Emollients adverse effects

The most common short-term side effects of PUVA are pruritus and transient nausea. Up to 25% of patients experience pruritus, which is UV dose-related and is associated with dryness of the skin. Usually, the pruritus responds well to emollients and antihistamines. Transient nausea affects 12% of patients taking 8-MOP and can be minimized by taking the medication with food or using antiemetics. PUVA pain is a rare, intermittent, severe burning pain that occurs 4—8 weeks after the onset of PUVA therapy. Because the pain worsens with ongoing therapy, PUVA must be discontinued and the pain usually resolves spontaneously in a few weeks. Other reported adverse effects include erythema and burning, maculopapular rash, exacerbation of photodermatoses, increased incidence of herpes simplex, and hepatotoxicity. 

As lotions, creams, or ointments, emollients often need to be applied several times per day (about four times per day) to achieve a beneficial response. Adverse effects of emollients include folliculitis and allergic or irritant contact dermatitis. 

Perfumes, preservatives, and emollients in cosmetic products are reported to be the major sources of adverse effects [207], The problems that have been reported include temporary hair loss, contact dermatitis, scalp seborrhea, photosensitivity reaction, and mild acneform eruptions and folliculitis [208], Bergfield attributes these problems either to preservatives or medicated ingredients rather than the active ingredients of hair products. 

In many cases of eczema, the use of emollients or astringents may not be sufficient to relieve the symptoms. Topical corticosteroids may then be required to reduce the inflammation. Corticosteroids come in different potencies and the potency of the preparation chosen should be appropriate to the severity of the condition. One percent hydrocortisone cream or ointment, which is available as a pharmacy medicine is usually effective. Long-term application of topical steroids can cause damage to the skin. The aim is to use the lowest effective concentration of corticosteroid for the shortest period. However, it is preferable to use a high potency steroid for a short period rather than a low potency steroid for a longer period. This minimizes the damage to the skin structure and reduces the possibility of systemic adverse effects. (See Chapter 7 page 119 and Table 7.1 for adverse effects of corticosteroids.)... 

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