# Skin creams containing paraffin linked to fire deaths



## Ursa major (Mar 19, 2017)

This is more of a health warning than a comment about a (simple) technology.

Skin creams containing paraffin have been linked to dozens of fire deaths across England, the BBC has learned:





> The products for conditions like eczema and psoriasis can leave people at risk of setting themselves ablaze. If people use the creams regularly but do not often change clothes or bedding, paraffin residue can soak into the fabric, making it flammable.
> 
> The medicines regulator has updated its guidance and says all creams containing paraffin should carry a warning. Despite warnings going back more than 10 years, BBC Radio 5 live Investigates has discovered there have been 37 deaths in England since 2010 linked to the creams.



I don't use skin creams regularly -- though I have been told that as I have type 2 diabetes, I have to be particularly careful about taking care of my feet (as the condition makes the consequences of cuts and infections more serious than for the general population) -- but I do have a 350g jar of E45 in the house.

By weight -- I think that's what w/w means -- its contents are 14.5% "white soft paraffin" and 12.6% "light liquid paraffin", which is 94.85g of paraffin in a full jar. I had thought (never having looked at its ingredients before) E45 was a completely harmless substance, but it seems that it may not always be. (I knew I was washing my socks for a reason....)


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## Susan Boulton (Mar 19, 2017)

It also seems, least from the article, that cigarettes paid a part in some of the deaths.


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## Danny McG (Mar 19, 2017)

I have industrial dermatitis on both hands. Years of working with various chemicals, long before barrier cream and protective workwear/gloves being issued free upfront became standard practice. Therefore I now have to totally slather my hands in E45 three or four times a day, then sit for fifteen minutes whilst it soaks in. I'm really glad I stopped smoking over ten years ago or I would no doubt have done a very convincing Johnny Storm impersation by now


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## Theophania Elliott (Mar 19, 2017)

There has not yet been a case of a patient using paraffin-based skin products catching fire spontaneously; there is always a naked flame involved. (Cases involving hyperbaric chambers with high concentrations of oxygen tend to require only excess heat or a spark.)

Essentially, when you apply enough paraffin to yourself and your clothing to turn yourself into a giant candle, then apply a naked flame, the result is unsurprising - if tragic.

The HSE Health and Safety Laboratory did some experiments and produced a report in 2006, which you can read here: Health and Safety Exec report - Paraffin-based skin ... - Patient Safety

The Americans (Civil Aeromedical Research Institute) did some experiments on the flammability of face and hair products in the presence of 100% oxygen, and you can read their report here: https://www.faa.gov/data_research/research/med_humanfacs/oamtechreports/1960s/media/am63-27.pdf 

People using large quantities of paraffin based skin products don't need to worry as long as they take care to avoid sources of ignition. Likewise, the stuff isn't going to explode in your bathroom cupboard.

And remember, it's not just cigarettes and matches: gas hobs count too. There has also, I believe, been at least one case where an e-cigarette caused a fire when used by a patient on oxygen - those things can get very hot, and sometimes they catch fire. It's enough to provide a source of ignition, so best avoided also.


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## Ursa major (Mar 19, 2017)

Theophania Elliott said:


> Essentially, when you apply enough paraffin to yourself and your clothing to turn yourself into a giant candle, then apply a naked flame, the result is unsurprising - if tragic.


The issue, though, is that the flammability of the cream is not highlighted. There is no warning to keep it (or things covered in it, or things that have absorbed it) away from naked flames. (And this in a world where packets of nuts have "May contain nuts" warnings on them.)

Now while some people will assiduously look down the list of contents of things they buy, others don't**, and if people don't think about it, the idea that something as benign as hand cream might be, in some circumstances, dangerous will not have occurred to them, so they won't have bothered to read what's in it.

As for myself, I'm neither a smoker not a frequent user of E45, so this isn't really an issue. Other have not been so lucky.


** - I don't tend to, unless it's food and I want to check the sugar and saturated fat content. (I tend to be anal about other things.... )


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## Theophania Elliott (Mar 19, 2017)

The Patient Information Leaflet for E45 cream states: "Regularly change your clothing, bedding or dressing when using large quantities (>100g) of this product, and keep away from naked flames." It's also available online here: https://www.medicines.org.uk/emc/PIL.23511.latest.pdf 

The National Patient Safety Agency has produced an additional leaflet that covers all paraffin-related products, which pharmacies can (and do) print off and give out with relevant products, available online here: Fire hazard with paraffin-based skin products Pharmacies have been giving these out since 2007.


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## J Riff (Mar 19, 2017)

So... parrafin plus alcohol saturation = spontaneous combustion?


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## Ursa major (Mar 19, 2017)

Theophania Elliott said:


> The Patient Information Leaflet for E45 cream states:


Because people _always_ read the information leaflets, even for powerful drugs. (Note: my E45 did _not_ come with a leaflet. The jars -- well, plastic containers with a screw top -- are sold as is on supermarket shelves; they don't come in a box.)

As I said, people simply assume that E45 is benign and that because one doesn't "take it internally" -- well, not through one's mouth  -- they probably don't read the leaflet. Putting hand cream on one's hands is usually thought to be an even simpler process than applying liquid soap, as no water is needed.


To solve the issue (and save lives), all that's needed is a highly visible warning on the outside of the jars. Presumably the manufacturer(s) is (are) resisting this as there's a risk that it might reduce sales.


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## Theophania Elliott (Mar 19, 2017)

No. See: https://www.faa.gov/data_research/research/med_humanfacs/oamtechreports/1960s/media/am63-27.pdf - the object of the exercise was to find out how far you would have to go to make hair and face products spontaneously combust.

The answer is, they don't, under any kind of normal conditions. That's why some sort of ignition source is required.

Hyperbaric chambers are a special case - it's _very easy _to set things on fire in a hyperbaric chamber. I have details of about 70 cases.


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## mosaix (Mar 23, 2017)

We have E45 in our house and never, not once, suspected it could be a problem. As Ursa said there's an expectation that something we don't take orally wouldn't normally be a problem. Fire would be the last thing on anyone's mind.

I suppose the lesson is 'always read the label'.


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## Allegra (Mar 23, 2017)

I also use E45 in winter for my hands. It's good to know!


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