Liquid paraffin (drug)
Liquid paraffin in a bottle
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Liquid paraffin, also known as paraffinum liquidum or Russian mineral oil, is a very highly refined mineral oil used in cosmetics and medicine. Cosmetic or medicinal liquid paraffin should not be confused with the paraffin (or kerosene) used as a fuel. It is transparent, colorless, nearly odorless, and oily and is composed of saturated hydrocarbons derived from petroleum.
The term paraffinum perliquidum is sometimes used to denote light liquid paraffin, while the term paraffinum subliquidum is sometimes used to denote a thicker mineral oil.
Petroleum is said to have been used as a medicine since 400 BCE, and has been mentioned in the texts of classical writers Herodotus, Plutarch, Dioscorides, Pliny, and others. 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." After Sir W. Arbuhnot 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.
Usage in medicine
Liquid paraffin is primarily used as a pediatric laxative in medicine and is a popular treatment for constipation and encopresis. 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). The drug acts by softening the feces and coats the intestine with an oily film. Hence, 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.
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. 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. 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, which is a recognized severe complication of this medication, and emphasizes the need for a heightened awareness among caregivers about the potential dangers of inappropriate mineral oil use. Some go as far as saying that it should never be used with children.
Usage in cosmetics
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.
Upon being taken orally, liquid paraffin might interfere with the absorption of fat-soluble vitamins, though evidence does not seem to fully support this. It can be absorbed into the intestinal wall and may cause foreign-body granulomatous reactions in some rat species. These reactions might not occur in humans, however. Some evidence suggests that it engenders a lack of carcinogenicity. If liquid paraffin enters the lungs, it can cause lipoid pneumonia.
If injected, it can cause granulomatous reactions.
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 (MOHA) and even polyaromatics in products containing mineral oils with Vaseline products containing the most MOHA of all tested cosmetics (up to 9%). The European Food Safety Authority sees MOHA and polyaromatics as possibly carcinogenic. Based on the results, Stiftung Warentest warns not to use Vaseline or any product that is based on mineral oils for lip care.
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- "Liquid Petroleum or "Russian Mineral Oil" *". Journal of the American Pharmaceutical Association. 3 (7): 1013–1018. 1914-07-01. doi:10.1002/jps.3080030718. ISSN 0095-9553.
- Gordon M, MacDonald JK, Parker CE, Akobeng AK, Thomas AG (August 2016). "Osmotic and stimulant laxatives for the management of childhood constipation". The Cochrane Database of Systematic Reviews (8): CD009118. doi:10.1002/14651858.CD009118.pub3. PMC 6513425. PMID 27531591.
- Nathan A (2010). Non-prescription Medicines. Pharmaceutical Press. ISBN 9780853698869.
- Weinstein M (March 2001). "First do no harm: The dangers of mineral oil". Paediatrics & Child Health. 6 (3): 129–31. doi:10.1093/pch/6.3.129. PMC 2804525. PMID 20084222.
- "Magnesium & Liquid Paraffin". Patient UK. Archived from the original on 2009-04-14.
- "Section 172.878, White mineral oil, of Title 21 of the Electronic Code of Federal Regulations". Government Publishing Office. 19 September 2019. Retrieved 22 September 2019.
- Gal-Ezer S, Shaoul R (November 2006). "The safety of mineral oil in the treatment of constipation--a lesson from prolonged overdose". Clinical Pediatrics. 45 (9): 856–8. doi:10.1177/0009922806295285. PMID 17041175.
- Fleming KA, Zimmerman H, Shubik P (February 1998). "Granulomas in the livers of humans and fischer rats associated with the ingestion of mineral hydrocarbons: A comparison". Regulatory Toxicology and Pharmacology. 27 (1 Pt 2): 75–81. doi:10.1006/rtph.1997.1109. PMID 9618325.
- Shoda T, Toyoda K, Uneyama C, Takada K, Takahashi M (December 1997). "Lack of carcinogenicity of medium-viscosity liquid paraffin given in the diet to F344 rats". Food and Chemical Toxicology. 35 (12): 1181–90. doi:10.1016/S0278-6915(97)00105-1. PMID 9449224.
- Sejben I, Rácz A, Svébis M, Patyi M, Cserni G (August 2012). "Petroleum jelly-induced penile paraffinoma with inguinal lymphadenitis mimicking incarcerated inguinal hernia". Canadian Urological Association Journal. 6 (4): E137-9. doi:10.5489/cuaj.11146 (inactive 2020-04-11). PMC 3430719. PMID 23093564.
- Warentest, Stiftung. "Mineralöle in Kosmetika - Kritische Stoffe in Cremes, Lippenpflegeprodukten und Vaseline - Stiftung Warentest". www.test.de.
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