Topical Tip #4: Lotion, Cream or Ointment?

Described in more detail under Types of emollient on p18 of Atopic Skin Disease - The Manual for Practitioners, a lotion, cream or an ointment is a preparation that is also used as a base or vehicle for a topical steroid - which is therefore also called a cream or ointment. The following remarks apply to topical steroids as they do to emollients used as moisturisers.

Lotions are thinner and more liquid than creams. Creams are thinner than ointments.

Lotions are easier to apply than creams or ointments, but are of limited or no value as moisturisers when treating atopic eczema. Creams, which contain less water than lotions, are easier to apply than ointments. Ointments contain less water than creams.

There are more additives in lotions and creams than in ointments. Partly because of the possibility of side-effects to additives, ointments are often preferred by dermatologists. Also, their effect as moisturisers is more efficient at any one time, and lasts longer between applications, compared with that of creams.

However, if an ointment is difficult or messy to apply, it may not be used. An emollient that is not used is clearly ineffective. The ideal moisturiser is one that is used appropriately, is effective in insulating against water loss and contains no additive causing side-effects.