Burns with emollientsBMJ 2022; 376 doi: https://doi.org/10.1136/bmj-2021-066102 (Published 14 February 2022) Cite this as: BMJ 2022;376:e066102
- Matthew J Ridd, GP and professor of primary health care1,
- Sarah Hall, senior lecturer in forensic analytical chemistry2,
- Majella E Lane, senior lecturer in pharmaceutics3,
- Amanda Roberts, patient with lived experience of eczema4,
- Hywel C Williams, consultant dermatologist and professor of dermato-epidemiology4
- 1Population Health Sciences, University of Bristol, Bristol, UK
- 2School of Pharmacy, De Montfort University, Leicester, UK
- 3School of Pharmacy, University College London, London, UK
- 4Centre for Evidence Based Dermatology, School of Medicine, University of Nottingham, Nottingham, UK
- Correspondence to M Ridd
What you need to know
Advise patients to continue using emollients but to be aware of burn risks, avoid naked flames, and stop smoking
Emollients are not flammable themselves but, when impregnated into fabric, can act as an accelerant
People most at risk are those with reduced ability to react quickly when emollient impregnated fabric is exposed to naked flames
A 72 year old man with poor mobility, Parkinson’s disease, and dementia attends the emergency department with upper body burns. He is a smoker and his carer applies emollients to most of his body daily as long term maintenance treatment for eczema. The attending clinician established that the patient’s burns were sustained when his cigarette came into contact with the right arm of his pyjamas, which quickly caught fire.
Emollients are an important treatment and generally safe; they are not flammable in themselves, in their container, or on the skin. However, awareness of fire risk—from fabric that has become impregnated with emollient residue—is low.123
Emollient can transfer from skin onto clothing, furniture, and bedding, which accumulates over time—even with regular washing, some residue remains. A naked flame is needed for ignition. The residue acts as an accelerant, increasing the speed of ignition and intensity of a fire, reducing the time available to extinguish it.
What are emollients?
Emollients are moisturising treatments used for dry skin conditions such as atopic eczema and psoriasis. Formulations include lotions, creams, gels, ointments, and sprays; and broadly are petroleum (paraffin) or non-petroleum based.
They are applied directly to the skin, typically …