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Urea is a naturally occurring organic compound that has been utilized in dermatological therapy for over a century. It serves as a potent emollient and keratolytic agent, making it a cornerstone in the management of conditions characterized by dry, scaly, or hyperkeratotic skin. At lower concentrations (typically 5-10%), urea acts primarily as a humectant, enhancing stratum corneum hydration by attracting and binding water. At higher concentrations (exceeding 20%), it exhibits keratolytic properties by disrupting hydrogen bonds in keratin proteins, which facilitates the shedding of dead skin cells and softens the skin. Urea is also frequently used as a penetration enhancer to improve the delivery of other topical medications. It is widely available in various topical formulations, including creams, lotions, and ointments, and is generally well-tolerated, though it may cause transient stinging or irritation on sensitive or broken skin.
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