Lotion, cream, ointment or gel: choosing the right texture

Stand in front of the moisturizer shelf and you’ll see four main textures: lotions, creams, ointments and gels. They’re not just different feels. Each one behaves differently on your skin, suits some body areas better than others, and has its own trade-offs. The good news is that the choice is less high-stakes than you might think.

The four textures in one minute

The main difference is how much oil and how much water each one contains.

• Lotions are mostly water with a little oil. They’re thin, spread easily and sink in fast.
• Creams carry more oil. They’re thicker, still absorb fairly quickly, and don’t leave much shine.
• Ointments are mostly oil with little or no water. They’re thick and greasy, and they form a long-lasting film that holds water in.
• Gels are water held in a light mesh, usually with little or no oil. They feel cool and non-greasy.

More oil generally means more sealing power and a longer-lasting effect. DermNet describes ointments as best for dry, thick, scaly areas, and creams as lighter and quicker to absorb but needing more frequent application.

What happened when researchers compared all four

For years, the standard advice was that thicker is better. Then a large trial in England put that to the test.

In 2022, researchers randomly assigned 550 children aged 6 months to 12 years with eczema to use a lotion, a cream, a gel or an ointment for 16 weeks. The result: there was no difference in eczema severity between the four types. Side effects overall were similar too.

One difference did stand out. Stinging was less common with ointments, reported by about 9% of children, compared with 17% to 20% in the other groups.

The researchers concluded that people need to be able to choose from a range of textures to find one they’ll use properly. The Eczema Society of Canada says much the same: the best moisturizer for eczema is the one you’re willing to use often enough to keep your skin moisturized.

That trial was in children with eczema, so it doesn’t settle every question for every skin type. But it’s a strong reminder that consistency matters more than texture.

Choosing by body area

Different parts of your body have different needs.

• Scalp, chest, arms and legs with lots of hair: a lotion. Both the NHS and DermNet suggest lotions for hairy areas because they spread without matting the hair.
• Face: a light cream or lotion by day for most people. If your skin is acne-prone, keep heavy, occlusive products off breakout areas, since DermNet notes they can aggravate acne and similar conditions.
• Hands: a cream you can reapply after every wash, and an ointment at bedtime if they’re cracked. The Eczema Society of Canada suggests moisturizing hands after every contact with water.
• Elbows, knees, heels and shins: these often do best with a rich cream or an ointment.
• Lips and eyelids: a plain ointment is usually the gentlest option.
• Skin folds (under the breasts, groin, armpits): lighter textures tend to be more comfortable where skin rubs together and stays warm.

Choosing by season and time of day

Canadian skin needs different things in July and January.

Winter: cold air outside and furnace heat inside make skin lose water faster. Many people move up one step, from lotion to cream, or from cream to an ointment on the driest spots.

Summer: heat and humidity make heavy products feel sticky, and occlusive films can block hair follicles. A lotion or gel is usually more comfortable.

Day versus night: the NHS suggests creams for daytime because they absorb quickly and aren’t very greasy, and ointments for night-time, when greasiness matters less. A rich ointment or balm at bedtime, with a lighter cream in the morning, is a common combination.

The trade-offs nobody puts on the label

Preservatives and stinging

Any product that contains water can grow bacteria and mould, so creams and lotions need preservatives. DermNet notes that some preservatives can cause allergic reactions in people who are already sensitized. Ointments with no water usually don’t need them.

That, along with the stinging finding from the trial, is one reason a simple ointment is often a good choice when skin is raw, cracked or inflamed.

Blocked follicles and breakouts

Heavy ointments aren’t for everywhere. DermNet lists acne, perioral dermatitis (a rash around the mouth) and folliculitis (inflamed hair follicles) among possible side effects of occlusive emollients. The NHS recommends smoothing emollients on gently in the direction the hair grows, rather than rubbing them in, to avoid blocking follicles.

Fire risk with fabrics

Both the NHS and DermNet warn about something few people know: emollients that build up on clothing, dressings or bedding can make fabric catch fire more easily, especially paraffin-based ones. Keep away from open flames and cigarettes, and wash heavily coated fabrics often.

Tubs versus pumps

Dipping fingers into a tub can introduce germs. The NHS suggests using a clean spoon or spatula to scoop out what you need. A pump or tube avoids the issue.

Putting it together

A simple way to choose:

1. Start with how dry your skin is. Mild dryness: lotion or light cream. Dry: cream. Very dry, thick or cracked: ointment.
2. Adjust for the body area and the season.
3. Pick something fragrance-free and dye-free, as the Eczema Society of Canada recommends, especially if your skin reacts easily.
4. Apply it to slightly damp skin after bathing. DermNet explains that water taken up by the skin during bathing stays there if you seal it in.
5. Most importantly, choose a texture you’ll actually use every day. Browse moisturizers or ointments and balms with that in mind.

If your skin stays dry, cracked or itchy after two weeks of regular use, or a product keeps stinging, see your doctor or pharmacist.

Lotions, creams, gels and ointments are really points on a scale from light and watery to rich and oily. Richer textures hold water in longer and sting less on raw skin, while lighter ones suit hairy areas, faces, folds and summer. But when researchers compared all four in children with eczema, they worked equally well. Match the texture to the spot and the season, and then pick the one you’ll happily put on every day.