, isopropyl palmitate, distearyldimonium chloride, avena sativa kernal flour, dimeticone, white soft paraffin, benzyl alcohol, allantoin, microcrystalline wax, myristyl alcohol, sodium chloride, cetyl alcohol and stearyl alcohol. NHS Somerset classify as scorecard project negative. |
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| Aveeno® - suitable for self-care | Cream: £6.47 (500ml) | Pump. Contains aqua, glycerin, distearyldimonium chloride, isopropyl palmitate, paraffinum liquidum, cetyl alcohol, dimethicone, avena sativa kernel flour, allantoin, paraffin, cera microcristallina, sodium chloride, BHT, benzyl alcohol. NHS Somerset classify as scorecard project negative. |
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| Aproderm®Colloidal Oat - suitable for self-care | Cream: £5.80 (500ml) | Pump. Contains avena sativa kernel flour 1%, purified water, apricot kernel oil, glycerin, sucrose stearate, glyceryl stearate SE, dimethicone, phenoxyethanol, vitamin F ethyl ester, ethylhexylglycerin, xanthan gum, disodium EDTA, vitamin E and cetearyl alcohol. NHS Somerset classify as scorecard project negative. |
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| Emollient creams and ointments, paraffin-containing | |||
| Aqueous cream is non-formulary. May cause skin irritation particularly in children with eczema, possibly due to sodium lauryl sulfate content. (MHRA December 2014) | |||
| Epimax®Eyelid - suitable for self-care | Ointment: £2.35 (4g) | Preservative free tube. Contains Yellow soft paraffin 80% w/w liquid paraffin 10% w/w, wool fat (lanolin) 10% w/w. | |
| Epimax®Original - suitable for self-care | Cream: £2.67 (500g) | Tottle. Contains white soft paraffin 15%, liquid paraffin 6%, polysorbate 60, phenoxyethanol, water and cetostearyl alcohol. | |
| Epimax®Excetra - suitable for self-care | Cream: £3.09 (500g) | Tottle. Contains white soft paraffin 13.2%, liquid paraffin 10.5%, emulsifying wax (sodium lauryl sulfate free), glycerol, phenoxyethanol, ethylhexylglycerin, citric acid monohydrate, trisodium citrate dihydrate, water and cetostearyl alcohol. |
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| Epimax®Isomol Gel - suitable for self-care | Gel: £3.08 (500g) | Tottle. Contains isopropyl myristate 15%, liquid paraffin 15%, glycerol, carbomer, polysorbate 20, triethanolamine, phenoxyethanol, ethylhexylglycerin and water. | |
| Aquamax® - suitable for self-care | Cream: £3.99 (500g) | Tub. Contains water, white soft paraffin, liquid paraffin, polysorbate 60, phenoxyethanol and cetostearyl alcohol. | |
| Exocream® - suitable for self-care | Cream: £3.99 (500ml) | Pump. Contains white soft paraffin 14.5%, light liquid paraffin 12.6% and hypoallergenic anhydrous lanolin 1%. | |
| ZeroAQS - suitable for self-care | Cream: £3.39 (500g) | Tub. Contains water, paraffin white soft 15%, liquid paraffin 6%, macrogol cetostearyl ether, chlorocresol and cetostearyl alcohol. | |
| Zerocream® - suitable for self-care | Cream: £4.30 (500g) | Pump. Contains water, white soft paraffin 14.5%, liquid paraffin 12.6%, cetyl alcohol, glyceryl monostearate, sodium cetostearyl sulfate, lanolin, citric acid monohydrate, carbomer, sodium hydroxide, sodium methyl hydroxybenzoate, sodium propyl hydroxybenzoate and butylated hydroxytoluene. | |
| Aproderm® - suitable for self-care | Cream: £4.95 (500g) | Pump. Contains white soft paraffin 15%, liquid Paraffin 6%, ceteareth-20, aqua, sodium dihydrogen phosphate dihydrate, phenoxyethanol, ethylhexylglycerin and cetearyl alcohol. | |
| Gel: £3.99 (500g) | Pump. Contains liquid paraffin 15% and isopropyl myristate 15%, aqua, glycerin, polyacrylate-13, polyisobutene, polysorbate-20, phenoxyethanol, benzoic acid, dehydroacetic acid, ethylhexylglycerin. | ||
| Myribase Gel® - suitable for self-care | Gel: £4.66 (500ml)) | Pump. Contains isopropyl myristate 15% and liquid paraffin 15%, glycerol, carbomer, sorbitan laurate, phenoxyethanol, triethanolamine and water. |
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| E45® Lotion - suitable for self-care | Lotion: £4.90 (500ml) | Pump. Contains aqua, petrolatum, isopropyl palmitate, paraffinum liquidum. | |
