What is acetone poisoning?

Acetone poisoning occurs when there’s more acetone in your body than your liver can break down.

Acetone is a clear liquid that smells like nail polish remover. When exposed to the air, it quickly evaporates and remains highly flammable. Acetone is dangerous to use around an open flame. Hundreds of commonly used household products contain acetone, including furniture polish, rubbing alcohol, and nail polish.

Every day, your body breaks down fats into organic molecules called ketones. Acetone is one of three types of ketone bodies. Your liver makes ketones, and your body can use them for fuel. However, accumulation of ketones in the body can be dangerous. Acetone poisoning can occur when there’s an abnormally high amount of ketones. This is a condition known as ketoacidosis.

If you have type 1 or type 2 diabetes, you can develop in ketoacidosis if you don’t manage your glucose levels properly.

Prolonged starvation can also lead to ketoacidosis. In that case, your body depletes your carbohydrate stores and begins to break down stored fats into ketones. Blood ketone levels can accumulate rapidly and grow dangerously high.

Acetone poisoning can have other causes, including:

  • drinking rubbing alcohol for intoxication
  • overexposure to specific paints in confined spaces
  • accidentally drinking cleaning solutions that contain acetone
  • drinking nail polish remover

Acetone poisoning is rare. Your body is capable of breaking down large amounts of acetone naturally. For overexposure to occur, you must produce, inhale, or ingest very large amounts within a short period of time. Mild acetone poisoning symptoms include:

  • headache
  • slurred speech
  • lethargy
  • lack of coordination
  • a sweet taste in the mouth

Severe symptoms are very rare and include:

Acetone poisoning can be life-threatening.

Acetone poisoning has an unusual symptom that aids in diagnosis: The ketones in your blood cause your breath to have a fruity odor. It’s difficult to test for acetone because of the amount naturally present in the body. Your doctor will look for high levels of acetone and ketones and physical symptoms to diagnose you.

  • Your doctor can use a urine test to look for the presence of ketones. Under normal circumstances, there are no ketones in your urine.
  • Your doctor can also give you a blood test to check your blood level of ketones and for a toxicology screening to determine the presence of certain toxic chemicals. A blood test can also determine how acidotic your blood has become.

There is no “cure” for acetone poisoning. But doctors can give supportive care while your body clears the ketones from your system. Your body’s natural response is to raise the breathing rate to get rid of the acids that have accumulated in the blood. Your doctor may insert a tube in your airway (intubation) to help you breathe. If you’re critically ill, you may also need blood pressure support to maintain an adequate oxygen supply to your organs. Often, doctors will also give fluids.

You shouldn’t induce vomiting if you’ve drunk large amounts of acetone. Acetone is harmful to the skin in your mouth and the lining of your esophagus. Your doctor can pump your stomach by putting a tube down your throat and into your stomach. They then pump small amounts of water or saline into your stomach and suck it back out until there’s no more acetone. However, because acetone is so quickly absorbed, this method is only effective within the first hour of ingestion.

Stomach pumping raises the risk of accidental aspiration pneumonia, a condition in which the water is accidentally pumped into the lungs instead of the stomach. A person can drown from the liquid filling their lungs.

If you have a metabolic disorder, such as diabetes, be sure to follow your doctor’s instructions about diet, medication, and lifestyle. If you notice changes in your symptoms, contact your doctor to discuss adjustments to your treatment regimen. This will keep internal sources of acetone under control.

Acetone from external sources can enter your body accidentally or purposely:

  • breathing it in from products such as nail polish or paint thinner
  • splashing it in your eyes
  • touching your skin to it
  • drinking it

You can prevent acetone exposure by taking basic precautions:

  • Keep spaces well ventilated when using products with acetone. Wear a face mask if you’re using products with acetone and the ventilation is poor.
  • Wear safety glasses to protect your eyes from acetone.
  • Keep children away from bottles of liquid containing acetone at all times.
  • Store acetone away from flames or heaters. It’s highly flammable.