Emollient creams and ointments, paraffin-containing

How it works

They act as occlusive and humectant barriers that reduce transepidermal water loss, soften the stratum corneum and help restore skin barrier function.

Prescribing in practice

• Paraffin-based emollients are a fire hazard: dressings, clothing and bedding contaminated with the product can ignite readily near naked flames or cigarettes, so patients must avoid smoking and open flames.
• Apply liberally and frequently, smoothing in the direction of hair growth to reduce the risk of folliculitis.
• Decant from tubs with a clean spoon or pump rather than fingers to minimise bacterial contamination.

Monitoring

No laboratory monitoring is required; review adequacy of skin hydration, product acceptability and any local reactions.

Counselling the patient

• Keep away from naked flames and do not smoke; fabrics soaked with the emollient can catch fire even after washing.
• Apply generously and often, especially after washing while the skin is still damp.
• Use a clean spoon or pump to remove product from tubs to keep it hygienic.

Evidence & guidelines

The MHRA has issued safety advice on the fire risk of paraffin-based and paraffin-free emollients, and NICE guidance positions emollients as first-line in dry skin and eczema.