• The most common adverse effect of emollients is irritation caused by sensitivity of the skin to an ingredient in the emollient.
• Skin reactions are usually irritant rather than allergic. The skin shows an immediate and dose-dependent inflammatory response:
• If a skin reaction occurs, stop use of the product and use a different emollient. If the person has had previous skin reactions to emollients, it may be prudent to test a small quantity before widespread application.
• Ingredients commonly implicated in skin reactions to emollients include perfumes and preservatives.
• If sensitivity to emollients is a known problem, the chance of a further reaction is reduced by prescribing a cream with few added ingredients or prescribing an ointment (these do not require preservatives and generally have fewer excipients).
• If the person has reacted to several products, consider referral for patch testing to confirm or exclude contact allergy and to identify the responsible allergen(s).
• The occlusive effect of ointments can cause folliculitis:
• Advise the person to apply the ointment in the direction of hair growth.
• If folliculitis occurs, stop use of the ointment (consider switching to a cream) and use an antibiotic if necessary.
• Emollients can present physical hazards:
• Paraffin-containing products are highly flammable and should not be used near naked flames or whilst smoking.
• Bath emollients can pose a slip hazard.

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