Aqueous cream is a cheap, unscented white moisturiser used for dry skin and eczema. It is widely recommended as a soap substitute for washing — and current dermatology advice is that it is a poor leave-on moisturiser, because the detergent in it can damage the skin barrier.
What is Aqueous?
Aqueous cream — Aqueous Cream BP — is a pharmacopoeial preparation, made to a published formula rather than as a proprietary brand. That is why it is sold in plain tubs, is inexpensive, and does not appear in the South African Medicine Price Registry alongside branded products. Its absence there is unremarkable.
(A search of that register for “aqueous” returns unrelated products whose names contain the word — steroid nasal sprays such as Flixonase Aqueous and Nasonex Aqueous, and a chemotherapy injection. None of them is aqueous cream. Disregard those matches if you search it yourself.)
Aqueous cream is essentially emulsifying ointment blended with water — paraffins, an emulsifying wax, and water, with a preservative. The result is lighter and easier to spread than a greasy ointment, which is why it became so widely used.
The emulsifying wax contains sodium lauryl sulphate, a detergent. That is what allows the cream to mix with water and makes it work as a wash. It is also the reason for the change in advice.
What changed and why it matters: research over the past fifteen years found that sodium lauryl sulphate, left on the skin, thins the stratum corneum and increases water loss through the skin — the opposite of what a moisturiser should do. In children with eczema it was associated with more stinging and irritation.
So the current position is a split one:
As a soap substitute — washed on and rinsed off — it remains useful. Contact is brief, and it is far gentler than ordinary soap, which strips the skin’s natural oils.
As a leave-on moisturiser it is no longer recommended. A proper emollient without sodium lauryl sulphate does the job better.
What is Aqueous commonly used for?
Where it is still a sensible choice:
- Soap substitute for washing in eczema, dry skin and sensitive skin — its best use.
- Bath and shower wash for anyone whose skin reacts to soap.
- Removing greasy ointments from the skin.
- A cleanser for irritated or sensitive skin.
Where it is commonly used but a better option exists:
- Leave-on moisturiser for dry skin and eczema. Use a proper emollient instead — an ointment, or a cream formulated without sodium lauryl sulphate. Ask a pharmacist; the alternatives are widely available and not expensive.
- Regular moisturising of children’s eczema, where the irritation risk is best avoided.
What it does not do:
- Treat eczema. It manages dryness. Active inflamed eczema needs a steroid cream during flares.
- Treat infection. Weeping, golden crusting, pus or fever needs antibiotic treatment.
- Treat fungal rashes, which need an antifungal.
The general principle in eczema care is worth restating, because it is the part most often neglected: the emollient is the treatment that does the long-term work. Applied every day, including when skin looks well, a good emollient reduces how often flares happen. The steroid treats the flare.
How Aqueous fits into this medicine category
| Group | Examples | Notes |
|---|---|---|
| Light emollients | Aqueous cream | Good as a wash; poor as a leave-on moisturiser |
| Greasy emollients | Emulsifying ointment, white soft paraffin | Strongest barrier; best overnight |
| Modern emollient creams | SLS-free formulations | Preferred leave-on option |
| Topical steroids | Betamethasone (Clomaderm), hydrocortisone | Treat inflammation during flares |
| Antifungals | Clotrimazole (Canex V) | Fungal skin infection |
| Antibiotic creams | Mupirocin, fusidic acid | Bacterial skin infection |
See the skin and wound care hub.
What to check before using Aqueous
- Decide what you are using it for. As a wash, it is a good choice. As a leave-on moisturiser, ask a pharmacist about an alternative.
- Check the ingredients on your tub — formulations vary slightly, and some products labelled aqueous cream differ from the standard formula.
- Stop if it stings. Stinging or increased redness after application is a signal, not something to push through — it is the detergent irritating the skin.
- Do not use it on broken, weeping or infected skin without advice.
- Apply in the direction of hair growth, in smooth downward strokes rather than rubbing in circles, which can irritate hair follicles.
- As a wash: work a small amount into wet skin instead of soap, then rinse. Pat dry rather than rubbing.
- As a leave-on (if you have nothing else): apply generously and often, and watch for irritation.
- Leave fifteen to twenty minutes between an emollient and a steroid cream rather than layering them at once.
- Use a clean spoon or pump to take cream from a tub rather than fingers, to avoid contaminating it.
- Note the fire risk. Paraffin-based emollients soak into clothing and bedding, and dried residue burns readily. Keep away from naked flames and do not smoke while wearing it or in bedding treated with it. People have died in fires started this way.
Possible cautions and when to ask a pharmacist or doctor
The commonest problems are stinging, burning, redness and itching, particularly in children and on already-irritated skin — usually from the sodium lauryl sulphate rather than an allergy.
Stop using it and ask a pharmacist about an alternative if the skin stings, reddens or itches more after use, or if eczema seems to be worsening despite regular application.
Get emergency help for swelling of the face, lips or tongue, difficulty breathing, or a widespread rash.
Contact a doctor if:
- Skin is not improving despite regular moisturising.
- Skin becomes red, hot, weeping, crusted or painful, or you develop fever — that suggests infection, which a moisturiser will not treat.
- Small blisters, punched-out sores or rapidly spreading painful lesions appear on eczema — this can be eczema herpeticum, which needs urgent antiviral treatment.
- A child’s eczema is disturbing sleep, spreading, or not responding.
- Skin is cracked and bleeding.
- You are using a steroid cream most weeks — the underlying eczema plan needs revisiting.
Related medicine guides
Frequently asked questions
What is aqueous cream used for? Mainly as a soap substitute for washing dry, sensitive or eczema-prone skin. It was long used as a leave-on moisturiser, but that is no longer recommended.
Why is it no longer recommended as a moisturiser? It contains sodium lauryl sulphate, a detergent, which research found thins the skin’s outer layer and increases water loss when left on — the opposite of what a moisturiser should do.
Can I still use it to wash? Yes. As a wash it is rinsed off quickly and is far gentler than soap. That remains a good use.
Why does it sting my child’s skin? Almost certainly the detergent in it. Stop and ask a pharmacist for a sodium lauryl sulphate-free emollient.
Is it the same as emulsifying ointment? Closely related — aqueous cream is essentially emulsifying ointment with water added, making it lighter and easier to spread.
Does it treat eczema? No. It manages dryness. Active eczema needs a steroid cream during flares, with a good emollient used daily between them.
What should I use instead as a moisturiser? A proper emollient without sodium lauryl sulphate — an ointment for very dry skin, or a modern emollient cream. A pharmacist can point to one.
Is there any real danger with it? Fire. Paraffin residue in clothing and bedding is flammable. Keep away from naked flames and do not smoke while using it.