Aqueous cream is a light, non-greasy, moisturiser that provides a layer of oil on the surface of the skin to prevent water evaporating from the skin surface, as easily occurs following the unnatural act of washing with anything other than cold water. Dry skin results from lack of water in the outer layer of skin cells, the stratum corneum. When this layer becomes dehydrated it loses its flexibility and becomes cracked, scaly and sometimes itchy. The stratum corneum contains natural water-holding substances that retain water seeping up from the deeper layers of the skin, and water is also normally retained in the stratum corneum by a surface film of natural oil (sebum) and broken-down skin cells, which slow down evaporation of water from the skin surface. Aqueous cream is helpful for all dry skin conditions, particularly eczema and dermatitis, which get worse when the skin is allowed to dry out. Used regularly they help restore the skin's smoothness, softness and flexibility by helping the skin retain moisture.

Many manufacturers of especially so-called ‘natural’ personal care products consider commercial aqueous cream to be too ‘unnatural’ for use as the basis of their cream products (it sometimes is but need not be). In Gaia Organics personal care products, aqueous cream it is deliberately used as an inert spreading agent to carry precious active ingredients across the skin without competing with these for cellular assimilation and also serves as a non-reactive protective carrier for these actives, not only whilst in storage, but also whilst on the skin exposed to 21% atmospheric oxygen, ultraviolet light and body heat and elevated ambient temperatures. All the aforementioned conditions synergistically facilitate aggressive reactive oxygen specie and free radical attack of and damage to the fragile actives on route to their new milieu inside living skin cells, a critical process taking some 10-15 minutes under comfortable ambient temperatures and after which any residual plant oils and other biological ingredients start actively participating in said destructive processes, in addition to several other destructive chemical and biological processes detailed in our report ‘Mineral vs Plant Oils as Carrier/Spreading Agents’.

If you have not been directly referred from page 4 of our Catalogue, we have detailed the composition of our special aqueous cream there and can link you directly here to a separate window. If you have not read the relevant sections in our Consumer Awareness dossier, more details can be found below in the section titled ‘Does and if so, why does Gaia use Aqueous Cream? Also, how is the product preserved?’


Aqueous cream is an emulsion of oil and water and is perfectly acceptable if manufactured using the finest raw materials intended for extended human use. Commercial aqueous creams might not consider these factors sufficiently and are almost certain to use the allergenic Chloro-cresol (Britton J, et al, Br J Dermatol, 148(2), 2003) or Phenoxyethanol preservatives (Marks J et al, J Am Acad Dermatol, 38(6), 1998). Aqueous cream itself is merely a spreading agent for several biologically active constituents. Gaia uses pure mineral oil, the molecular size of which ensures non-entry into the skin, so serving as an inert non-inhibiting carrier for the precious fragile active ingredients and an inert barrier against environmental pollution. If not needed, residual cream may be tissued-off after 10-15 minutes, by which time the actives, including the vulnerable plant sourced essential fatty acids, having no competition, will all have been safely assimilated into the cells.

Not listed in the catalogue entries are the constituent ingredients of the Aqueous Cream, which like other complex ingredients, is listed as the complex. However, because the once standard British Pharmacopoeia Ung Emulcificans Aqueosum (UEA) formula is modified to meet our needs as entirely suitable for leave-on applications, Gaia Organics, in the interests of total transparency, shall proportionally list all the individual constituents: 1) water; 2) mineral gel; 3) cetyl stearyl alcohol; 4) mineral oil; 5) sodium lauryl sulphate; 6) methyl paraben and 7) propyl paraben. Items 2&4 are fractionally distilled to purity from crude oil, the richest and purest natural organic repository on Earth; 3&5 are synthesised from coconut oil and 6&7 from gum benzoin and are nature-identical to those found in Oka (an edible tuber) and Mangoes respectively and are used in traces just sufficient to maintain the integrity of the base cream long enough to complete product formulation, when colloidal silver and essential oils assume ultimate duty in the cream products. No parabens are used in non-cream products (those not listed as containing aqueous cream), which non-cream, but rather water-based products, are manufactured individually from start to finish, rather than from a common base.

Using a plant oil as a spreading agent is counter-productive, by virtue of having to protect it against harmful oxidation and rancidity, which itself will quickly render not only the cream undesirable, but also denature many of the otherwise active natural ingredients, including the anti-oxidants intended to protect the actives and skin itself. Gaia’s aqueous cream is specially formulated and is preserved with just enough of the nature identical Paraben preservatives to maintain the integrity of the cream prior to production of the final products, which utilise colloidal silver, fruit acids, gum benzoin and essential oils etc., instead of conventional preservatives. The colloidal silver preservative uniquely survives indefinitely to ensure that the products remain entirely safe in the long term without the use of high levels of any other preservative agent.

