Emollient Creams

Emollient cream build-up in fabric can lead to fire deaths

People who use emollient creams to treat dry and itchy skin conditions are being warned that creams can build up in fabrics and cause them to catch fire more easily. The Medicines and Healthcare products Regulatory Agency (MHRA) is recommending that labelling and product information for these emollient products include a warning about the fire hazard, clear advice not to smoke or go near naked flames and information about the risk of severe burn injury or death when clothing, bedding and dressings with emollients dried on them are accidentally ignited.

Emollients are moisturising treatments applied directly to the skin to soothe and hydrate it. They cover the skin with a protective film to trap in moisture. Emollients are important treatments, widely used to help manage dry, itchy or scaly skin conditions such as eczema, psoriasis and ichthyosis.

The likelihood of fabric catching fire when using emollients and smoking or being near a naked flame is low, but if this does occur it could cause severe burns which may result in death. We want users to be aware that fabrics which have come into contact with emollient can be highly flammable, even after washing.  The risk is greater when emollients are applied to large areas of the body.

The recommendations from the Commission on Human Medicines include that:

• Outer packaging and product containers should include a warning about the fire hazard and advice not to smoke, accompanied by short explanatory text and a picture warning in the most prominent field of view
• Where available, the Patient Information Leaflet or Instructions for Use and the Summary of Product Characteristics (SmPC) should be updated to include warnings about the risk and how best to minimise it

The text will clearly warn users not to smoke or go near naked flames due to the risk of severe burns, that fabric (such as clothing, bedding and dressings) which has been in repeated contact with this product burns more easily and can be a serious fire hazard, and that washing clothing and bedding may reduce product build-up but not totally remove it.

The MHRA and industry are working together to apply the CHM recommendations and develop appropriate ways to make sure the warning is appropriately prominent. Additionally, NFCC are setting up a specific stakeholder group to manage education and awareness of this issue.

It was previously thought the risk occurred with emollients which contain more than 50% paraffins.  However, the evidence now points to a risk with emollients which contain lower levels of paraffin and with paraffin-free emollients. This advice therefore applies to all emollients whether they contain paraffin or not.

Watch Manager Chris Bell from West Yorkshire Fire and Rescue Service and National Fire Chiefs Council's lead for emollient creams, said:

“We welcome this recommendation. There have now been in excess of 50 deaths in the UK where the build-up of emollients on bedding, dressings or clothing may have contributed to the speed and intensity of the fire. Many of these fires were caused by people who smoked and were unaware of the fire risks associated with emollient build-up on fabrics.

“We have been trying to raise awareness about this issue with the public and health and care professionals. Ensuring that these products carry warnings will certainly help us as we continue to work with pharmacists, the NHS and care sector to prevent any future deaths.”