3 Handy Tips for Applying Moisturiser
Published on the 04 August 2015
Published on the 04 August 2015
The first line of management for many dermatological conditions are moisturisers which foster skin hydration and barrier function. They can allow easier absorption of topical medications, reduce symptoms such as itching and burning, and maintain pliability and elasticity decreasing the risk of tears (especially in the older person). However, applying moisturiser to your patient’s skin can also help to facilitate caring touch.
Moisturisers and emollients both hydrate and soften the skin, however, they achieve this through different means. Moisturisers add moisture while emollients soften through two skin effects. Occlusive emollients consist of a lipid (fatty) layer such as petrolatum or dimethicone, which slows the evaporation of water, increasing the moisture content of the stratum corneum (the outermost layer of the epidermis). Humectant emollient, on the other hand, is an additive in a lipid emulsion, such as glycerine or urea, which draws dermal moisture into the epidermis increasing hydration.
Moisturisers vary in consistency due to their lipid/water ratio and are available as cleansers (wash off) and leave on formulations. There are three different weights that moisturisers come in—ointments, creams, and lotions—all of which have different benefits and disadvantages.
Generally speaking, whenever you are applying a new moisturiser it is best to test a small area and observe for 48 hours. Slight stinging can be normal, but should settle quite quickly, if there are no other reactions you may continue with the use of this product. The best time to use moisturiser is within the three minutes following your patient’s shower when the skin is still damp and warm. Using pump packs and tubes lowers the risk of contamination—if you are using a tub, be sure to use a clean utensil to dispense each time. Spread the moisturiser in a gentle downward motion with the direction of the hair to avoid clogging the pores and triggering folliculitis.
If you applying multiple products it is best to allow at least 30 minutes between applications so that each has a chance to penetrate the skin. An initial application of a greasy topical ointment may impede the absorption of the next substance it is applied too soon. If you are applying a medicated topical, this is particularly important as you want this product to be confined to a specified area and not smeared in the process of additional applications.
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Remember, choose the moisturiser to suit the patient, their condition, whether they are itching, and the desired outcome. While heavier products are more effective for dry skin, patient adherence is more difficult as they may find these moisturisers greasy. Lighter lotions or creams are preferable in warmer climates and for occluded or hairy areas. As a nurse, you are in a unique position to not only to increase the comfort of your patient, but also to make them feel pampered and cared for with your ready attention and gentle touch.
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Jan Riley is a specialist dermatology nurse based in regional New South Wales, Australia. Her postgraduate studies include a Certificate in Dermatology Nursing (USA), Master of Nursing (NP) and Certificates in Dermoscopy and Skin Cancer Medicine. Driven by a passion for “all things skin”, Jan is a staunch and passionate mentor and advocate, who is always ready and willing to share knowledge and inspire nurses to understand skin’s impact on daily lives. Her active participation in a range of professional activities has greatly assisted to raise the profile of dermatology and skin disease in the community. Jan currently develops and presents skin education modules through a co-directed nurse education company (Dermatology Nurse Education Australia) for nurses across all areas of care delivery.