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Eczema is one of the most common dermatological diseases, with the number of cases in the UK rising. The use of emollients to maintain skin hydration and help restore barrier function, remains the principal treatment. Unfortunately, many health professionals, and patients themselves, fail to consider emollients an active treatment and may overlook the vital role they play in the maintenance of intact, healthy skin. Despite the overwhelming acceptance of the importance of emollient therapy, there remains a lack of good quality evidence on their effectiveness or whether one is better than another. Even when appropriate emollients are supplied, they are often used incorrectly or accompanied by conflicting/limited advice from health professionals. This article aims to explore normal skin barrier function, the disruption caused by eczema, and some of the contemporary issues surrounding emollient therapy.

Dry skin (xerosis) is a common problem, and ranges from mild dryness through to severe dryness and skin breakdown. The use of emollients continues to be the main therapeutic approach to this problem. However, patients and healthcare professionals do not always appreciate the importance of emollient therapy, and are faced with an overwhelming choice of products. This article aims to review skin barrier function and hydration, the factors causing dry skin and some of the issues that surround the use of emollients.

The promotion and maintenance of skin integrity is one of the most common challenges for nurses in every sphere of practice, but particularly for those caring for patients with chronic inflammation of the skin (such as in eczema and psoriasis), and to those at risk of skin breakdown due to immobility, circulatory disease, or incontinence. A significant amount of nursing time is spent washing patients, or assisting them to wash. However, little attention has been given to a scientific appraisal or evidence of the effectiveness of these activities.

Abstract: The literature reveals there has been limited critical discussion of the inter-relationship between urinary incontinence, the vulnerability of the skin and the clinical implications. This paper critically re-examines the literature to identify and apply relevant scientific principles and evidence to inform effective intervention. It includes background on the structure, function and disruption to the skin''s barrier. The implications for fundamental and largely taken-for-granted nursing practices, such as washing the skin, are examined. The current state of knowledge is analysed, specifying the types of evidence available and its weaknesses, highlighting implications for a research agenda. [Copyright &y& Elsevier]