Emollients — SCE Dermatology MCQ

Correct answer: B — Ointment — the higher lipid content provides superior barrier function and occlusion

Ointments (e.g., white soft paraffin, 50:50 white soft paraffin/liquid paraffin) provide superior barrier function compared to creams because of their higher lipid (oil) content and lower water content, creating a more effective occlusive layer that reduces transepidermal water loss. Creams (oil-in-water emulsions) are more cosmetically acceptable, lighter, and easier to apply but contain water, emulsifiers, and preservatives that may irritate sensitive/eczematous skin. For maximum barrier restoration in eczema, greasy ointment-based emollients are preferred. Patient preference is important for adherence — the best emollient is the one the patient will use regularly. Multiple emollients for different body sites and times of day can be prescribed.

Reference: NICE CG57; BAD Emollient Guidelines