Emulsifying ointment - suitable for self-care | Ointment: £3.97 (500g) | Jar. Contains emulsifying wax 30%, white soft paraffin 50% and liquid paraffin 20%. |
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| Epimax®Ointment - suitable for self-care | Ointment: £3.13 (500g) | Tub. Contains liquid paraffin 40%, yellow soft paraffin 30% and cetomacrogol emulsifying wax (contains macrogol cetostearyl ether and cetostearyl alcohol). | |
| White soft paraffin - suitable for self-care | Ointment: £5.32 (500g) | Tub. Contains white soft paraffin 100%. | |
| Fifty:50 - suitable for self-care | Ointment: £3.92 (500g) | Tub. Contains white soft paraffin 50% and liquid paraffin 50%. | |
| Zeroderm® - suitable for self-care | Ointment: £4.29 (500g) | Tub. Contains liquid paraffin, white soft paraffin, polysorbate 60 and cetostearyl alcohol. | |
| Dermipar® - suitable for self-care | Ointment: £4.92 (500g) | Tub. Contains cetomacrogol emulsifying wax, white soft paraffin and liquid paraffin. | |
| QV® - suitable for self-care | Lotion: £5.47 (500ml) | Pump. Contains aqua, glycerin, petrolatum, C12-15 alkyl benzoate, cetearyl alcohol, ceteareth-20, steareth-2, dimethicone, glyceryl stearate, methylparaben, propylparaben, dichlorobenzyl alcohol, polyacrylic acid, triethanolamine. NHS Somerset classify as scorecard project negative. |
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| Diprobase®Advanced Eczema - suitable for self-care | Cream: £7.01 (500ml) | Pump. Contains purified water, white soft paraffin, isopropyl palmitate, liquid paraffin, glycerin, behenyl alcohol, cellulose, glyceryl stearate, PEG-100 stearate, dimeticone, citric acid (anhydrous), arachidyl alcohol, arachidyl glucoside, hydroxyacetophenon, potassium hydroxide, and xanthan Gum. NHS Somerset classify as scorecard project negative. |
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| Ultrabase® - suitable for self-care | Cream: £7.01 (500ml) | Pump. Contains white soft paraffin 10%, polyoxyl 40 stearate [E431], liquid paraffin, stearyl alcohol, carbomer, sodium hydroxide, methyl parahydroxybenzoate (methyl paraben) [E218], propyl parahydroxybenzoate (propyl paraben) [E216], disodium edetate, purified water and citrus-rose perfume oil. NHS Somerset classify as scorecard project negative. |
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| Epaderm® - suitable for self-care | Cream: £7.09 (500g) | Pump. Contains purified water, liquid paraffin, yellow soft paraffin, cetomacrogol, chlorocresol, glycerine and emulsifying wax (contains macrogol cetostearyl ether 22 and cetostearyl alcohol) NHS Somerset classify as scorecard project negative. |
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| E45® - suitable for self-care | Cream: £5.99 (500g) | Tub. Contains anhydrous lanolin 1%, white soft paraffin 14.5%, light liquid paraffin 12.6%, cetyl alcohol 0.5%, methyl parahydroxybenzoate (E218) 0.15%, propyl parahydroxybenzoate (E216) 0.04%, Empilan GMS, cetyl alcohol, sodium cetostearyl sulphate, carbomer, methyl hydroxybenzoate, propyl hydroxybenzoate, sodium hydroxide, citric acid monohydrate, purified water. NHS Somerset classify as scorecard project negative. |
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| Hydromol® - suitable for self-care | Cream: £12.88 (500g) | Pump. Contains sodium pyrrolidone carboxylate 2.5%, liquid paraffin, isopropyl myristate, sodium lactate solution, cetomacrogol emulsifying wax, myristyl myristate, macrogol cetostearyl ether, hydroxybenzoates (E218, E214, E216), phenoxyethanol and purified water. NHS Somerset classify as scorecard project negative. |
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| QV® - suitable for self-care | Cream: £6.60 (500g) | Pump. Contains aqua, paraffinum liquidum, glycerin, petrolatum, dimethicone, squalane, glyceryl stearate SE, ceteareth-20, stearic acid, laureth-3, glyceryl stearate, methylparaben, dichlorobenzyl alcohol and cetearyl alcohol. NHS Somerset classify as scorecard project negative. |
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| Zeroguent® - suitable for self-care | Cream: £7.32 (500g) | Tub. Contains light liquid paraffin, white soft paraffin, soya bean oil, glyceryl monostearate 40-55, propylene glycol, colloidal anhydrous silica, sorbic acid, polysorbate, purified water and cetostearyl alcohol. NHS Somerset classify as scorecard project negative. |
