Liquid paraffin (drug)

Petroleum is said to have been used as a medicine since 400 BC, and has been mentioned in the texts of classical writers Herodotus, Plutarch, Dioscorides, Pliny, and others.[2] It was used extensively by early Arabians and was important in early Indian medicine. Its first use internally is attributed to Robert A. Chesebrough, who patented it in 1872 for the manufacture of a "new and useful product from petroleum."[1] After Sir W. Arbuthnot Lane, who was then Chief Surgeon of Guy's Hospital, recommended it as a treatment for intestinal stasis and chronic constipation in 1913, liquid paraffin gained more popularity.

Liquid paraffin is primarily used as a pediatric laxative in medicine and is a popular treatment for constipation and encopresis.[1] Because of its ease of titration, the drug is convenient to synthesize. It acts primarily as a stool lubricant, and is thus not associated with abdominal cramps, diarrhea, flatulence, disturbances in electrolytes, or tolerance over long periods of usage, side effects that osmotic and stimulant laxatives often engender (however, some literature suggests that these may still occur).[1][3] The drug acts by softening the feces and coats the intestine with an oily film.[4] Because of this it reduces the pain caused by certain conditions such as piles (haemorrhoids). These traits make the drug ideal for chronic childhood constipation and encopresis, when large doses or long-term usage is necessary.[1]

Consensus has not been entirely reached on the safety of the drug for children. While the drug is widely accepted for the management of childhood constipation in North America and Australia, the drug is used much less in the United Kingdom.[1] The drug is endorsed by the American Academy of Pediatrics and the North American Society for Gastroenterology and Nutrition, with the latter organization outlining it as a first choice for the management of pediatric constipation.[1] The drug is suggested to never be used in cases in which the patient is neurologically impaired or has a potential swallowing dysfunction due to potential respiration complications. Lipoid pneumonia due to mineral oil aspiration is thus a recognized severe complication of this medication, and there is a need for a heightened awareness among caregivers about the potential dangers of inappropriate mineral oil use.[5] Some go as far as saying that it should never be used with children due to this risk.[4]

Liquid paraffin is also used in combination with magnesium as an osmotic laxative, sold under the trade name Mil-Par (among others).[6]

Additionally, it may be used as a release agent, binder, or lubricant on capsules and tablets.[7]

Liquid paraffin is a hydrating and cleansing agent. Hence, it is used in several cosmetics both for skin and hair products. It is also used as one of the ingredients of after wax wipes.

Paraffin in beaker

Upon being taken orally, liquid paraffin might interfere with the absorption of fat-soluble vitamins, though evidence does not seem to fully support this.[8] It can be absorbed into the intestinal wall[4] and may cause foreign-body granulomatous reactions in some rat species. These reactions might not occur in humans, however.[9] Some evidence suggests that it engenders a lack of carcinogenicity.[10] If liquid paraffin enters the lungs, it can cause lipoid pneumonia.[4]

If injected, it can cause granulomatous reactions.[11]

In 2015, German consumer watchdog Stiftung Warentest analyzed cosmetics containing mineral oils. After developing a new detection method they found high concentrations of Mineral Oil Aromatic Hydrocarbons (MOAH) and even polyaromatics in products containing mineral oils with Vaseline products containing the most MOAH of all tested cosmetics (up to 9%).[12] The European Food Safety Authority sees MOAH and polyaromatics as possibly carcinogenic.[12] Based on the results, Stiftung Warentest warns not to use Vaseline or any product that is based on mineral oils for lip care.

• Mineral oil
• Petroleum jelly