Optimization of Basic Emollient Therapy for the Management of Xerosis Cutis

Topical emollients are the mainstay of basic therapy for managing xerosis cutis (dry skin). In general, most emollient formulations are safe and effective for xerosis cutis and diseases associated with dry skin; however, several other factors can vary widely between products, influence patient adherence, and ultimately affect treatment success. This article reviews key practical and clinical considerations when prescribing emollients for xerosis cutis and discusses strategies to optimize treatment and clinical outcomes for these patients. Although the optimal quantity and frequency of emollient use depend on the extent and severity of skin dryness, frequent (i.e., up to several times daily) and liberal application (i.e., up to 600 g/week) are generally recommended. Lipid-rich ointments are indicated for very dry skin, while hydrophilic creams and lotions are suitable for less severe xerosis cutis; however, treatment decisions should also be guided by other factors (e.g., cosmetic acceptability and practicality) to ensure that patients can adhere to long-term emollient therapy. Strategies to promote shared decision-making and improve treatment adherence include patient education, allowing patients to trial a range of emollient products, regularly following-up with patients, and adjusting treatment to suit their preferences. Emollient therapy is a cost-effective strategy to manage patients with chronic dry skin conditions; however, access to basic, lower-cost formulations remains important to minimize the financial burden on patients. Overall, treatment effectiveness and clinical need should be balanced with individual patient preferences to ensure that the full benefits of emollient therapy for xerosis cutis are realized.