When should you use urea cream, and can people with diabetes use it?

Which strength should you choose?

The right strength depends on the area and the product's intended use. For example, Allpresan diabetic foam cream Basic contains 5% urea and is intended for dry, sensitive foot skin; its Intensive version contains 10% and is intended for very dry to chapped foot skin. General foot care options include 10% or 20% creams, with a podiatrist helping you choose. For dry, cracked heels, 10% to 25% urea is an option. Pick a product for its intended job, not because its percentage looks impressive enough to deserve a promotion.345

What changes if you have diabetes?

Dry skin and skin infections occur in both type 1 and type 2 diabetes. Keeping skin moisturized helps it stay flexible and prevents cracks that can lead to infection. Urea products have a place in diabetic foot care: options include 10% cream and 25% heel balm for patients whose dry skin or callus puts them at risk of foot problems. If you have a corn or callus, get care from a dermatologist or podiatrist instead of treating the thick skin yourself.267

How should you apply urea cream?

1. 1Wash gently, then apply a thin film to the affected skin while it is still damp. Follow the product label for frequency.
2. 2For daily foot moisturizing, apply cream to the tops and bottoms of your feet. Dry between your toes thoroughly and keep ordinary foot cream out of those spaces.
3. 3For dry, cracked heels in people with diabetes, apply a 10% to 25% urea cream before bed, then a layer of petroleum jelly.
4. 4Put on white cotton socks and wear them in bed. Repeat the heel routine daily until the skin heals.
5. 5Allow foot cream to soak in for a few minutes before walking, because freshly creamed feet can be slippery.

The rule about avoiding cream between the toes has a product specific exception: Allpresan diabetic Basic and Intensive foam creams are intended for use there and around wound edges. That permission is not a direction to put any urea cream into an open wound.13

What should you expect?

Urea hydrates and softens skin; there is no fixed number of days by which dry heels must heal. Continue regular moisturizing, and get help if severe cracks persist or your heels do not improve. Moisturizing is the useful part of the routine; assembling a small museum of heel creams is optional.15

When should you be careful or get medical help?

Before using urea, tell your care team about broken, inflamed or burnt skin, infection, allergies, pregnancy or breastfeeding. Keep it away from eyes, lips and sensitive areas, and use caution on the face. Discuss other products or prescription treatments used on the same area with your care team. Report burning, itching, crusting or peeling promptly; persistent irritation also needs advice. Seek urgent help for swelling of the face, tongue or throat.1

With diabetes, check your feet daily, including the soles and between your toes. Get immediate medical care for suspected infection, including swelling, discoloration, pain or leaking fluid, and for wounds other than minor cuts. A wound that worsens or fails to heal also needs immediate care. Use a mirror if reaching your feet is difficult.24