Why is urea cream prescribed?

What does urea do?

Urea attracts and holds water in the outer layer of skin. It also softens keratin, the material in the skin's outer layer, helping loosen thickened, scaly skin. These actions are called humectant and keratolytic effects. The purpose is to improve hydration and reduce the buildup of hard skin, rather than simply coat the surface.23

What problems is it used for?

• Very dry, thickened or cracked skin, particularly on the hands, soles and heels.
• Dry, scaly conditions such as ichthyosis, psoriasis and thickened eczema.
• Keratosis pilaris and keratoderma, conditions involving a buildup of keratin.
• Corns, calluses and certain damaged nails, for which a doctor can prescribe a 40% preparation.

Some urea containing creams are also used for significant itching associated with dry skin. The exact formula matters: a cream selected for itch is not automatically interchangeable with one selected to soften a callus.5

Why does the percentage matter?

Names such as "Intensive" appear on several creams, which makes the front of the tube a poor filing system. Check the urea percentage and the directions on your own product.1

A short course of 10% urea does not necessarily mean using that strength indefinitely. Once intensive treatment is finished, maintenance can involve a standard emollient, meaning a moisturizer, or 5% urea if continued keratin softening is needed. Ask when to make that change.3

Does urea cream always need a prescription?

No. Some urea products are available to buy without a prescription, and NHS prescribing rules vary locally. Bedfordshire and Luton restrict prescribing of Flexitol 10% cream and 25% heel balm to cracked diabetic feet. North Yorkshire and York list urea creams for dry, scaly skin. A prescription can therefore reflect both the skin problem and local access rules.67

The range includes creams, lotions and heel balms, because apparently one shelf category would have been too convenient.1

How should you apply it?

1. 1Check the prescribed strength, treatment area and frequency. Use the cream only for the problem it was prescribed to treat.
2. 2Wash your hands before applying it. Follow your product's directions: Laser Pharmaceuticals Urea Cream 40% is applied twice daily, or as directed by the physician, and rubbed in until absorbed.
3. 3Avoid the eyes, lips and mucous membranes. Wash your hands afterwards unless your hands are the treatment area.
4. 4If cream enters your eyes, rinse well with water and seek medical advice.

If you also use a prescription skin treatment, check how to combine them. Urea is sometimes used alongside topical corticosteroids to increase their penetration into skin, so do not decide the combination or application order yourself.1

When should you stop or get advice?

Urea 40% can cause stinging, burning, itching or irritation. Stop using it and contact your doctor if redness or irritation develops. Do not use a product containing an ingredient you are allergic to. Sensitive skin that cannot tolerate urea can need a different emollient.25

If you are pregnant or breastfeeding, check with your prescriber before using 40% urea. Human pregnancy data are limited, and use during pregnancy should be reserved for when clearly needed. Whether it passes into breast milk is unknown.2

Keep clothing, bedding and dressings with dried cream residue away from flames. Emollient residue on fabric increases the speed and intensity of a fire, including with paraffin free products.13