Among all the trendy salves and serums, there’s an old-school ingredient that dermatologists continue to rely on for dry, cracked skin: urea.
Urea, a water-absorbing molecule, is found naturally in your skin’s moisture barrier — and, although not particularly sexy, it’s also a waste product made in your liver and eliminated through urine and sweat. But the laboratory-made version is what you’ll find in creams and lotions.
Products made with urea are readily available in drugstores. But many people may not be aware of urea until they hear about it from a dermatologist, according to Robert Dellavalle, chair of dermatology at the University of Minnesota Medical School.
“It definitely works,” he said. “So it’s good for people to know about it.”
What the science says
Numerous studies have shown that creams and lotions containing urea can improve hydration, scaly skin and cracked heels. A recent review of randomized controlled trials found that creams containing urea were more effective for severely dry, scaly and cracked skin on feet than other formulations.
Urea is often used as a daily moisturizer, particularly for notably dry skin on the legs and feet. At lower concentrations (2 percent to 10 percent), urea draws in and retains moisture to help keep skin hydrated, said Anthony Rossi, a dermatologist based in New York.
At higher concentrations (20 percent to 40 percent), urea works as an exfoliator, breaking down built-up keratin, a protein that makes up hair, nails and the outermost layer of your skin. Rossi said it’s especially helpful in treating xerosis — rough and scaly skin on the feet, often with cracks called fissures.
It can also help manage chronic skin conditions, including psoriasis, which causes skin cells to build up quickly; keratosis pilaris, which causes small, rough bumps; and ichthyosis vulgaris, which causes dry, scaly skin.
It’s probably best to use higher concentrations mostly on your lower extremities, however. “I don’t think it’s super elegant for the face,” Rossi said, explaining that urea can cause irritation, especially on skin that is more sensitive, such as on the face and around the eyes.
How you should use urea
When starting out with urea, Dellavalle recommends a measured approach — opting for a lower concentration for dryness and roughness, then increasing to a higher concentration for heavily calloused or cracked feet.
You can use urea-containing creams or lotions once or twice daily. Apply the product to your feet after a shower while your skin is still damp to help lock in moisture. When using urea before bed, wear socks overnight to help keep the product from rubbing off.
For thick calluses you’re treating with urea, use a pumice stone once a week to help remove the dead skin that is shedding, but don’t overdo it. Scrub your skin gently. And once your skin is smoother, ease up on the pumice stone and consider switching to a lower urea concentration marketed for hydration, Rossi said.
While usually mild, urea can cause side effects, which may include stinging, burning, itching or irritation. Don’t use it around your eyes, lips, nose or near any skin irritation, rashes or wounds, and wash your hands after applying it so that you don’t accidentally spread it to those other areas, Dellavalle said.
And just a fair warning: Some higher-concentration urea creams and lotions can have “a tad of an interesting smell,” Rossi said.
But, he said, it’s a classic, versatile ingredient that works.
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