Urea Cream: Why Are There Different Over-the-Counter Strengths?

When would low-dose urea be useful?

Urea at lower concentrations—between 2% and 10%—is available over the counter and acts as a skin moisturizer for people with dry skin, psoriasis, and eczema (atopic dermatitis). The most common concentration in this range is urea 10 cream. At low concentrations, urea can be found a stand-alone products or mixed with other ingredients, as in Eucerin Repair Foot Cream and U-Cort.

When would high-dose urea be useful?

Urea at higher concentrations—between 10% and 40%—is also available over the counter. The most common concentrations in this range are urea 20 cream and urea 40 cream. Doctors often recommend high-dose urea for people struggling with dry and rough skin, skin cracks and fissures (like heel fissures), psoriasis, eczema, corns, calluses, and nail fungus.

At these higher concentrations, urea can work as an emollient (moisturizer) and has what we call a “keratolytic action”—think of this as descaling the skin. It’s also useful for thick, misshapen nails. Applying a thick layer of topical urea 40 cream or ointment to the nails and taping in a dressing overnight softens the nail, making it easier to clip.

Another use for high-dose urea is to help other medications penetrate the skin better, and for convenience, is often combined in the same formula with those medicines. In prescription medications, urea is commonly combined with anti-inflammatory topical steroids and antifungal drugs. Research studies show that urea 40% combined with topical antifungal medications like clotrimazole and ciclopirox is more effective for treating nail fungus than antifungals alone.

Dr O.

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