Urea is a well-established topical agent in dermatology, primarily valued for its keratolytic and hydrating properties. Its use in the management of lesions—specifically hyperkeratotic or dry, scaly lesions such as those seen in eczema, psoriasis, ichthyosis, and chronic wounds—is supported by scientific evidence. Urea at concentrations between 5% and 40% helps break down the intercellular matrix in the stratum corneum, softening and loosening thickened or hardened skin and facilitating desquamation. This mechanism promotes healing by improving skin barrier function and moisture retention and may enhance the efficacy of other topical medications by increasing skin permeability.

Several clinical studies and reviews have demonstrated the effectiveness of urea-containing creams and ointments for managing lesions associated with dry, scaly skin conditions. For example, a 2013 review in the journal Dermatology and Therapy found that urea-based formulations significantly improved skin hydration, reduced scaling, and promoted repair of the skin barrier. Urea is also frequently recommended in clinical guidelines for the care of chronic wounds and certain dermatologic lesions, although its role is supportive rather than curative. It is not typically indicated for acute or infected lesions.

In summary, the use of urea to support the management of certain lesions has a scientific basis, particularly for those involving hyperkeratosis or dryness, but the evidence is moderate rather than strong, and its use is mainly adjunctive.