Lotion vs. Cream vs. Ointment: Which to Use When
Medical review by Jennifer Rivera, APRN
Creams, lotions, ointments — they’re all more or less the same, right? Wrong. If you use one moisturizing product for everything, you could be missing out on more effective treatment, whether you’re battling dry skin, oily skin, cracked heels, chapped lips, psoriasis, or other skin challenges.
To know when to use a lotion vs. a cream vs. an ointment helps to understand the differences. The ingredients vary, but all three are ultimately a combination of water and oil in different ratios. Those ratios determine how moisturizing they are, how well they prevent the body’s own moisture from evaporating from the skin, and how light or heavy they feel.
Lotion vs. cream
The main difference between a lotion and a cream is the water content, which also dictates the thickness.
Lotions
Lotions contain more water than creams and are, therefore, thinner. They are typically formulated with lightweight ingredients such as hyaluronic acid, which is hydrating and skin-plumping without leaving a residue or clogging pores, resulting in more frequent applications.
Uses: Lotion is best for people with normal to oily skin and those who live in warm, humid climates. Some lotions are oil-free. Lighter moisturizing ingredients, such as glycerin and hyaluronic acid, are used instead. These can be a good choice if you have acne-prone skin.
Tip: Because they contain more water, lotions require more preservatives. If your lotion irritates your skin, it could be the preservative. Try another brand, or switch to a cream. For best absorption, apply within 5 min of showering on slightly damp skin.
Recommended products:
- Elta MD UV Clear with Broad-Spectrum SPF 46 (Face: acne/rosacea/oily)
- Elta MD UV Daily Broad-Spectrum SPF 40 (Face: Normal/Combination)
- Wederm 15% Glycolic Body Lotion (body)
- Vanicream Moisturizing Lotion (face and body)
- Aveeno Daily Moisturizing Sheer Hydration Lotion (body)
- Eucerin Advanced Repair Lotion (Body and face)
Creams
Creams are thicker than lotions because they contain more oil — typically, they are composed of about half oil and half water. They also contain heavier ingredients, such as lanolin and shea butter. Creams absorb into the skin less rapidly than lotions. Most creams come in a jar or a squeeze tube versus a pump bottle.
In addition to emollients (fats and oils that soften skin) and/or humectants (substances that hydrate the skin by attracting water from deeper layers), some creams contain occlusives, heavy ingredients that form a film, or barrier between the skin and the environment, which prevents moisture from escaping.
Uses: Reach for cream if you have dry skin, sensitive skin or you live in a cold or dry climate. Creams are also helpful for rough spots such as the elbows and heels and for dry hands. Because the skin produces less natural oil with age, many anti-aging face moisturizers come in cream formulas. Products intended to treat skin conditions such as rashes and eczema are also often creams.
Tip: Creams that contain ceramides, such as CeraVe Moisturizing Cream, help shore up the skin’s barrier function. If you’re developing irritation from wearing a face mask, try applying a cream that contains a ceramide before you put your mask on.
Recommended products:
- Wederm Restorative Lipid Replenishing Cream (face)
- Olay Regenerist Ultra Rich Moisturizer (face)
- Eucerin Original Healing Cream (body)
- CeraVe Moisturizing Cream (body)
- Eucerin Advanced Repair Hand Cream (hands)
Balms
Balms are thicker than creams but not quite as thick as ointments. Unlike creams, they don’t contain water. Their texture is typically paste-like or waxy. Beeswax is a common ingredient.
Uses: Lip and foot balm are among the most common balms. Many anti-chafing and blister-blocking products are available as balms.
Tip: For men with dry skin, beard balm is a great way to keep the skin under a beard moisturized.
Recommended products:
- Aveeno Cracked Skin Relief CICA Balm
- Aveeno Eczema Therapy Itch Relief Balm
Ointment vs. cream
Creams are thicker than lotions, and ointments are thicker still, and greasier. An occlusive such as mineral oil or petrolatum (petroleum jelly) is the main ingredient. Medicated products such as topical antibiotics often come in ointment form because ointments stay on the skin longer.
Uses: Ointments are beneficial for very dry, chapped or cracked areas of skin, such as dry heels and psoriasis patches. The ointment is also a good choice for people whose hands are very dry and chapped due to frequent hand-washing. For dry, chapped lips, ointments keep moisture sealed in longer than waxes or balms do. An ointment may be applied to a minor wound before a bandage is placed on it to help seal in moisture, which aids in healing.
