International journal of clinical practice
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Urea is a well-known moisturiser and keratolytic topical agent. As it is widely used in dermatology, several formulations at different concentrations have been marketed: lotions, creams, foams, ointments, gels and lacquers. Availability of different vehicles and concentration may vary in different countries, but in general products at low, medium and high urea concentration are accessible worldwide. The proper formulation should be chosen according to the disorder to treat, its severity, body areas involved and patients' preference.
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Urea-based topical compounds at medium concentrations (15%-30%) represent useful dermatological agents for their humectant and keratolytic effects by enhancing stratum corneum hydration and by loosening epidermal keratin, respectively. The aim of this paper is to review the clinical evidences of the use of 15%-30% urea as single topical agent. Although limited evidence supports the use of these concentrations of urea in skin disorders characterised by xerosis and hyperkeratosis, in clinical practice they are largely used especially in xerosis of limited skin areas, in which the side effects are tolerable, or hyperkeratosis involving large or more sensitive (eg, face, genital region, etc) areas, in which higher concentration may be irritant. In addition, urea at medium concentrations is used in combination with other substances including topical antifungals as penetration enhancer.
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Int. J. Clin. Pract. · Dec 2020
Clinical evidences of urea at high concentration on skin and annexes.
The antiproliferative, keratolytic, moisturizing and emollient properties of urea are already known. Clinical evidences of urea at high concentration indicate its important role in the presence of hyperkeratosis that, if severe or localized in specific body areas, may cause discomfort to the patient and may interfere with absorption of topical drugs, delaying response to treatment. ⋯ The keratolytic effect of urea is well-tolerated and virtually free from side effects. Compliance with topical therapy is directly related to the aesthetic and sensory acceptability of a topical agent that may considerably vary in odour, spreadability and post-application residue.
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Urea, also known as carbamide, is a polar, hygroscopic molecule produced by the human body that was first discovered in urine in 1773 by the French chemist Hilaire Rouelle and was artificially synthesised from inorganic precursors in 1828 by the German chemist Friedrich Wöhler. The importance of urea in dermatology is twofold: it primarily has a physiological key role for the maintenance of skin hydration, and it secondarily has been used for more than a century in different topical preparation and concentration in various skin conditions. One of the first uses of urea was the topical treatment of wounds because of its antibacterial and proteolytic properties. Since the second part of the 20th century, urea became one of the most common moisturisers and keratolytic agents, useful for the treatment of xerosis, atopic dermatitis, ichthyosis and psoriasis.
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Urea is a major component of many daily skincare products which is widely used. Its role in the treatment of, for example atopic skin, atopic eczema, psoriasis and ichthyosis, is undisputed. ⋯ This article shall elucidate biophysical characteristics and properties of molecular biology that explain how urea affects healthy skin and exerts efficacy in various skin diseases. Knowledge about the mode of action of urea enables physicians to better understandthe appropriate use of urea in clinical routine.