How often should you use urea cream?

Does the percentage change how often you use it?

Urea attracts and holds water in the outer skin layer. It also softens that layer so excess surface skin can shed more easily, an effect called keratolysis. Urea creams are used for dry, scaly skin; the percentage helps determine whether the goal is maintenance or intensive treatment.345

Maintenance does not always require urea. After intensive treatment, a standard emollient, meaning a moisturiser that softens skin, can be enough; 5% urea is an option when continued keratolysis is needed. The Flexitol heel regimen above is a specific exception that uses 10% cream for maintenance, not a schedule to copy onto every urea product.13

How should you apply urea cream?

1. 1Read the label for the frequency and intended body area. Follow a prescribed schedule rather than changing it to a general moisturising routine.
2. 2Wash your hands. If the cream comes in a tub, remove it with a clean spoon or spatula to reduce contamination.
3. 3Apply a thin film to the affected skin, preferably while the skin is still damp after washing or bathing.
4. 4Smooth the cream in the direction of hair growth. Keep it away from eyes, lips and other sensitive areas.
5. 5Wash your hands afterwards unless your hands are the area being treated. If you miss a scheduled application, do not use double or extra amounts.

Should you stop when the skin feels better?

Continue moisturising after improvement because emollient effects are short lived. Skin looking normal is a reason to review the strength, not automatically abandon moisturising, because a moisturiser is maintenance rather than a graduation ceremony. Expect urea to hydrate and soften dry, rough or thick skin. Tell your clinician if symptoms do not improve rather than simply adding more applications.26

The best emollient is one you will use, which gives texture a more useful job than looking impressive on a bathroom shelf. If a cream does not suit you, another emollient can be a better maintenance choice.3

When should you be careful or stop?

Do not apply urea to broken, bleeding, infected or oozing skin, or areas with severe widespread redness. For cracked heels, distinguish rough, thick skin from an open fissure; get advice before treating an open crack. Mild stinging, itching or rash can occur. Stop and seek medical advice for burning, crusting or peeling, or irritation that persists or becomes bothersome. Seek urgent help for swelling of the face, lips, tongue or throat.24

Discuss use with your care team if you are pregnant, trying to conceive or breastfeeding. Children's use needs age and product specific advice. Urea can increase corticosteroid penetration, so check the routine before combining it with a prescribed skin treatment.24

Keep clothing, bedding and dressings carrying emollient residue away from cigarettes, candles and open flames. Washing fabric does not completely remove this fire risk. Cream residue can also make bathing surfaces slippery.7