Tip: If you find ointments too greasy to use during the day, use a cream during the day and an ointment at night, under a pair of cotton gloves or socks. For extreme hydration, an ointment can be applied under occlusion with the guidance of your healthcare professional.
Recommended products:
- Aquaphor Healing Ointment
- Vaseline Healing Jelly Original
- Vanicream Moisturizing Ointment
- CeraVe Healing Ointment
- Vaseline Lip Therapy
- Neosporin Lip Health Overnight Renewal Therapy
Written by Jessica Brown, a health and science writer/editor based in Brooklyn, New York. Her work has appeared in Prevention, Johnson & Johnson, the Breast Cancer Research Foundation, and many more.
How to Heal Dry, Cracked Hands
Medical review by Ted Schiff, MD
Frequent hand-washing may be key to staying healthy, especially now and during cold and flu season, but it can really take a toll on your skin. That goes double in winter when colder temps and drier air conspire to zap skin of the natural oils that maintain moisture and provide a protective barrier. This can lead to dry, cracked hands.
"People think water is moisturizing, but it's actually drying — when it evaporates, it reduces skin’s natural oils," said Dr. Alissa O’Brien, a dermatologist at Water’s Edge Dermatology. "And if you're using hot water and harsh soap over and over throughout the day, it’s the perfect storm for drying out your skin."
Soap doesn’t discriminate between germs and the skin’s protective oils; neither does the alcohol in hand sanitizer. With frequent use, both can lead to dryness, irritation, and rash-like dermatitis or eczema. They can also lead to cracks in the skin which allow for the entry of germs like staph that make you more susceptible to skin infections.
To curb dry, cracked hands while practicing good hand hygiene, Dr. O’Brien offered this advice:
Wash your hands correctly
- Steer clear of harsh soap. A gentle moisturizing soap (Dr. O’Brien recommends Dove) will get the job done just as well as antibacterial soap, which is more drying and hasn’t proven to do a better job at preventing illness than regular soap. Of course, if your dermatologist has prescribed an anti-bacterial soap due to recurrent infections or other special circumstances, keep using it.
- Wash with lukewarm water. Lukewarm water is as effective as boiling water is at reducing germs. That’s because the goal of hand-washing isn’t to kill germs. "When you wash your hands, the germs get washed off," Dr. O’Brien explained. "They go down the drain." After washing, pat your skin dry. No need for vigorous rubbing, which can disrupt your skin barrier, lead to irritation and cause dry, cracked skin.
Moisturize regularly
"The best thing is literally to moisturize, moisturize, moisturize," said Dr. O’Brien. Moisture after every hand-washing. This will lock in moisture that got into your skin while washing and prevent evaporation that dries out the skin even more. For extra dry skin, apply an ointment at bedtime and then wear a pair of cotton gloves to help seal it in. Ointments can work extra well overnight when skin naturally loses more water.
Opt for ointment or cream moisturizer
Ointments work better than other types of moisturizers because they penetrate the skin better, according to Dr. O’Brien. "That’s why, when we prescribe topicals, we usually pick ointment forms — more medicine gets in that way." She recommends a product like Aquaphor Healing Ointment or a thin layer of petroleum jelly. "It sounds messy, but it’s extremely moisturizing and your hands are going to love it."
If an ointment is messier than you prefer, choose a cream moisturizer, which contains more oil than water-based lotions. Cream moisturizers are also more effective at trapping water in the skin and repairing its barrier function. Here are a few brands to try: Cetaphil, CeraVe, Eucerin, Gold Bond and Aveeno. Ingredients to search out include petrolatum and ceramides. Petrolatum helps block water loss from your skin; Ceramides are a type of lipid (fat) that helps form your skin’s barrier and increase hydration. Ceramides are a key ingredient in CeraVe products.
Be sure to stay away from lotions and moisturizers with fragrances and dyes. "Some dyes can irritate dry skin, so generally, I wouldn’t get the pink frilly one," said Dr. O’Brien.
Choose the right-hand sanitizer
Washing your hands is your best bet at removing all types of germs — even better than hand sanitizer. For instance, according to the Centers for Disease Control and Prevention, hand sanitizers don’t kill the stomach bug or a type of parasite that causes severe diarrhea. However, hand sanitizer is far better than nothing when you don’t have access to soap and water. If using a hand sanitizer, choose one that contains at least 60 percent alcohol and is enriched with an emollient like glycerin or vitamin E to help counteract the drying effect.