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| Oilatum® - suitable for self-care | Cream: £5.28 (500ml) | Pump. Contains light liquid paraffin 6%, white soft paraffin 15%, macrogol 1000, monostearate, glycerol, potassium sorbate, benzyl alcohol, citric acid monohydrate, povidone, water and cetostearyl alcohol. NHS Somerset classify as scorecard project negative. |
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| Zerobase® - suitable for self-care | Cream: £5.58 (500g) | Pump. Contains liquid paraffin (11%), white Soft paraffin (10%), macrogol cetostearyl ether, sodium dihydrogen, phosphate dihydrate, chlorocresol, phosphoric acid, water and cetostearyl alcohol. NHS Somerset classify as scorecard project negative. |
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| Doublebase® - suitable for self-care | Gel: £5.83 (500g) | Pump. Contains isopropyl myristate 15%, liquid paraffin 15%, glycerol, carbomer, sorbitan laurate, trolamine, phenoxyethanol and purified water. NHS Somerset classify as scorecard project negative. |
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| Zerodouble® - suitable for self-care | Gel: £5.14 (500g) | Pump. Contains purified water, isopropyl myristate, liquid paraffin, glycerol, triethanolamine, phenoxyethanol, acrylates, sorbitan laurate. NHS Somerset classify as scorecard project negative. |
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| HypoBase® - suitable for self-care | Gel: £5.83 (500g) | Pump. Contains: isopropyl myristate 15%, liquid paraffin 15%, glycerol, carbomer, sorbitan laurate, phenoxyethanol, triethanolamine and purified water. NHS Somerset classify as scorecard project negative. |
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| Emollient creams and ointments, paraffin-free | |||
| Epimax® paraffin-free - suitable for self-care | Ointment: £4.99 (500g) | Tub. Contains hydrogenated castor oil, polyoxyethylene hydrogenated castor oil 38%, macrogol cetostearyl ether, medium chain triglycerides, polyoxypropylene stearyl ether, cetostearyl alcohol, hydrogenated castor oil, D&C Yellow/Red. | |
| Emollients, urea-containing | |||
| imuDERM® - suitable for self-care | Emollient: £6.79 (500g) | Pump. Contains aqua, paraffinum liquidum, Urea (5%), glycerine (5%), ceteareth-20, glyceryl stearate, cetrimonium Bromide, tocopheryl acetate, benzyl alcohol, phenoxyethanol, lactic acid, potassium sorbate; xanthan gum and cetearyl alcohol. | |
| GlucoRx Allpresan® diabetic foam cream | Cream (basic): £5.50 (125ml) £9.75 (300ml) | Pressurized container. Aqua, Butane, Urea (basic 5% and intensive 10%), decyloleate, octyldodecanol, propane, stearic acid, propylene glycol, glycerin, glyceryl stearate, panthenol, saccharide isomerate, undecyl alcohol, allantoin, potassium lauroyl wheat amino acids, palm glycerides, capryloyl glycine, sodium lauroyl sarcosinate, sodium citrate, citric acid and cetearyl alcohol. | |
| Cream (intensive): £5.50 (125ml) £9.75 (300ml) |
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ClearZal®Hard Skin Remover - suitable for self-care | Cream: £4.30 (100g) | Tube. Contains urea, salicylic acid and trichloroacetic acid. | |
| Dermatonics®Once Heel Balm - suitable for self-care | Cream: £9.44 (200ml) | Tube. Contains aqua, urea (25%), lanolin cera petrolatum, C12-15 alkyl benzoate, cera alba, dimethicone, glycerin, acrylates, copolymer, parfum, phenoxyethanol, ethylhexylglycerin and triethanolamine. | |
| Flexitol®10% Urea - suitable for self-care | Cream: £12.36 (500g) | Pump. Contains urea (10%), wool fat, light liquid paraffin, PEG-20 stearate, glyceryl monostearate (40-55), decyl oleate, glycerol, phenoxyethanol, sodium PCA 50% solution, shea butter, benzyl alcohol, dimeticone, vitamin E acetate, panthenol, perfume enzeau, water and cetostearyl alcohol. | |
