Treatment options

Find answers to the most commonly asked questions about E45

1. What is the safety record of topical steroids?

Though topical steroids do have some side effects (like thinning of the skin), when used properly they can be a very effective treatment for some dry and itchy skin conditions. They have been available since the 1950s with a relatively good record of safety and efficacy, and can be used by most adults and children. 3


  1. NHS Choices. (2016). Topical Corticosteroids. [accessed April 2017] via

2. Concerns about the use of paraffin in cream

Paraffin is a type of moisturiser found in some skincare products. It creates a protective layer on the skin that helps the skin retain moisture and stay hydrated.

Patients who’ve been prescribed large quantities of (>100g) of paraffin-based products should be advised to regularly change clothing, bedding or dressings impregnated with the product and keep away from naked flames, as there is a fire hazard.

3. Is Lanolin associated with skin allergy?

Lanolin is a wax derived from sheep’s wool which comprises of oils that have a similar chemical composition to those that are found in our skin. For this reason, Lanolin is used in lots of emollient products as it can help skin retain water by forming a barrier across the surface to reduce moisture loss. 5

Decades ago the wool used to derive Lanolin was not sufficiently purified and traces of impurities were left in the Lanolin, which caused some people to be sensitive to creams that included the ingredient. 6

However, in an epidemiological study carried out on 825,000 people, the frequency of Lanolin allergy was estimated to be as little as 0.0006% (5 to 6 per million), in other words very few people were shown to be sensitive to Lanolin itself. 6 Certain people can be allergic to Lanolin, which has been associated with an allergy to sheep’s wool, and so people who have a known wool allergy should not use Lanolin.

Some creams, including E45, contain an ingredient called Medilan™. This is a highly purified form of Lanolin with similar moisturising properties – but it’s also hypoallergenic, so it’s unlikely to cause sensitisation. 7


  1. The Open University. (2007). Lanolin, Wool and Hand Cream. [accessed April 2017] via
  2. Kligman AM. (1999). The myth of lanolin allergy: lanolin is not a contact sensitizer – The Lanolin Book. Paul Beiersdorf. Westbrook Lanolin Company and Beiersdorf AG
  3. Stone L. (2000). Br J Nurs. 9(1): 54-57