Comparative Effectiveness of 10% Urea Cream and 0.1% Hyaluronic Acid Cream in Diabetic Xerosis: A Prospective Split-Body Clinical Trial

Objective: Xerosis cutis is a common dermatological complication in diabetes mellitus and is associated with impaired skin barrier function. This study compared the efficacy of 10% urea cream and 0.1% hyaluronic acid cream in improving skin hydration, reducing transepidermal water loss (TEWL), and alleviating xerosis severity in diabetic patients. Material and Methods: A prospective split-body clinical trial was conducted in 30 adults with diabetic xerosis. Participants applied 10% urea cream to one lower leg and 0.1% hyaluronic acid cream to the contralateral leg twice daily for 28 days. Skin hydration, TEWL, and xerosis severity were evaluated using Corneometer® CM 825, Tewameter® TM Hex, and the Overall Dry Skin Score, respectively, at baseline, day 14±1, and day 28±1. Statistical analyses were performed using paired tests with a significance set at p-value<0.05.Results: At day 28, the increase in skin hydration was significantly greater with urea cream than with hyaluronic acid cream (mean difference: 2.71 arbitrary units; 95% confidence interval: 0.56–4.86; p-value=0.015), corresponding to a moderate effect size (Cohen’s dz ≈ 0.47), suggesting a clinically meaningful difference.Conclusion: In patients with diabetic xerosis, ten percent urea cream provided superior enhancement of skin hydration relative to 0.1% hyaluronic acid cream, whereas both formulations showed similar efficacy in improving barrier function and reducing clinical xerosis severity.