In 2003 an audit of adverse reactions in children with atopic eczema to emollients at a hospital dermatology clinic in Sheffield, dispensing an aqueous cream amongst other emollients, revealed that out of 71 that had used aqueous cream, 40 (56.3%) developed an immediate reaction (one or more of burning, stinging, itching and redness) [not unusual for any preserved high water content (aqueous) product medicating sensitised skin with an impaired barrier (ST)], compared with 17.8% for the other emollients. The researchers surmised that this may be due to differences in formulations between aqueous creams or that some were designed as a wash product rather than a ‘leave on’ emollient. The researchers also pointed out the following: None of the children were being treated in accordance with best practice guidelines. There were insufficient numbers using each of the other emollients, so a comparison was made between them all and aqueous cream to detect a statistical difference between them [which skewed numbers to meaningless (ST)]. (Cork M et al, The Pharmaceutical Journal, 271: 747-748, 2003)

Peter Lapsley, chief executive of The Skincare Campaign, issued a sensational press release claiming that “an irritant reaction occurs in over 56% of children with atopic eczema when aqueous cream is used as an emollient”. This inaccurate and imbalanced perception hit the newspapers and was subsequently blindly repeated all over the Internet by well-meaning do-gooders, yet is not the conclusion reached in this study and does not match international experience. The authors actually pointed out that various forms of discomfort can be caused by topical agents, the best described as ‘stinging’ and that these reactions were NOT allergic and could occur with any emollient. They also determined that some patients reported that they react to aqueous cream obtained in one part of the UK and not another and suggested that one possible explanation was that aqueous cream is provided by a number of manufacturers, since the use of different preservatives is permitted. Their conclusion was that “the key to effective emollient therapy is education and tailoring the treatment to the individual child”, nothing else. (Cork et al, 2003)

Unfortunately, no one bothered to determine which emulsifier or preservative had been used in the aqueous creams that could have elicited the responses compared to the formulation of those that did not do so. Had they done this, it would have rendered the study far more meaningful. This problem, the authors pointed out, was highlighted in an earlier letter to the Journal (Highsted M, Emollients – Aqueous Creams Should Not Be Condemned (letter), Pharm J, 265:514, 2000) and precisely as I had predicted, Highsted reported cutaneous reactions to formulations of aqueous cream containing phenoxyethanol as preservative, but not to those containing chlorocresol (the old standard anti-microbial), as preservative. As I stated in my Consumer Awareness dossier, before even seeing the full published paper by Cork: “aqueous cream is generally inappropriately preserved for leave-on purposes, traditionally with chlorocresol, but now more frequently with phenoxyethanol, which latter has spoilt a long and impressive widespread-use history of suitability for even troubled skin conditions such as eczema and burns”.

Aqueous cream is recommended as most suitable alternative to warm water for washing a baby’s nappy area (Maternal and Child Health, Skincare in Babies and Young Children, Department of Dermatology, St. Vincent’s Hospital Melbourne, Australia, 2002); (Mahmoud Hijazy, Principles of Paediatric Dermatology, Electronic Book, 2000). Aqueous cream (and also mineral oil) is recommended to prevent and treat nappy rash (napkin dermatitis) (New Zealand Dermatological Society, DermNet NZ, 2005). Aqueous cream BP is recommended for the treatment and prevention of dry skin, contact dermatitis and atopic eczema from 1 month onwards (National Health Service, Department of Health, UK, 2005). Atopic Eczema, otherwise known as Atopic Dermatitis or Infantile Eczema, is a chronic relapsing itchy disease of the skin and the Allergy Society of South Africa also recommends aqueous cream as a wash and as a mainstay of atopic eczema treatment, for which it is completely safe and should be applied liberally at least twice daily to hydrate and protect the skin (Dr Adrian Morris, Atopic Eczema, ALLSA, 2006).

At the Hospital and Primary Health Care levels, the standard treatment guideline for mild cases of atopic eczema in the Essential Drugs List is the emollient aqueous cream (UEA) applied daily as a moisturizer (especially after washing) (Standard Treatment Guidelines and Essential Drugs List for South Africa, The National Department of Health, 1998); (National Prescribing Centre, MEREC Bulletin, 12(9), 1998). Topical treatment with aqueous cream is an essential part of the treatment of pruritis (itching), and is sometimes sufficient on its own (Ian Back, Palliative Medicine Handbook, BPM Books, Cardiff, UK, 2006). Aqueous cream is also recommended daily as a bland moisturizer in the treatment of vaginitis and vulvitis to reduce dryness and fissuring (Australian Prescriber Vol. 24 No. 3 2001). Aqueous cream is even recommended as a moisturiser following a chemical peel (Cosmetic Dermatology, The Private Skin Care Laser Clinic, Dermatology Department, Royal Free Hospital, Pond Street, London, 2005).

the results of this Phase III study on the efficacy of topical aloe vera gel on irradiated breast tissue:


The aim of the study was to see if topical aloe vera gel would be beneficial in reducing the identified skin side-effects of radiation therapy, including erythema, pain, itching, dry desquamation, and moist desquamation, when compared with aqueous cream (the standard measure - ST).


