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E45 Cream for children concise consultation card - digital

This concise consultation card was developed by Guidelines for Pharmacy in partnership with Reckitt. 

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Dry skin conditions are common in children (atopic eczema, for example, affects 1 in 5 UK children)1–4 and may have a clear impact on quality of life.2

This Guidelines for Pharmacy card summarises key professional guidance to help you advise parents and carers and make confident recommendations.

What the guidelines say

“Emollients should form the basis of atopic eczema management and should always be used, even when the atopic eczema is clear – NICE1

“Replacement of soaps and detergents with emollients is useful even if they are not the cause of the dematitis – British Associated of Dermatologists5

“Leave-on emollients should be prescribed in large quantities (250 g to 500 g weekly) and easily available to use at nursery, pre-school or school – NICE1

Advice and discussion points 

Recommend emollients as first-line treatment for many different dry skin conditions.1,6–9

Explain how to apply emollients, including how to smooth emollients onto the skin rather than rubbing them in.1

Advise that emollients should be used in larger amounts (250–500 g weekly) and more often than other treatments.[A],1

Refer to GP if symptoms do not get better, keep coming back, or are really affecting quality of life.

[A] Do not use more than is specified by the product label or GP.


[B] For verification, please contact PO Box 4044, Slough SL1 0NS

What the studies show:

  • Healthcare professional advice can reduce eczema symptom severity by up to 89%[C],10
  • Applying E45 Cream 3 times a day for 12 weeks reduces the severity of symptoms in children with mild to moderate eczema[D],11
  • At the beginning of treatment, and up to the appropriate quantity, there is a positive correlation between the control of eczema and the quantity of emollient used.10

[C] Based on a nurse intervention study on 51 children with atopic eczema for one year, 2003.
[D] Based on an education support programme (ESP) involving 136 British children with atopic eczema for 12 weeks, 2013.

Key facts:12

E45 Cream

  • E45 Cream is suitable in children and infants over the age of 1 month
  • E45 Cream is indicated for the symptomatic relief of dry skin conditions, where use of an emollient is indicated, such as flaking, chapped skin, ichthyosis, traumatic dermatitis, sunburn, the dry stage of eczema, and certain dry cases of psoriasis
  • E45 Cream can be applied up to 3 times a day.


  1. NICE. Atopic eczema in under 12s: diagnosis and management. Clinical guideline 57. NICE, 2007. Available at: www.nice.org.uk/cg57.
  2. Lewis-Jones S. Int J Clin Pract. 2006; 60: 984–992.
  3. Nursing in Practice. Treating dry skin conditions in children and babies. www.nursinginpractice.com/clinical/treating-dry-skin-conditions-in-children-and-babies (Accessed 1 July 2021)
  4. Telofski LS et al. Dermatol Res Pract 2012; 2012: 198789.
  5. Johnston GA et al. Br J Dermatol 2017; 176: 317–332.
  6. NICE. Clinical Knowledge Summaries. Itch – widespread. https://cks.nice.org.uk/topics/itch-widespread (Accessed 1 July 2021)
  7. NICE. Clinical Knowlege Summaries. Dermatitis – contact. https://cks.nice.org.uk/topics/dermatitis-contact (accessed 1 July 2021)
  8. NICE. Clinical Knowledge Summaries. Psoriasis. https://cks.nice.org.uk/topics/psoriasis (Accessed 1 July 2021)
  9. PCDS. Ichthyosis. www.pcds.org.uk/clinical-guidance/ichthyosis (Accessed 1 July 2021)
  10. Cork MJ et al. Br J Dermatol 2003; 149: 582–589.
  11. Mason JM et al. BMC Dermatol 2013; 13: 7.
  12. E45 Cream. SPC. Accessed June 2021. www.medicines.org.uk/emc/product/6586

Adverse events should be reported. Reporting forms and information can be found at www.mhra.gov.uk/yellowcard. Adverse events should also be reported to Reckitt Benckiser Healthcare (UK) Ltd on: 0333 200 5345 


Date of preparation: July 2021