Urea creams and ointments appear on the World Heath Organisations list of essential medications for a basic healthcare system. This is due to its safety, effectiveness and affordability.
For over a century, Urea containing formlations have been used in a concentration dependent manner to restore skin hydration.
Urea's role in skin hydration and repair has expanded to include regulation of epidermal genes necessary for proper barrier function. Taken together, Urea's versatility in topical formulations and broad range of therapeutic mechanism highlights its utility to clinicians and benefit to patients.
10% Urea Cream in senile xerosis: Clinical and instrumental evaluation.
Results:After 7 and 14 days of treatment, the tested Urea based cream resulted in a significant, progressive clinical improvement of xerosis and related pruritus (itching)in all patients.
Conclusions: Urea confirms to represent a key molecule for the treatment of senile xerosis (the medical term for abnormally dry skin).
-Journal of Cosmetic Dermatology 20/04/2021
Urea is an organic compound that has been used clinically for dermatological diseases for more than a century.
Urea is a potent emollient and keratolytic agent, making urea an effective monotherapy for conditions associated with dry and scaly skin. A systematic review of the literature is needed to provide clinicians with evidence-based applications of urea in the treatment of dermatological diseases
Methods:
A PubMed search was conducted using the term “urea” combined with “skin,” “ichthyosis,” “psoriasis,” “xerosis,” “emollient,” “onychomycosis,” “dermatitis,” and “avulsion.” A total of 81 publications met inclusion criteria and were evaluated. Treatment indication(s), test agents, number of subjects, treatment protocols, results, and side effects were recorded.
Results:
Effective treatment with urea has been reported for the following conditions: ichthyosis, xerosis, atopic dermatitis/eczema, contact dermatitis, radiation induced dermatitis, psoriasis/seborrheic dermatitis, onychomycosis, tinea pedis, keratosis, pruritus, and dystrophic nails. Furthermore, urea has been used with other medications as a penetration enhancing agent. Mild irritation is the most common adverse event, proving urea to be a safe and tolerable topical drug without systemic toxicity.
Discussion/Conclusion:
Urea is a safe, effective dermatologic therapy with wide-ranging clinical utility and minimal, non-systemic side effects. In order to optimize patient care, dermatologists should be well informed with regards to urea’s indications and efficacy
How does urea work?
Urea preparations are emollients that are essential in the management of dry skin conditions. Emollients moisturise dry skin by reducing water loss from the epidermis (upper layer of skin) resulting in softer and more supple skin.
The specific actions of urea include:
• Hydrating effects — urea is strongly hygroscopic (water-loving) and draws and retains water within skin cells
• Keratolytic effects — urea softens the horny layer so it can be easily released from the surface of the skin
• Regenerative skin protection — urea has a direct protective effect against drying influences and if used regularly improves the capacity of the epidermal barriers for regeneration
• Irritation-soothing effects — urea has anti-pruritic activity based on local anaesthetic effects
• Penetration-assisting effects — urea can increase the penetration of other substances such a scorticosteroids, as it increases skin hydration.
References (Click links to read further information and proven studies on Urea):
Eighty four outpatients with either ichthyosis vulgaris or X‐linked ichthyosis were treated with 4 topical applications (only cream,B.P.; salicylic acid ointment, B.P.; a urea cream; and Boots E.45 cream) in a doubleblind control trial.
At the end of the 2‐week treatment period the response was assessed by soliciting the patient's opinion and by personal assessment of the clinicians in charge. The patient'sassessment did not reveal any statistically significant difference between the groups, but on the assessment of the clinicians, the urea cream (Calmurid) was statistically significantly better in controlling the ichthyosis than the other 3 preparations.