A Phase III study was conducted involving 225 patients with breast cancer after lumpectomy or partial mastectomy, who required a course of radiation therapy using tangential fields. Patients were randomized to either topical aloe vera gel or topical aqueous cream to be applied 3 times per day throughout and for 2 weeks after completion of radiation treatment. Weekly skin assessments were performed by nursing staff.


Aqueous cream was significantly better than aloe vera gel in reducing dry desquamation and pain related to treatment. For subjects who had undergone lymphocele drainage, the aloe vera group experienced significantly more pain than the aqueous cream group. In this study, aloe vera gel did not significantly reduce radiation-induced skin side effects.


Aqueous cream was useful in reducing dry desquamation and pain related to radiation therapy. (Heggie S et al, Cancer Nurs, 25(6), 2002)

Here follows an interesting published article relating to the importance of preservative capacity.

(Hugbo P et al, Bioline International, 6 January 2006)

Cosmetic and topical products need not be sterile but may contain low (set maximum) levels of microbial load during use. Warm and humid conditions tend to support the survival and growth of many micro-organisms. Product contamination may arise from raw materials or water used in formulation or accidentally, during use. In a situation where a nutritionally rich pharmaceutical/cosmetic product is severely contaminated, rapid growth and multiplication would be expected. This could lead to biodegradation of the product and hence the risk of infection to consumers of the product.

A cream with good preservative capacity is capable of inhibiting immediate post-production contaminants as well as subsequent low inocula of in-use contaminants to maintain acceptable low levels of micro-organisms in the preparation. Studies carried out till date do not simulate actual use conditions and hence do not realistically monitor true capacity to suppress accidental in-use contamination; a very important consideration for successful preservation. This study determined the level and type of microbial contaminants in commercial cosmetics and an aqueous cream and their preservative capacities in-use.


Ten brands of commercially available cosmetic creams and lotions were randomly purchased and their bacterial and fungal loads as well as types were evaluated using standard procedures, all carried out in duplicates. Preservative capacity was then further evaluated by challenging the creams and lotions with isolates of Staph. aureus, the most frequently identified (potentially pathological) contaminant of such products, storing the products ambient room temperature for 30 days and performing viable counting on days 1, 2, 6, 12 and 30 for enumeration of bacterial survivors. The aqueous cream was similarly challenged with the test organism. Un-inoculated samples served as baseline controls.


The “Preservative Capacity (PC)”of a product is the ability to consistently maintain low and acceptable levels of microbial contaminants when such product is challenged with fresh microbial load(s), for which in cosmetic creams, the official specified limits are, not more than 1.0×103 for bacteria, and 1.0×102 for moulds/g/ml of the product. (British Pharmacopoeia Appendix XV1B, Tests for microbial contamination. The Pharmaceutical Press, London, 1993.)

Results 1 (Initial evaluation of microbiological quality of cosmetics): All the commercial products were contaminated to varying degrees. Gram-positive cocci were the most preponderant; gram-negative species were hardly found and there were lower levels of fungal contaminants. The initial bacterial loads per gm. of material in 6 of the 10 samples exceeded 1×103 , which is in excess of the acceptable bottom line for bacteria in non–sterile topical products (8). The aqueous cream was essentially sterile at the initial stage.

Results 2 (Challenge test for preservative capacity): Challenge test with Staph. aureus revealed the commercial products as having low capacity for suppressing microbial proliferation as may be encountered during in–use contamination, indicating that the preservatives are not sufficiently potent and persistent to maintain the preparation at the original level of bacterial numbers or less. All the products maintained their original physical characteristics in terms of appearance, yet qualitative microbiological quality tests showed that the creams were generally contaminated to varying degrees within 24h and 48h. Counts in general ranged between 5.0×102 - 1.25×104 cfu ml-1 for bacteria and less for moulds.

In some products there was initially a decrease in the bacterial populations for the first 12 days, but this was followed by a rapid increase in numbers (over 200 log percent). Products not showing initial decreases also displayed increases in the bacterial numbers, but at much reduced rates (50–60 percent log increases). With regards to the aqueous cream, the initial count was very low and the contaminant species was only Bacterium subtilis. No moulds were isolated from this preparation. There was an initial decline in bacterial counts for days 2-6, followed by a resurgence of growth though, at a much-reduced rate.


The preservatives employed in these cosmetic products did not possess adequate capacity to bring about acceptable low levels of microbial contamination as demanded by regulatory bodies. There is a pressing need to ensure the microbiological wholesomeness of such products. Although Enterobacteria were generally absent from the creams, the frequent isolation of Staphylococcus aureus, Microsporium canis and Aspergillus fumigatus is of some concern because of the pathogenic potential of these organisms.

Commercial cosmetic creams evaluated did not generally meet the standards for microbial limits as specified in official monographs. Such products can adversely affect health status of consumers as well as the stability profiles of the products.


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