Stand in the moisturiser aisle in Boots for long enough and a pattern appears. Lotion, cream, gel, ointment, balm. Fifteen brands, four or five textures, and one itchy forearm you'd like to calm down before the weekend. The names sound interchangeable. They're not. Water content, feel and staying power vary enormously between them, and if your skin is dry, itchy and quick to react, texture is the single most useful thing to understand before you spend another £9 on a tub that gets abandoned by Tuesday.
So let's sort it out properly. What a balm actually is. How it differs from a cream and an ointment. What a large NIHR-funded trial found when it compared emollient types head to head. And how to pick the one you'll still be using in March.
Lotion, cream, ointment, balm: what actually separates them
Every emollient on the shelf is doing a version of the same job. Skin loses water to the air constantly (faster in winter, faster still in a centrally heated house with the radiators running from October). An emollient slows that loss by leaving an oily layer on the surface that traps moisture underneath. Chemists call this occlusion. The rest of us call it "the greasy bit that actually works". The textures differ mainly in one thing: how much water is in the pot.
- Lotions are mostly water. They spread easily, sink in fast, feel like nothing. They also evaporate quickly, so the effect is short-lived, and all that water means they need a proper preservative system to stay safe in the bottle.
- Creams are an oil-and-water emulsion, the middle of the spectrum. Light enough for daytime, moisturising enough to be worth the bother. They need emulsifiers to hold the oil and water together, plus preservatives, which is why a "simple" cream often has twenty ingredients.
- Gels are the newer arrival: water-based, cooling on contact, quick to sink in. Pleasant in summer, less convincing on a genuinly rough patch in January.
- Ointments flip the ratio: mostly or entirely grease, often paraffin-based, with little or no water. Highly occlusive, meaning they hold moisture in for hours. Also properly greasy, which matters far more than anyone admits (more on that below).
- Balms sit near ointments in richness but are usually built from plant butters, oils and wax rather than paraffin. And a true balm is anhydrous: no water at all. No water means nothing for microbes to grow in, which means no preservative system is needed. The ingredients list can be genuinely short.
There's a quick trick for reading any pot in the aisle: look at the first ingredient. If it's aqua, you're holding a lotion, gel or cream and the rest of the list will include the machinery that keeps water-based formulas stable. If the list opens with oils, butters or wax, you're holding an ointment or balm, and the list will likely be short. Neither is a moral victory. They're just different tools.
The BEE trial: what a big NHS study honestly found
Here's the part most skincare blogs skip, because it's inconvenient for anyone selling a "best" texture.
The BEE trial (Best Emollients for Eczema) was a large NIHR-funded randomised trial that compared the four main emollient types (lotions, creams, gels and ointments) in more than 500 children with eczema across England. The finding: no type outperformed the others. Not the posh one, not the greasy one, none of them. Effectiveness was broadly similar across the board, and the researchers' practical conclusion was refreshingly plain: the best emollient is the one the family will actually keep using.
We love this result, and not because it flatters balms. It doesn't, particularly. We love it because it moves the question from "which texture is scientifically superior" (answer: none, apparently) to "which texture will you genuinely apply every single day". That's a question about your life. Your mornings. Your child's tolerance for feeling sticky in a classroom. You're allowed to choose on feel, because the evidence suggests feel is the deciding factor anyway.
To be clear on the medical side: if you or your child has eczema, your GP, pharmacist or health visitor is the right person to advise on managing it, and the NHS page on emollients is worth ten minutes of your time before you buy anything at all.
Where a thick balm earns its place
Within that "use what you'll keep using" logic, balms have a specific territory where they make obvious sense.
The very dry, rough patches. Elbows, knees, shins, knuckles: the spots that drink a light lotion and look exactly the same ten minutes later. A balm's waxy richness stays put on these patches, softening them and locking in moisture instead of vanishing by lunchtime.
Overnight. Nobody cares about greasiness while they're asleep. A balm applied at bedtime (old cotton pyjamas help) gets eight uninterrupted hours to do its work. No sleeves shoved up, no sofa arms to worry about, no reapplying.
Hands. Washing-up, hand gel, school-run weather. Hands have moisture stripped out of them a dozen times a day, and a thin smear of balm after each wash does more for them than one thick application ever could.
