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Functional creams and urea-containing formulations significantly reduce xerosis severity in patients with diabetesFunctional creams with urea improve dry skin in people with diabetes

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Key Takeaway
Consider functional creams or urea-containing formulations to reduce xerosis severity in patients with diabetes.

This meta-analysis evaluates the efficacy of functional creams, which include base formulations with added ingredients like humectants, compared to standard base formulations for managing foot xerosis in adults with diabetes. The study specifically focused on patients without active ulcers.

Key findings indicate that functional creams significantly reduced xerosis severity compared to standard bases at 2 weeks (SMD -0.58; 95% CI -1.05 to -0.11) and 4 weeks (SMD -0.30; 95% CI -0.46 to -0.14). Additionally, creams containing urea were found to be more effective than standard bases at 4 weeks (SMD -0.36; 95% CI -0.55 to -0.17). Skin hydration was significantly increased with functional creams (SMD 0.31; 95% CI 0.11 to 0.52).

Limitations noted by the authors include low certainty of evidence regarding skin hydration and a lack of high-quality randomized controlled trials providing long-term outcomes, such as the risk of foot ulcers. Clinical practice relevance suggests that functional creams, particularly those containing humectants or urea, are more effective than standard bases for xerosis management. Adverse events were reported as rare and mild.

How this fits prior evidence

This meta-analysis addresses a gap in the management of diabetic foot complications by providing specific evidence on topical treatments for xerosis. While previous coverage established the global incidence and prevalence rates for diabetic foot complications, this study provides specific evidence on the efficacy of functional creams and urea-containing formulations to manage skin condition. It does not address the rs741301 polymorphism, Vitamin D deficiency, zinc supplementation, or self-care adherence rates.

Living with diabetes can often lead to dry, cracked skin on the feet, a condition known as xerosis. This can be uncomfortable and may make it harder to keep the skin healthy. New research looks at how different types of creams can help manage this specific issue.

Researchers compared standard base creams to functional creams, which contain extra ingredients like humectants. They found that these functional creams significantly reduced the severity of dry skin after two weeks and four weeks of use. Specifically, creams containing urea were found to be more effective than standard bases at reducing dryness over a month.

While the study showed that these creams also improved skin hydration, the evidence for that specific finding is less certain. The study also noted a lack of long-term data regarding the prevention of foot ulcers. However, the results show that urea-based creams are a reliable way to improve skin texture and hydration for those dealing with dry skin.

What this means for you:
Creams containing urea are more effective than standard lotions at treating dry skin in people with diabetes.

Common questions

What is the benefit of using urea in skin creams?

Creams containing urea were found to be more effective than standard base creams at reducing the severity of dry skin over a four-week period. This makes them a reliable option for people with diabetes who struggle with dry skin on their feet.

How do functional creams compare to standard lotions?

Functional creams, which include ingredients like humectants, significantly reduced the severity of dry skin compared to standard base formulations. These results were observed at both the two-week and four-week marks.

Is it safe to use these creams for dry skin?

The study reported that side effects from these creams were rare and mild. While the evidence for improved skin hydration is less certain, the use of urea-based creams showed high certainty for reducing the severity of dry skin.

Study Details

Study typeMeta analysis
EvidenceLevel 1
PublishedSep 2026
View Original Abstract ↓
Foot xerosis in people with diabetes increases the risk of skin fissuring, ulceration and complications like amputation, sepsis and death. Preventive skin care is therefore important, yet evidence-based guidance on the most effective formulations remains limited. This systematic review aimed to identify effective ingredients and formulations to treat diabetic foot xerosis. A literature search was conducted in Medline, Cinahl, Embase, CENTRAL and Scopus. Randomized controlled trials (RCTs) involving adults with diabetes and foot xerosis (without ulcers) that compared topical formulations were eligible. Reviewers screened studies, extracted data, assessed risk of bias and certainty of evidence in accordance with Cochrane Intervention Review standards. Outcomes included xerosis severity, skin hydration, skin barrier integrity and adverse events. Meta-analyses of RCTs were conducted. The review was registered in PROSPERO (CRD42024579919). Eleven articles reporting twelve RCTs were included. Functional creams (i.e., base formulations with added ingredients, most commonly humectants, intended to enhance their effect) significantly reduced xerosis severity compared with standard base formulations after both two weeks (standardized mean difference [SMD] -0.58, 95% CI -1.05 to -0.11) and four weeks (SMD -0.30, 95% CI -0.46 to -0.14). The certainty of evidence was moderate. Functional creams significantly increased skin hydration (SMD 0.31, 95% CI 0.11 to 0.52), although the certainty of evidence was low. Creams containing urea were more effective than standard base creams after four weeks (SMD -0.36, 95% CI -0.55 to - 0.17), with high-certainty evidence. Adverse events were rare and mild. Functional creams, particularly those containing humectants and primarily urea, show greater efficacy than standard bases. However, high-quality randomized controlled trials with long-term outcomes such as risk of foot ulcers are warranted. https://www.crd.york.ac.uk/PROSPERO/view/CRD42024579919, identifier CRD42024579919.
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