Dimethicone barrier cream: what it does and how to use it

What does dimethicone do?

Dimethicone is a silicone used in moisturizers as an emollient, meaning a skin softening ingredient, and as an artificial barrier. It spreads into a thin layer and smooths the skin surface by filling gaps between cells in the outer skin layer. Dimethicone is insoluble in water, but its film allows water vapor to pass through. A water repellent finish is therefore not the same as the strongest possible seal against moisture loss.1

Your skin's own barrier protects the body and limits water loss. A barrier product supports that surface by protecting against irritants and helping prevent dryness. Barrier creams can also come as pastes, ointments and sprays, because skincare categories are not keen on staying in their lane.3

Who is a dimethicone barrier cream useful for?

Barrier creams are used for very dry skin and hands exposed to frequent water contact, harsh chemicals or repeated friction. They also have roles in care for skin exposed to urine, stool or fluids around a stoma, an opening made surgically in the abdomen. Small amounts of silicone barrier cream do not reduce dressing adhesion, which is useful around stoma appliances.3

Dimethicone containing barrier creams have evidence for preventing irritant contact dermatitis, skin inflammation caused by irritating substances. Prevention is a different job from treating an established allergic reaction. Reducing exposure to the cause remains central: identify the irritating substance, limit contact where possible and use protective clothing for workplace exposure. A pharmacist, GP or dermatologist can help when the trigger is difficult to identify or avoid.24

For adults with incontinence, skin care usually combines cleansing with a protective product left on the skin. Whether particular products reliably prevent the resulting dermatitis remains uncertain. Comparisons of cleansers, barrier products and combined routines have produced inconsistent results. A dimethicone washcloth is also a different product from a dimethicone cream, so do not treat their results as interchangeable. Choose the cleansing and protection routine with the clinician overseeing continence care rather than assuming one ingredient settles the choice.5

Dimethicone or petroleum based barrier cream?

Texture depends on the whole product, not just the presence of dimethicone. Creams sit between lotions and ointments in oil content. Ointments contain the most oil and keep moisture in most effectively; lotions contain the least and are less greasy. For contact dermatitis, creams and lotions tend to suit inflamed areas, while ointments suit very dry areas that are not inflamed.4

How do you apply a dimethicone barrier cream?

1. 1After washing, gently pat the skin dry. Moisturizing emollients are best applied promptly after washing, while the skin is still moist.
2. 2Apply a barrier cream sparingly. Do not borrow the instruction to use generous amounts of ordinary emollient as the dose for every barrier product.
3. 3Smooth the product gently in the direction the hair grows rather than rubbing it vigorously.
4. 4Reapply the barrier cream as necessary. Barrier products can remain on the skin for several hours, even after gentle washing.

For a moisturizer used alongside the barrier cream, frequent application helps keep dry skin hydrated. General emollient guidance suggests at least three or four applications a day, especially after washing. Creams are practical for daytime use because they absorb quickly and are less greasy; richer ointments can suit very dry skin at night. Keeping separate supplies at home and work makes regular application easier, rather than giving one tube a daily commute.6

Can you use it with a prescription cream?

Separate an emollient from a steroid cream or another prescribed skin treatment by 20 to 30 minutes, and ask the prescriber which goes first. This helps avoid diluting the medicine or spreading it onto skin that does not need treatment. For contact dermatitis, the usual sequence is emollient first, then the topical corticosteroid around 30 minutes later. Follow the instructions for your medicine.46

What results should you expect?

Dimethicone provides a surface film and a smoother feel when applied. Clearing contact dermatitis depends on addressing the trigger and, when needed, treating inflammation rather than simply adding more barrier cream. Symptoms can improve or clear when the cause is avoided. Sore, inflamed skin sometimes needs a prescribed topical corticosteroid, which usually starts having an effect within a few days. If prescribed treatment is not controlling the symptoms, return to your GP.14

Who should be careful?

Dimethicone is described as noncomedogenic, meaning it does not tend to clog pores, and is used in facial moisturizers for oily skin. That does not make every barrier cream suitable for the face: some occlusive formulas aggravate acne. Barrier creams are generally well tolerated, but preservatives, fragrance or other ingredients can cause allergic contact dermatitis. Most barrier creams should not be applied directly to broken skin.13

• Stop using a product if your skin reacts, and speak to a pharmacist about an alternative. Persistent burning, stinging, facial rashes or inflamed hair follicles need advice from a pharmacist, nurse or GP.
• For severe skin symptoms, speak to a GP or nurse because a moisturizing product alone might not be enough.
• Keep emollient treated clothing, bedding and dressings away from flames and cigarettes. This applies to products with and without paraffin.
• Use a clean spoon or spatula to take emollient from a tub, and take care with slippery residue in the bath or shower.