Emollient bath and shower products, paraffin-containing

How it works

The paraffin oils coat the skin during bathing to form an occlusive layer that reduces transepidermal water loss and restores the skin barrier.

Prescribing in practice

• Paraffin-based products soak into fabrics and create a serious fire hazard, so patients and carers must be warned that clothing, bedding and dressings can ignite more easily near naked flames or cigarettes.
• Treated baths and showers become very slippery, posing a falls risk that warrants non-slip precautions.
• Direct evidence that bath additives add benefit over leave-on emollients is limited, so they should be used as an adjunct rather than a substitute for regular emollient application.

Monitoring

No laboratory monitoring is needed; review skin condition, tolerability and adherence to fire-safety advice at follow-up.

Counselling the patient

• Keep away from naked flames and do not smoke; fabrics in contact with these products burn very easily even after washing.
• Take care getting in and out of the bath or shower as the surface becomes slippery.
• Pat the skin dry and apply your leave-on emollient afterwards.

Evidence & guidelines

The MHRA has issued repeated safety alerts on the fire risk of paraffin-based and other emollients, and the BATHE trial questioned added benefit of bath emollients in childhood eczema.