Emollients and Associated Fire Risks
Emollients are essential for managing dry skin conditions, but they pose a serious fire hazard when residue builds up on clothing, bedding, dressings, or bandages. This risk applies to both:
- Paraffin-based emollients (e.g. white soft paraffin, emulsifying ointment).
- Paraffin-free emollients (e.g. AproDerm ®, Epimax® paraffin-free ointment) which can act as fire accelerants even though they are not flammable themselves.
The risk of severe or fatal burns was first highlighted in Drug Safety Updates (2008, 2016) and extended by MHRA in December 2018 to include all emollients. Fatal incidents have occurred when fabrics impregnated with emollients ignited from naked flames or cigarettes and tests show that emollient residue significantly increases the speed and intensity of ignition. Increased risk happens when application is to large body areas or in large volumes for prolonged periods and there is often a build-up on chairs, soft furnishings, bedding, and clothing.
Advice for Healthcare Professionals and Patients
This advice should be provided to all patients and carers irrespective of the products being used.
- Do not smoke and stay away from naked flames (including gas hobs, fires).
- Change clothing and bedding regularly (ideally daily); wash at high temperatures to reduce residue (though not completely remove it).
- Patients using oxygen therapy should use water-based moisturisers or non-paraffin products.
- Consider water-based emollients for patients who smoke or require large quantities (>100g).
- Ensure packaging and leaflets include fire hazard warnings and alert symbols and alert patients to the risks.
- Report incidents via the Yellow Card Scheme.