Practical tips for applying the emollient

The application of moisturizer (or emollient) is part of the daily routine of parents of babies and atopic children. At first sight, nothing could be simpler... Yet, in practice, many questions arise about this essential treatment, which is not always well respected. To help parents acquire the right reflexes and apply the emollient correctly, Dr Magali Bourrel-Bouttaz, Dermatologist - Lyon Sud Hospital (France) has co-constructed a method approved by the Association Française de l'Eczéma.

1. What is the use of the emollient?

This is the essential basis for the treatment of atopic dermatitis. People who suffer from it have dry skin, which is actually a perforated skin. The holes make the skin permeable like a sponge, it absorbs all the air particles that will pass through it and trigger the immune system - which is responsible for the itching.

The only way to block the holes is to apply moisturizer (otherwise known as an emollient) every day. This simple action is a first step in preventing relapses.

2. To which area should the emollient be applied?

It is necessary to apply an emollient on the whole body and face every day, and not only on the dry areas.

3. How to evaluate the right amount of emollient to apply?

Follow 3-6-9 Method, a simple way to retain the amount of emollient needed for each type of patient.

3 pumps for a baby (3 x 2ml)
6 pumps for a child (6 x 2ml)
9 pumps for an adult (9 x 2ml)
Ideally this should be repeated twice a day

4. How to apply the emollient?

The correct gestures must be adapted to the patient's age. But in any case, you should avoid taking a large amount of emollient in your hands before applying... Too much cream on one side, nothing on the other: bad reflex!

For a baby, 3 pressures: apply the cream in small dabs to spread evenly over the body, then massage for a long time. Hydration becomes a moment of bonding and relaxation.

For a child, 6 pressures: Engage in a game of drawing when applying the cream on your child. For example, use the cream to create ladybugs, drawing dots all over the body before spreading it out. Another example could be to use the cream to create zebras by drawing long stripes down your child's legs, before massaging and spreading it out. The idea is to engage and involve the child in his/her treatment and assist him/her to adopt the habit of moisturising as soon as possible.

For an adult, 9 pressures.

5. When to apply the emollient?

The right frequency is every day, ideally twice a day, in the morning and in the evening.

It is up to everyone to create their own routine to anchor habits: in the room or bathroom, on the bed or changing table, playing, singing, listening to music, etc.

6. Emollient and dermocorticoid, to be applied together or separately?

The eczema plaque is a red and/or itchy area, with redness and scratching not necessarily associated. These two criteria should encourage parents to apply a dermocorticoid.

Any emollient applied alone on a red or itchy area may sting. This does not mean that you have to change the emollient, it simply means that the skin also needs a dermocorticoid.

This raises the question of mixing the emollient and dermocorticoid, or applying them separately. In fact, it doesn't matter, as long as the gesture is easy and practical for the parents: the application can be done in one go, or separately.

For example, it is possible to apply the emollient to the entire body and face and immediately add dermocorticoid to the eczema areas. Once the eczema plaque has disappeared, it is essential to continue to apply the emollient alone to the entire body every day to prevent future flare-ups.

It is true that the application of emollient is often easier on slightly damp skin.

The shower itself is an important moment because the hygiene product used must be carefully chosen. It must be soap-free since it degreases the skin, which is not compatible with atopic skin. Nowadays, shower oils are the softest thing.

If the water is very hard, it is better to bathe or shower the child once every 2 days. On the other hand, the cream must be applied every day, even on days without a shower.