Urea cream or lactic acid lotion for rough skin?

What is the actual difference?

Cream and lotion describe the base, not a league table. Urea also comes in lotions, so choosing an ingredient and choosing a base are separate decisions. A cream is generally suited to moderate dryness; a lotion is useful for mild dryness on the trunk and limbs.13

Urea preparations range from 3% to 40%, with strength chosen for the condition and its severity. That range is not a reason to reach straight for 40%. Some formulas combine both ingredients: Calmurid cream contains 10% urea and 5% lactic acid. There is no single best percentage for all rough skin.34

Which should you choose?

For dry, scaly skin, choose by the degree of dryness as well as the active ingredient. Both urea and lactic acid can reduce scale. For small rough bumps around hair follicles, especially on the upper arms, thighs or buttocks, either can be useful if the condition is keratosis pilaris. Those bumps contain plugs of keratin, the protein that forms the outer skin layer.256

Research supports both as reasonable options for keratosis pilaris, but studies are small and do not settle which is better. The practical aim is softer plugs, better hydration and smoother texture, rather than a permanent cure.6

How do you use it?

1. 1Wash with a non soap cleanser rather than stripping the skin with hot water and soap.
2. 2Apply moisturizer after bathing while the skin is still damp. For keratosis pilaris, apply within five minutes; for diagnosed ichthyosis, a condition causing dry scales, apply within two minutes.
3. 3Gently massage the moisturizer into rough areas. Moisturizing treatment for keratosis pilaris can involve application two or three times daily, but an exfoliating medicine should be used only in the amount and frequency your dermatologist recommends.
4. 4Pause an exfoliating treatment for a few days if the skin becomes dry or irritated.

How long should you give it?

For keratosis pilaris, tell your dermatologist if your treatment plan has not improved the skin after four to six weeks. Some people need to try several treatments. Treatment controls the bumps rather than curing them, which makes 'finished' an ambitious word for the bathroom shelf. Maintenance can involve less frequent medicine or switching to a moisturizing cream.7

When should you be careful?

Neither ingredient is automatically gentler on sensitive skin: both can sting on scratched, cracked or inflamed areas. Do not apply urea to broken, bleeding, infected or oozing skin, or areas with severe widespread redness, and keep it away from the eyes. Seek medical advice if stinging, itching or a rash persists and becomes bothersome.13

Avoid acid creams for keratosis pilaris in young children because of burning and stinging. Urea use from age one requires a diagnosed dry skin condition and a doctor's recommendation; low strength preparations for ordinary dry skin can be used from age three. If you use a topical corticosteroid, ask about combining it with urea, which can increase penetration of other substances.23