Wear gloves
If your hands are frequently immersed in water, such as when washing dishes or washing your car, wearing rubber or latex gloves can prevent the water from stripping away your skin’s oils. Gloves lined in cotton may be more comfortable on dry skin and are easier to put on and take off. Gloves are also recommended if you work with chemicals or plants, especially if you have sensitive skin that is prone to dryness.
Remember the sunscreen
It won’t be your main line of defense against dry, cracked hands, but because the sun can dry out your skin, sunscreen can help prevent further parching. "The sun not only makes dermatitis worse, but skin will be more prone to burning if it’s already irritated," said Dr. O’Brien. She likes CeraVe AM, a moisturizer with an SPF 30.
Written by Karyn Repinski is a Brooklyn, NY-based award-winning health and beauty writer.
Shingles, Seniors & Medicare Coverage
Chances are, most young people have little idea of what Shingles is, much less how doctors treat it, or Medicare covers it. But the skin disease that’s scourge to so many millions of seniors has its roots in childhood. Chickenpox, in fact.
Back in the day as they say, there wasn’t a vaccine preventing most kids from contracting the varicella-zoster virus that causes chickenpox. On the other hand, children traditionally experience a significantly milder version of the virus than adults do. In fact, many parents have breathed a sigh of relief when their little ones presented with the telltale red, itchy spots; relieved to get it over and done with.
Well, there’s over and done with. And then there’s the difficult reality that if you did have chickenpox as a child, your body still hosts the varicella-zoster virus. It hides out in your nerve tissue near the spinal cord, waiting for years. Then, when the immune system of some unsuspecting senior dips low enough, it can reactivate as shingles.
So, What’s Shingles & What Do You Do About It?
While chickenpox is generally not feared, shingles is another story. While not a life-threatening condition, it remains a skin disease dreaded by at-risk seniors. Dreaded, because as anyone who’s suffered through it can tell you, shingles can be extremely painful. Think itchy red rash, fluid-filled blisters, numbness and/or burning in the skin.
The good news is, shingles is preventable for more than 9 out of 10 people, with a new, more effective-than-ever shingles vaccine. And if you do contract shingles, more good news is that it usually goes away on its own after 2-3 weeks.
Getting to your dermatologist’s office in the first 2-3 days of a shingles outbreak can be a huge help. This allows common treatments such as oral antiviral medication, pain relievers and possibly corticosteroids to provide real relief before things get out of hand.
If you’re over 50, certainly if you’re over 60, the shingles vaccine is highly recommended. Good alternative to all the medical care and treatment you’ll need if you do get it. Which raises a question important to so many senior healthcare patients/consumers:
What Will Medicare Cover When It Comes To Shingles?
Medicare Part A covers hospital benefits and Part B covers outpatient benefits. If you develop shingles, your visits to the dermatologist for diagnosis and treatments are covered by Medicare Part B.
After you meet your annual Medicare Part B deductible ($183 in 2018), Medicare pays 80% of the cost of your doctor visits and related lab tests. You’re responsible for the other 20%, unless you purchase “Medigap” coverage to help limit out-of-pocket costs for such deductibles and copayments.
While Part B covers your doctor’s visits related to shingles, the medications for treating and/or preventing shingles are generally going to fall under Medicare Part D coverage.
How can Medicare Part D Drug Coverage help with Shingles?
Beneficiaries purchase Part D policies from private insurance companies. Some Part D companies include the varicella-zoster vaccine in their drug formularies. When considering aPart D policy, you’ll want to check on that. While this vaccine might cost $200 or more without coverage, beneficiaries with Part D often pay around half that amount when they use their coverage.
For individuals with an active case of shingles, Part D plans should cover a number of medications which help control the infection. Having Part D coverage means you’ll only be responsible for your plan’s required copayment for any of these covered medications instead of full cost.
The most common and least expensive medication is Acyclovir. This medication has been around since the 1980’s and is a generic form of the brand-name antiviral medication called Zovirax.
Your doctor may also prescribe valacyclovir or famciclovir, which are two newer forms of antivirals that may treat shingles more rapidly than acyclovir. That means it’s worth checking for Part D coverage of these drugs too.
Do take note though; many seniors with Medicare Part D Drug coverage still have to confront the infamous Medicare Part D “Donut Hole” (till 2020). This is an actual reduction in coverage that kicks in for seniors whose drug costs exceed a prescribed monthly and/or annual limit.
For the time being, seniors and their loved ones need to take this and all the other above information into consideration when evaluating the costs and coverages for prevention or treatment of shingles.