Journal Mobile Options
Table of Contents
Vol. 15, No. 3, 2002
Issue release date: May–June 2002
Skin Pharmacol Appl Skin Physiol 2002;15:166–174

Urea and Sodium Chloride in Moisturisers for Skin of the Elderly – A Comparative, Double-Blind, Randomised Study

Kuzmina N. · Hagströmer L. · Emtestam L.
Department of Medicine, Section of Dermatology and Venereology, Karolinska Institutet at Huddinge University Hospital, Stockholm, Sweden

Individual Users: Register with Karger Login Information

Please create your User ID & Password

Contact Information

I have read the Karger Terms and Conditions and agree.

To view the fulltext, please log in

To view the pdf, please log in


Urea has long been used to treat dry skin. In the present report, we compared two identical creams, with the exception that one contained both urea and sodium chloride and the other urea alone, in 23 healthy elderly subjects. Following a 2-week wash-out, their clinically non-eczematous, rough- or normal-appearing skin on the anterior proximal part of the lower legs was treated twice daily in a double-blind and randomised manner. We examined the treated areas by measuring transepidermal water loss, capacitance and electrical impedance. Our findings suggest that both moisturisers seem equally effective, at least concerning the ability to reverse impedance indices towards normal, an effect ascribed to changes in hydration of the stratum corneum. However, the relevance of the impedance parameters to the clinical picture is disputable and further studies of moisturisers in elderly subjects are needed.

Copyright / Drug Dosage

Copyright: All rights reserved. No part of this publication may be translated into other languages, reproduced or utilized in any form or by any means, electronic or mechanical, including photocopying, recording, microcopying, or by any information storage and retrieval system, without permission in writing from the publisher or, in the case of photocopying, direct payment of a specified fee to the Copyright Clearance Center.
Drug Dosage: The authors and the publisher have exerted every effort to ensure that drug selection and dosage set forth in this text are in accord with current recommendations and practice at the time of publication. However, in view of ongoing research, changes in goverment regulations, and the constant flow of information relating to drug therapy and drug reactions, the reader is urged to check the package insert for each drug for any changes in indications and dosage and for added warnings and precautions. This is particularly important when the recommended agent is a new and/or infrequently employed drug.
Disclaimer: The statements, opinions and data contained in this publication are solely those of the individual authors and contributors and not of the publishers and the editor(s). The appearance of advertisements or/and product references in the publication is not a warranty, endorsement, or approval of the products or services advertised or of their effectiveness, quality or safety. The publisher and the editor(s) disclaim responsibility for any injury to persons or property resulting from any ideas, methods, instructions or products referred to in the content or advertisements.