| Udrate® - suitable for self-care | Cream: £9.89 (100g) | Tube. Contains aqua, Urea (10%), lactic acid, caprylic/capric triglyceride, methyl glucose sesquistearate, glycerin, isopropyl isostearate, olus oil, butyrospermum parkii (shea) butter, lanolin, isopropyl myristate, glyceryl stearate, pentylene glycol, triethyl citrate, camelina sativa seed oil, allantoin, panthenol, tocopheryl acetate, hydroxyethyl acrylate/sodium acryloyldimethyl taurate copolymer, polyacrylate crosspolymer-6, hydroxyacetophenone, amino methyl propanol, citric acid and cetearyl alcohol. | |
| Balneum Plus® - suitable for self-care | Cream: £14.99 (500g) | Pump. Contains lauromacrogols 3%, urea 5%, dimethicone, phenyl dimeticone, liquid paraffin, cetylpalmitate, stearic palmitic acid, octyldodecanol, glycerol 85%, polvsorbate, carbomer, trometamol, benzyl alcohol and purified water. NHS Somerset classify as scorecard project negative. |
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| Eucerin Intensive® - suitable for self-care | Cream: £6.26 (100ml) | Tube. Contains aqua, urea 10%, glycerin, capryliccapric triglyceride, glyceryl stearate, ethylhexyl cocoate, hydrogenated coco-glycerides, octyldodecanol, sodium lactate, glyceryl stearate SE, distarch phosphate, ceramide NP, lactic acid, arginine HCL, sodium PCA, cholesterol, helianthus annuus seed oil, alanine, carnitine, glycine, sodium chloride, dimethicone, carbomer, sorbitan stearate, sodium cetearyl sulfate, phenoxyethanol and cetearyl alcohol. NHS Somerset classify as scorecard project negative. |
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| Flexitol® Urea Heel Balm - suitable for self-care | Cream: £9.85 (200g) | Tube. Contains water, 25% urea, lanolin, mineral oil, glyceryl stearate, decyl oleate, PEG-20 stearate, paraffin, phenoxyethanol, sodium PCA, butyrospermum parkii, allantoin, glycolic acid, panthenol, tocopheryl acetate, benzyl alcohol, melaleuca alternifolia oil, arginine, aloe vera gel, fragrance and cetearyl alcohol. NHS Somerset classify as scorecard project negative. |
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| Aquadrate® - suitable for self-care | Cream: £4.62 (100g) | Tube. Contains urea 10%, white soft paraffin, isopropyl myristate, maize starch, glyceryl tribehenate, palmitic acid, sorbitan laurate and polyoxyethylene fatty glyceride. NHS Somerset classify as scorecard project negative. |
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| E45 Itch Relief® - suitable for self-care | Cream: £4.28 (100g) | Tube. Contains lauromacrogols 3%, urea 5%, dimeticone, phenyl dimeticone, liquid paraffin, cetyl palmitate, stearic palmitic acid, octyldodecanol, glycerol 85%, polysorbate, carbomer, trometamol, benzyl alcohol and purified water. NHS Somerset classify as scorecard project negative. |
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| Flexitol® Hand Balm - suitable for self-care | Cream: £3.67 (75g) | Tube. Contains purified water, urea 10%, lanolin, 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 and cetostearyl alcohol. NHS Somerset classify as scorecard project negative. |
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| Flexitol® Skin Balm - suitable for self-care | Cream: £4.76 (100g) | Tube. Contains purified water, urea, lanolin, glycerine, dimethicone, light liquid paraffin, glyceryl monostearate, decyl oleate, PEG-20 stearate, phenoxyethnol, sodium PCA, butyrospermum parkii, panthenol, tocophyeryl acetate, benzyl alcohol, butylated hydroxytoluene, parfum and cetearyl alcohol. NHS Somerset classify as scorecard project negative. |
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| Hydromol Intensive® - suitable for self-care | Cream: £4.62 (100g) | Tube. Contains urea 10%, white soft paraffin, isopropyl myristate, maize starch, glyceryl tribehenate, palmitic acid, sorbitan laurate and polyoxyethylene fatty glyceride. NHS Somerset classify as scorecard project negative. |
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| Emollient creams and ointments, antimicrobial-containing | |||
| Emollients containing antimicrobials should only be used when infection is present and should be stopped once it is cleared. | |||
| Dermol®500 - suitable for self-care | Lotion: £6.04 (500ml) | Pump. Contains liquid paraffin 2.5%, isopropyl myristate 2.5%, benzalkonium chloride 0.1% and chlorhexidine dihydrochloride 0.1% | |