pH-Modified Aqueous Cream

pH-modified aqueous cream is a specialized formulation of standard aqueous cream engineered to possess a more acidic pH, typically around 4.5. This pH is significantly lower than that of standard aqueous cream (7.32-7.58) and closer to the natural pH of healthy skin. The modification is achieved by incorporating approximately 5% citric acid into the standard aqueous cream base. Citric acid is selected due to its availability and presence as a natural moisturizing factor component. Topical citric acid application has shown benefits in conditions like ichthyosis. The base formulation commonly includes emulsifying wax (9%), liquid paraffin (6%), white soft paraffin (15%), methyl paraben (0.15%), and propyl paraben (0.08%). Clinical studies evaluating pH-modified aqueous cream have indicated greater improvements in skin pH, transepidermal water loss (TEWL), and SCORAD values in patients with atopic dermatitis, although these improvements did not reach statistical significance when compared to standard moisturizer. Concerns exist regarding standard aqueous cream, particularly its common inclusion of sodium lauryl sulfate (SLS), which can irritate eczematous skin. Chronic use of standard aqueous cream has been linked to reduced stratum corneum thickness, increased TEWL, altered protease activity, and accelerated skin turnover. Consequently, standard aqueous cream BP is not recommended as a leave-on emollient for atopic dermatitis patients, though it may be used as a rinse-off soap substitute. SLS-free aqueous cream versions and other emollients like ceramide-containing formulations are available alternatives. The pH-modified formulation was generally well-tolerated in studies, although some adverse effects were reported, including localized erythema, mild flares, hypertrichosis, and temporary tingling sensations.

Other names

pH-modified moisturizer