A urea

Urea

Urea or carbamide is an organic compound with the chemical formula CO2. The molecule has two —NH2 groups joined by a carbonyl functional group....

(or carbamide)-containing cream (trade names including Decubal, Carmol 40, Keralac and UriSec 40) is a potent keratolytic

Keratolytic

Keratolytic therapy is treatment to remove warts and other lesions in which the epidermis produces excess skin. In this therapy, acid medicine, such as salicylic acid is put on the lesion. Keratolytic therapy thins the skin on and around the lesion. It causes the outer layer of the skin to loosen...

 emollient. It generally contains about 35% or 40% urea

Urea

Urea or carbamide is an organic compound with the chemical formula CO2. The molecule has two —NH2 groups joined by a carbonyl functional group....

 for skin use, and 50% urea for nail use.

Mechanism of action

Urea dissolves the intercellular matrix of the cells of the stratum corneum

Stratum corneum

The stratum corneum is the outermost layer of the epidermis, consisting of dead cells that lack nuclei and organelles. The purpose of the stratum corneum is to form a barrier to protect underlying tissue from infection, dehydration, chemicals and mechanical stress...

, promoting desquamation

Desquamation

Desquamation , also called skin peeling, is the shedding of the outermost membrane or layer of a tissue, such as the skin.-Skin:Normal, nonpathologic desquamation of the skin occurs when keratinocytes, after moving apically over about 14 days, are individually shed unnoticeably...

 of scaly skin, eventually resulting in softening of hyperkeratotic areas. In nail

Nail

Nail may refer to:* Nail , toughened keratin at the end of an animal digit* Nail , a plate of hard horny tissue at the tip of some bird beaks* Nail , the pin-shaped fastener used in engineering, woodworking and construction...

s, urea causes softening and eventually debridement of the nail plate.

Indications

Urea cream is indicated for debridement and promotion of normal healing of skin areas with hyperkeratosis

Hyperkeratosis

Hyperkeratosis is thickening of the stratum corneum, often associated with a qualitative abnormality of the keratin, and also usually accompanied by an increase also in the granular layer...

, particularly where healing is inhibited by local skin infection

Skin infection

A skin infection is an infection of the skin. Infection of the skin is distinguished from dermatitis, which is inflammation of the skin, but a skin infection can result in skin inflammation...

, skin necrosis, fibrinous or itching debris or eschar

Eschar

An eschar is a slough or piece of dead tissue that is cast off from the surface of the skin, particularly after a burn injury, but also seen in gangrene, ulcer, fungal infections, necrotizing spider bite wounds, and exposure to cutaneous anthrax....

. Specific condition with hyperkeratosis where urea cream is useful include:

• Dry skin and rough skin
• Dermatitis
  Dermatitis
  -Etymology:Dermatitis derives from Greek derma "skin" + -itis "inflammation" and genetic disorder.-Terminology:There are several different types of dermatitis. The different kinds usually have in common an allergic reaction to specific allergens. The term may describe eczema, which is also called...
  
  
• Psoriasis
  Psoriasis
  Psoriasis is an autoimmune disease that appears on the skin. It occurs when the immune system mistakes the skin cells as a pathogen, and sends out faulty signals that speed up the growth cycle of skin cells. Psoriasis is not contagious. However, psoriasis has been linked to an increased risk of...
  
  
• Ichthyosis
  Ichthyosis
  Ichthyosis is a heterogeneous family of at least 28, generalized, mostly genetic skin disorders. All types of ichthyosis have dry, thickened, scaly or flaky skin...
  
  
• Eczema
  Eczema
  Eczema is a form of dermatitis, or inflammation of the epidermis . In England, an estimated 5.7 million or about one in every nine people have been diagnosed with the disease by a clinician at some point in their lives.The term eczema is broadly applied to a range of persistent skin conditions...
  
  
• Keratosis
  Keratosis
  Keratosis is a growth of keratin on the skin. More specifically, it can refer to:* actinic keratosis * hydrocarbon keratosis* keratosis pilaris , also known as * seborrheic keratosis-See also:...
  
  
• Keratoderma
  Keratoderma
  -Congenital:* Simple keratodermas** Diffuse palmoplantar keratodermas*** Diffuse epidermolytic palmoplantar keratoderma*** Diffuse nonepidermolytic palmoplantar keratoderma*** mal de Meleda** Focal palmoplantar keratoderma*** Striate palmoplantar keratoderma...
  
  
• Corns
  Corn (medicine)
  A corn is a specially shaped callus of dead skin that usually occurs on thin or glabrous skin surfaces, especially on the dorsal surface of toes or fingers. They can sometimes occur on the thicker palmar or plantar skin surfaces...
  
  
• Callus
  Callus
  A callus is an especially toughened area of skin which has become relatively thick and hard in response to repeated friction, pressure, or other irritation. Rubbing that is too frequent or forceful will cause blisters rather than allow calluses to form. Since repeated contact is required, calluses...
  
  es
• Damaged, ingrown and devitalized nail
  Nail
  Nail may refer to:* Nail , toughened keratin at the end of an animal digit* Nail , a plate of hard horny tissue at the tip of some bird beaks* Nail , the pin-shaped fastener used in engineering, woodworking and construction...
  
  s

Side effects

More common side effects of urea cream are:

• Mild skin irritation
• Temporary burning sensation
• Stinging sensation
• Itching

In severe cases, there can be an allergic reaction with symptoms such as skin rash, urticaria

Urticaria

Urticaria is a kind of skin rash notable for pale red, raised, itchy bumps. Hives is frequently caused by allergic reactions; however, there are many non-allergic causes...

, difficulty breathing and swelling of the mouth, face, lips, or tongue.