Thermal burns associated with the use of ointments

Author: Isabelle Lewis, House officer, Waikato Hospital, Hamilton, New Zealand. DermNet New Zealand Editor in Chief: A/Prof Amanda Oakley, Dermatologist, Hamilton, New Zealand. September 2017.


Introduction

Paraffin–based ointments and creams are often used to treat common skin conditions, such as eczema or psoriasis. Unfortunately, they are potential fire hazards. Ointments and creams are applied directly onto skin, as well as onto dressings and clothing, and are easily ignited with a naked flame or cigarette resulting in serious thermal burns or death.

The risks include:

    • Smoking, or being near to those who are smoking
    • Exposure to an open flame (or any possible cause of ignition).
Paraffin-based emollients

Advice to patients in all settings

Patients should be informed of the associated fire hazard of paraffin based products when they are first prescribed them, both in an inpatient and outpatient setting.   

  • Discourage patients from smoking, and offer practical advice to quit; if they intend to smoke, advise them to wear a thick outer covering that is free of paraffin.
  • Stress importance of frequently washing clothing and bedding that are exposed to paraffin.
  • Encourage them to share the information with their relatives.

Paraffin fire hazard in the media

Paraffin–containing skin creams have recently come into the spotlight after being linked to several deaths from fire. One BBC article reported that since 2010 there have been 37 fire deaths in England that have been linked to the creams.  

Examples of paraffin based products

  • White soft paraffin
  • White soft paraffin plus 50% liquid paraffin
  • Emulsifying ointment

Alternatives to paraffin products

Less greasy emollient creams with lower fire hazard may be suitable.

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References

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