When fabric with dried-on emollient cream makes contact with a naked flame, testing has shown that the fabric burns much more quickly and at a higher temperature. This is a real challenge for care homes where emollient creams are used to help manage a variety of skin conditions such as eczema or psoriasis. These creams are easily transferred onto clothing and bedding and they can react with fibres of dressings, bedding, clothing, bandages and items such as towels. Not only are they easily transferable but they are also highly flammable. 

Issue 3 of the CQC’s Learning from safety incidents publication refers to a fire in May 2018 at a residential care home in Lancashire. The fire started in the laundry room, as a result of emollient creams reacting with cotton towels, causing them to become flammable. Nine residents had to be evacuated and luckily there were no injuries. However, the outcome is not always injury-free and the CQC has reported that these incidents are unfortunately not uncommon. We wrote a blog in January 2022 regarding a prosecution that in part related to a failure of a care home provider to appropriately assess the risks of emollient creams – this blog can be found here.

When carrying out personal care using emollients or caring for those that use such creams, care providers need to ensure that they consider the associated fire risks and implement suitable and sufficient mitigation measures to ensure the safety of residents and staff. This should feed into care providers' wider fire safety considerations, such as fire risk assessments and evacuation plans.

The Medicines Healthcare Products Regulatory Agency (MHRA) issued an update safety alert in 2018, to extend the warning of the risks of severe and fatal burns from emollients to include all paraffin-based emollients regardless of paraffin concentration. It also includes paraffin-free emollients.

The MHRA guidance on emollients advises providers and other healthcare professionals to:

• Advise those who are using emollient creams and their relatives of the risks the creams may pose, and remind them not to smoke, use naked flames or go near anyone smoking or using naked flames.
• Change clothing and bedding regularly as the regular washing of fabrics does not remove the risk, as the emollients soak into fabrics but it may help to remove the build-up.
• Be aware that fabrics with dried residue of an emollient on them, such as bedding or bandages, will easily ignite.
• Keep emollients off furniture wherever possible as the cream can transfer from skin onto the fabric of furniture when sitting or lying on it.
• Any fire incidents with emollients or other skin care products should be reported to MHRA’s Yellow Card Scheme which tracks the side effects and incidents related to medicines and medical devices to ensure safe and effective use.

For further advice, please contact Molly Quinney or a member of the regulatory team.