Here’s the rub: creams or ointments?

The terms ‘cream’ and ‘ointment’ are often used interchangeably, but when it comes to taking care of your skin they can mean very different things. 

And while a cream may appear to have the same active ingredients as the same product in an ointment, they do, in fact, work differently. 

In general, the difference is in how the product is absorbed by the skin. Because of this, two products with the same active ingredient but different rates of absorption will have different results. 

This is particularly important with prescription preparations. As such, a cream should not be used as a substitute for an ointment and vice versa.

The major factor which determines the rate of absorption of a topical medication is its base. Creams are made from equal parts of water and oil. 

The formulation of an ointment is 80 per cent oil and only 20 per cent water, so the base is oil as opposed to water. 

The addition of other ingredients or modification of the active ingredient can also have the same effect.

The result is that creams effectively penetrate the outer layer of the skin, so are absorbed quickly. 

They are more spreadable and can cover large areas of skin. 

However, creams can also include other ingredients, such as preservatives, that may cause sensitivity. Creams can also contain alcohol that evaporates and may dry skin, so are better suited to oilier skin.

Ointments, on the other hand, are greasy and very moisturizing; they stay on the skin longer and are not easily absorbed, making them good for dry skin. 

They rarely cause sensitivity because the ingredients usually don’t include much more than the base oil. 

Ointments are not generally used for large areas of skin as they do not spread easily. Because they are greasy, some people don’t like to use them.

So whether cream or ointment, which do you choose? 

That depends on your condition. Topical creams and ointments are available for a variety of complaints, from allergic reactions and bug bites to itchiness and chronic skin conditions and even cosmetic uses. 

There is no one wonder-cream or ointment that does it all. 

The most common types are outlined below, but your pharmacist will help you find the best preparation for you.

n Antiseptic and antibiotic creams and ointments are similar in that they attack bacteria that can cause infection. Antiseptics weaken or slow the growth of the bacteria to prevent further infection, while antibiotics kill the bacteria. 

Infections

They can be used for cuts, insect bites and infections. Dettol and Savlon are examples of antiseptics creams found at the pharmacy, while Polysporin and Neosporin offer antibiotic creams and ointments.

n Hydrocortisone is used to reduce swelling, itching, allergic reactions, rash, insect bites and a variety of skin conditions like eczema. 

n Topical antifungals kill or inactivate fungi and yeast such as athlete’s foot and ring worm. Examples include Canesten and Daktarin.

n If you have a crying baby with a sore bottom, you might reach for a cream or ointment for diaper rash, such as Desitin or Penaten. 

Remember that topical creams and ointments are medicines and should be used as directed. 

Your pharmacist is able to determine the best formulation for your needs, based on the type and severity of your condition, your skin type and other factors. 

They will guide you in proper use so you can be happy in your skin again in no time.

Stephanie Simons is the head pharmacist at Lindo’s Pharmacy in Devonshire. She earned her Bachelor of Science in Pharmacy at Massachusetts College of Pharmacy and has been practicing for over 20 years. She is a registered pharmacist with the Bermuda Pharmacy Council and is a member of the Bermuda Pharmaceutical Association. For helpful information, visit Lindo’s at www.lindos.bm.