  1. Pigatto P, Bigardi A, Cannistraci C, Picardo M: 10% urea cream (Lanceran) for atopic dermatitis: A clinical and laboratory evaluation. J Dermatol Treat 1996;7:171–175.
  2. Nicander I: Electrical Impedance Related to Experimentally-Induced Changes of Human Skin and Oral Mucosa; thesis, Stockholm, 1998.
  3. Lodén M: Urea-containing moisturizers influence barrier properties of normal skin. Arch Dermatol Res 1996;288:103–107.
  4. Jacobi OK: Moisture regulation of the skin. Drug Cosmet Ind 1959;88:732–812.
  5. Thune P: Evaluation of the hydration and the water-holding capacity in atopic skin and so-called dry skin. Acta Derm Venereol Suppl (Stockh) 1989;144:133–135.
  6. Miettinen H, Johansson G, Gobom S, Swanbeck G: Studies on constituents of moisturizers: Water-binding properties of urea and NaCl in aqueous solutions. Skin Pharmacol Appl Skin Physiol 1999;12:344–351.
  7. Lodén M, Andersson AC, Lindberg M: Improvement in skin barrier function in patients with atopic dermatitis after treatment with a moisturising cream (Canoderm). Br J Dermatol 1999;140:264–267.
  8. Swanbeck G: Treatment of dry hyperkeratotic, itchy skin with urea-containing preparations. Dermatol Dig 1972;11:39–44.
  9. Swanbeck G: A new treatment of ichthyosis and other hyperkeratotic conditions. Acta Derm Venereol 1968;48:123–127.
  10. Hagströmer L, Nyren M, Emtestam L: Do urea and sodium chloride together increase the efficacy of moisturisers for atopic dermatitis skin? A comparative, double-blind and randomised study. Skin Pharmacol Appl Skin Physiol 2001;14:27–33.
  11. Swanbeck G: The effect of urea on the skin with special reference to the treatment of ichthyosis; in Marks R, Dykes PG (eds): The Ichthyosis. Lancaster, Technical Press, 1978, pp 163–166.
  12. Grice K, Sattar H, Baker H: Urea and retinoic acid in ichthyosis and their effect on transepidermal water loss and water-holding capacity of stratum corneum. Acta Derm Venereol 1973;53:114–118.
  13. Andersson A-C, Lindberg M, Lodén M: The effect of two urea-containing creams on dry, eczematous skin in atopic patients. I. Expert, patient and instrumental evaluation. J Dermatol Treat 1999;10:165–169.
  14. Potts RO: Stratum corneum hydration: Experimental techniques and interpretation of results. J Soc Cosmet Chem 1986;37:9–33.
  15. Hashimoto-Kumasaka K, Takahashi K, Tagami H: Electrical measurement of the water content of the stratum corneum in vivo and in vitro under various conditions: Comparison between skin surface hygrometer and corneometer in evaluation of the skin surface hydration state. Acta Derm Venereol 1993;73:335–339.
  16. Serup J: A double-blind comparison of two creams containing urea as the active ingredient. Assessment of efficacy and side-effects by non-invasive techniques and a clinical scoring scheme. Acta Derm Venereol Suppl (Stockh) 1992;177:34–38.
  17. Lévêque JL, de Rigal J: Impedance methods for studying skin moisturization. J Soc Cosmet Chem 1983;34:419–428.
  18. Lodén M, Lindberg M: The influence of a single application of different moisturizers on the skin capacitance. Acta Derm Venereol 1991;71:79–82.
  19. Clar EJ, Her CP, Sturelle CG: Skin impedance and moisturization. J Soc Cosmet Chem 1975;26:337–353.
  20. Yamamoto T, Yamamoto Y: Electrical properties of the epidermal stratum corneum. Med Biol Eng 1976;14:151–158.
  21. Yamamoto T, Yamamoto Y: Analysis for the change of skin impedance. Med Biol Eng 1977;15:219–227.
  22. Lodén M: Biophysical methods of providing objective documentation of the effects of moisturizing creams. Skin Res Technol 1995;1:101–108.
  23. Grimnes S, Martinsen O: Bioimpedance and Bioelectricity Basics. San Diego, Academic Press, 2000.
  24. Pinnagoda J, Tupker RA, Agner T, Serup J: Guidelines for transepidermal water loss (TEWL) measurement. A report from the Standardization Group of the European Society of Contact Dermatitis. Contact Dermatitis 1990;22:164–178.
  25. Serup J, Jemec G: Handbook of Non-Invasive Methods and the Skin. Boca Raton, CRC Press, 1995.
  26. Triebskorn A, Gloor M, Greiner F: Comparative investigations of the water content of the stratum corneum using different methods of measurement. Dermatologica 1983;167:64–69.
  27. Werner Y: The water content of the stratum corneum in patients with atopic dermatitis. Measurement with the Corneometer CM 420. Acta Derm Venereol 1986;66:281–284.
  28. Kirk RE: Experimental design: Procedures for the Behavioural Sciences. Pacific Grove, Brooks/Cole Publishing Company, 1995.
  29. Wilhelm KP, Maibach HI: Influence of aging on the barrier function of human skin evaluated by in vivo transepidermal water loss measurements; in Lévêque JL, Agache PG (eds): Aging Skin. New York, Dekker, 1993, pp 239–250.
  30. Lodén M: Urea; in Lodén M, Maibach HI (eds): Dry Skin and Moisturisers. Chemistry and Function. Boca Raton, CRC Press, 2000, pp 243–250.
  31. Ollmar S, Nyren M, Nicander I, Emtestam L: Electrical impedance compared with other non-invasive bioengineering techniques and visual scoring for detection of irritation in human skin. Br J Dermatol 1994;130:29–36.
  32. Nicander I, Ollmar S, Lundh Rozell B, Eek A, Emtestam L: Electrical impedance measured to five skin depths in mild irritant dermatitis induced by sodium sulphate. Br J Dermatol 1995;132:718–724.
  33. Nicander I, Ollmar S, Lundh Rozell B, Emtestam L: Allergic contact reactions in the skin assessed by electrical impedance – a pilot study. Skin Res Technol 1997;3:121–125.
  34. Nicander I, Ollmar S: Mild and below threshold skin responses to sodium lauryl sulphate assessed by depth-controlled electrical impedance. Skin Res Technol 1997;3:259–263.
  35. Nicander I, Ollmar S, Eek A, Lundh Rozell B, Emtestam L: Correlation of impedance response patterns to histological findings in irritant skin reactions induced by various surfactants. Br J Dermatol 1996;34:221–228.
  36. Norlén L: The Skin Barrier – Structure and Physical Function; thesis, Stockholm, 1999.
  37. Harvell JD, Maibach HI: Percutaneous absorption and inflammation in aged skin: A review. J Am Acad Dermatol 1994;31:1015–1021.
  38. Tabata N, O’Goshi K, Zhen YX, Kligman AM, Tagami H: Biophysical assessment of persistent effects of moisturizers after their daily applications: Evaluation of corneotherapy. Dermatology 2000;200:308–313.
  39. Ghadially R, Halkier-Sorensen L, Elias PM: Effects of petrolatum on stratum corneum structure and function. J Am Acad Dermatol 1992;26:387–396.
  40. Yoshizawa Y, Tanojo H, Kim SS, Maibach HI: Sea water or its components alter experimental irritant dermatitis in man. Skin Res Technol 2001;7:36–39.

Pay-per-View Options
Direct payment This item at the regular price: USD 38.00
Payment from account With a Karger Pay-per-View account (down payment USD 150) you profit from a special rate for this and other single items.
This item at the discounted price: USD 26.50