Liquid paraffin with white soft paraffin and wool alcohols

How it works

It works physically rather than pharmacologically, forming an occlusive lipid layer that reduces transepidermal water loss and restores skin barrier hydration; the wool alcohols act as an emulsifier.

Prescribing in practice

• Paraffin-based emollients are flammable: warn patients that dressings, clothing and bedding in contact with the product can ignite readily near naked flames, cigarettes or other ignition sources.
• The wool alcohols (lanolin) component can cause contact sensitisation, so use with caution in patients with known lanolin allergy.
• Apply liberally and frequently in the direction of hair growth, and use clean technique to avoid contaminating tubs.

Monitoring

Monitoring is clinical, reviewing skin hydration and condition and watching for any contact dermatitis suggesting sensitisation to the lanolin component.

Counselling the patient

• Keep away from naked flames and avoid smoking — fabric soaked with this ointment can catch fire.
• Apply generously and as often as needed, smoothing it on in the direction the hair grows.
• Stop and seek advice if the skin becomes more red or itchy, which could indicate an allergy to the lanolin.

Evidence & guidelines

Emollients are the cornerstone of dry-skin and eczema care recommended by NICE, and the MHRA has issued safety advice on the fire risk of paraffin-containing skin products.