Skin that reacts to everything. When skin flares at the slightest thing, fewer ingredients means fewer variables. Our own PureSoothe Eczema Relief Balm contains exactly five: cold-pressed linseed oil, sesame oil, calendula flower extract, beeswax and shea butter, hand-blended in small batches here in the UK. No water, so no preservatives needed. No parabens, no synthetic fragrance, and it's dermatologist tested. It soothes dry, itchy skin, softens rough patches and calms the look of redness, and it's also suitable for skin prone to eczema. (Honesty corner: the beeswax means it isn't vegan, though it's cruelty free and never tested on animals.) If you're wondering why calendula keeps turning up in gentle skincare, we've written about that seperately in our guide to calendula for eczema-prone skin.
Texture is the real reason people give up
Our slightly spiky opinion: most abandoned emollients weren't the wrong formula. They were the wrong feel.
Think about how these things actually fail in a real house. The ointment that made a seven-year-old's school jumper cuffs shiny by Wednesday, so it quietly stopped being applied. The cream that stung going on (often the fragrance or preservatives meeting skin that's already cross), so a toddler now bolts at the sight of the tub. The lotion that felt lovely and did approximately nothing for a rough elbow, so faith in the entire category died on the spot. None of these are effectiveness failures in the trial sense. They're texture failures. And texture failures are what end routines.
Go and look under your bathroom sink. We'd bet money there's a small graveyard of half-used tubs down there, each one abandoned for a reason that had nothing to do with whether it worked and everything to do with how it felt at 7.40am on a school morning.
The answer isn't hunting for one perfect product. It's matching texture to moment. A light cream after the morning shower when there's a bus to catch. Something richer in the evening when nobody's going anywhere. A balm on the worst patches at night and on hands through the day. After a paddling pool afternoon that somehow leaves everyone's skin feeling tight, something thick before bed. If you want our full thinking on picking a simple everyday option, it's here: our guide to choosing a natural cream or balm in the UK.
A balm sits alongside a prescription, never instead of one
This matters enough to get its own section.
If a GP has prescribed treatment for you or your child, keep using it exactly as directed. A balm is a cosmetic. It cares for skin: moisturises it, softens it, helps protect it from drying out. It is not a replacement for anything medical, and we'd never suggest otherwise. The National Eczema Society has good plain-English guidance on using emollients alongside prescribed treatments, including the commonly given advice to leave a gap of around half an hour between the two (your pharmacist can confirm what's right for your specific prescription).
In practice, plenty of families run both quite happily: prescribed treatment when and where the GP says, and a simple balm doing the unglamorous everyday work of keeping skin soft and comfortable. That's the slot PureSoothe Eczema Relief Balm was made for. Not the medical bit. The every-single-day bit.
The questions everyone asks
Is a balm or a cream better for eczema-prone skin?
Neither wins outright. The NIHR-funded BEE trial compared emollient types in children and found no texture outperformed the others, so the better one is whichever you'll use consistently. Creams suit daytime and larger areas; balms suit very dry patches, hands and overnight. Plenty of people use both. For skin prone to eczema, talk to your GP or pharmacist first, then choose the feel you'll actually stick with.
Are ointments better than creams?
Ointments are more occlusive: more grease, little or no water, so they hold moisture in the skin longer than creams do. That doesn't make them better overall. Trial evidence found no clear winner between emollient types, and the greasiness of ointments is exactly why so many people quietly stop using them. Choose the texture you can live with daily, or use a cream by day and something richer at night.
Can I use a balm on broken skin?
We'd say no. A cosmetic balm belongs on intact, dry skin. If skin is cracked open, weeping, bleeding or looks sore and angry, that's a conversation for your GP or pharmacist, not a job for any moisturiser. Once skin is intact again, a balm can return to its normal role: softening rough patches and locking in moisture. And whenever you try anything new, a small patch test first is sensible.
So that's the honest picture. The textures genuinely differ, the evidence crowns none of them, and the real winner is whichever pot is still being opened in three months. If a five-ingredient list and a rich, waxy texture sounds like the one you'd stick with, PureSoothe Eczema Relief Balm is our one and only product: 50ml of balm made to soothe dry, itchy skin and soften rough patches, rated 4.7 out of 5 by the 16 people who've reviewed it so far (we're small, we know), with a 30-day money-back guarantee if it isn't for you. UK delivery is £2.99 with Royal Mail Tracked 48 (2 to 3 working days) and free over £40, a threshold two jars happen to cross.