Urea-containing cream

{{Short description|Dermatologic drug}}

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| image = Urea 2D & Urea 3D.png

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| caption = 2D and 3D image of urea molecule

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| tradename = Decubal, Carmol 40, Keralac, others

| Drugs.com = {{Drugs.com|mtm|urea-topical}}

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| pregnancy_US = C

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| routes_of_administration = Topical

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| CAS_number_Ref = {{cascite|correct|CAS}}

| CAS_number = 57-13-6

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| UNII = 8W8T17847W

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| ATC_prefix = D02

| ATC_suffix = AE01

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Urea, also known as carbamide-containing cream,{{clarify|reason=what kind of base is used as the cream?|date=November 2020}} is used as a medication and applied to the skin to treat dryness and itching such as may occur in psoriasis, dermatitis, or ichthyosis.{{cite book|title=British national formulary : BNF 69|date=2015|publisher=British Medical Association|isbn=9780857111562|edition=69|pages=796–798}}{{cite web|title=Urea topical medical facts from Drugs.com|url=https://www.drugs.com/mtm/urea-topical.html|website=www.drugs.com|access-date=15 January 2017|url-status=live|archive-url=https://web.archive.org/web/20170118043117/https://www.drugs.com/mtm/urea-topical.html|archive-date=18 January 2017}} It may also be used to soften nails.

In adults side effects are generally few.{{cite book| vauthors = Paradisis M, El Hachem M, Diociaiuti A, Giannetti A | chapter = Ichthyoses | veditors = Katsambas A, Lotti T, Dessinioti C, D'Erme AM |title=European Handbook of Dermatological Treatments |date=2015 |publisher=Springer |isbn=9783662451397 |page=439|edition=3rd | chapter-url = https://books.google.com/books?id=fHi6CAAAQBAJ&pg=PA439 |language=en|url-status=live|archive-url=https://web.archive.org/web/20170116172421/https://books.google.ca/books?id=fHi6CAAAQBAJ&pg=PA439|archive-date=2017-01-16}} It may occasionally cause skin irritation.{{cite book | title = WHO Model Formulary 2008 | year = 2009 | isbn = 9789241547659 | vauthors = ((World Health Organization)) | veditors = Stuart MC, Kouimtzi M, Hill SR | hdl = 10665/44053 | author-link = World Health Organization | publisher = World Health Organization | page = 310 }} Urea works in part by loosening dried skin.{{cite web|title=Urea Cream - FDA prescribing information, side effects and uses|url=https://www.drugs.com/pro/urea-cream.html|website=www.drugs.com|access-date=15 January 2017|url-status=live|archive-url=https://web.archive.org/web/20170118043309/https://www.drugs.com/pro/urea-cream.html|archive-date=18 January 2017}} Preparations generally contain 5 to 50% urea.

Urea containing creams have been used since the 1940s.{{cite book| vauthors = Harding CR, Bartolone J, Rawlings AV | chapter = Effects of natural moisturizing factor and lactic acid isomers on skin function. | veditors = Loden M, Maibach HI |title=Dry Skin and Moisturizers: Chemistry and Function|date=1999|publisher=CRC Press|isbn=9780849375200|page=235| chapter-url = https://books.google.com/books?id=JpfgVgb62nsC&pg=PA235|language=en|url-status=live|archive-url=https://web.archive.org/web/20170116172650/https://books.google.ca/books?id=JpfgVgb62nsC&pg=PA235|archive-date=2017-01-16}} It is on the World Health Organization's List of Essential Medicines.{{cite book | vauthors = ((World Health Organization)) | title = The selection and use of essential medicines 2023: web annex A: World Health Organization model list of essential medicines: 23rd list (2023) | year = 2023 | hdl = 10665/371090 | author-link = World Health Organization | publisher = World Health Organization | location = Geneva | id = WHO/MHP/HPS/EML/2023.02 | hdl-access=free }} It is available over the counter.

Medical uses

Urea cream is indicated for debridement and promotion of normal healing of skin areas with hyperkeratosis, particularly where healing is inhibited by local skin infection, skin necrosis, fibrinous or itching debris or eschar. Specific condition with hyperkeratosis where urea cream is useful include:

Side effects

Common side effects of urea cream are:

  • Mild skin irritation
  • Temporary burning sensation
  • Stinging sensation
  • Itching

In severe cases, there can be an allergic reaction with symptoms such as skin rash, urticaria, difficulty breathing and swelling of the mouth, face, lips, or tongue.{{cite web | title = Urea Cream (Consumer Information) | url = https://www.drugs.com/cdi/urea-cream.html | work = Drugs.com | archive-url = https://web.archive.org/web/20110226112501/http://www.drugs.com/cdi/urea-cream.html | archive-date=2011-02-26 | date = May 4, 2011 }}

Mechanism of action

Urea in low doses is a humectant while at high doses (above 20%) it causes breakdown of protein in the skin.{{cite journal | vauthors = Sethi A, Kaur T, Malhotra SK, Gambhir ML | title = Moisturizers: The Slippery Road | journal = Indian Journal of Dermatology | volume = 61 | issue = 3 | pages = 279–287 | date = 2016 | pmid = 27293248 | pmc = 4885180 | doi = 10.4103/0019-5154.182427 | doi-access = free }}

Urea dissolves the intercellular matrix of the cells of the stratum corneum, promoting desquamation of scaly skin, eventually resulting in softening of hyperkeratotic areas. In nails, urea causes softening and eventually debridement of the nail plate.

References

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