Nonetheless, such results do not detract from the appropriateness of lanolin for other dry skin indications. Notably, in 2003, investigators conducted a 4-week double-blind, randomized-comparison clinical trial to assess the effectiveness of pure lanolin, compared with ammonium lactate 12% cream in the treatment of moderate to severe xerosis on the feet. Of the original 92 patients enrolled, 51 completed the study. Both treatment groups exhibited significant improvement in xerosis scores after 2 and 4 weeks of treatment, with no statistically significant differences identified between the groups. The researchers concluded that pure lanolin as well as ammonium lactate cream used twice daily for a month were effective in ameliorating moderate to severe dry skin (Cutis 2003;71:78-82).
In 2008, researchers reported on a comparison of two different topical ointments used in cutaneous therapy on 173 prospectively enrolled infants born between 25 and 36 weeks of gestation. The infants were admitted to a neonatal intensive care unit between October 2004 and November 2006. Each infant was treated for up to 4 weeks after being randomly assigned to daily treatment with water-in-oil emollient cream (Bepanthen), olive oil cream (70% lanolin, 30% olive oil), or a topical control. Skin was assessed weekly. The investigators found that while both treatment groups displayed greater improvement than the control group, with enduring treatment effects, infants in the lanolin/olive oil group exhibited significantly less dermatitis than did those in the water-in-oil emollient group (Pediatr. Dermatol. 2008;25:174-8).
It is also worth acknowledging that scientists at Nippon Fine Chemicals, Tokyo, announced in 2006 that they had developed a plant-derived lanolin or adsorption-refined lanolin substitute (bis-beheyl/isostearyl/phytosteryl dimer dilinoleyl dimer dilinoleate). This phytosterol ester (an oligomer ester) is noted for its pale color, mild odor, superlative stability, moisturizing effects in human tests, and lanolin-like water-retention capacity (200%). Researchers for the company claim that this oligomer ester is suitable for inclusion in skin and hair care products, makeup, and cleansing formulations (J. Cosmet .Sci. 2006;57:193-4). Indeed, traditional lanolin is found in various cosmetic products, such as facial lotions, body washes, foot creams, hair care products, lipsticks, and lip balms.
Conclusion. Through the last several decades, only a small proportion of the population has been found to be allergic to lanolin. Significantly, allergic responses have not been reported with the use of more modern, medical-grade and other highly refined lanolin products. It is worth mentioning these facts to patients with dry skin who may benefit from using lanolin but who offer objections simply because they heard that it may induce allergic reactions.
To patients who may object because of the animal origin of the substance, it is important to at least mitigate this argument by mentioning that while lanolin is secreted by the sebaceous glands of sheep and then obtained from their shorn wool and refined, the process is conducted without harming the animal. Lanolin, particularly in the more recent formulations, is an effective first-line occlusive and emollient agent option for various xerotic conditions.