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Is Vicks VapoRub® safe?

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Vicks VapoRub® has been used for many years as a cough and cold remedy. While this product is relatively safe to use when applied to the skin as directed on the package label, it should not be consumed or applied to the insides of the eyes, ears, or nose. To reduce the risk of burns and serious tissue damage, Vicks VapoRub® should never be heated in a microwave.

This Really Happened

Case 1: A 3-year-old girl with epilepsy presented to the hospital with a seizure lasting for 9 minutes. Prior to the onset of the seizure, the girl’s mother had rubbed a vaporizing chest rub on the child’s chest, forehead, and back for 10 hours. In addition, the mother had added camphor tablets to a vaporizer and placed the vaporizer in a bowl with water under the girl’s crib. The mother also hung camphor tablets in mesh on crib posts, and spread crushed tablets around the home as a pesticide. After camphor use was discontinued, the child had no further seizures. 

Case 2: A 4-year-old girl ate up to 2 ounces of Vicks VapoRub®. She vomited 5 hours later and developed seizures 9 hours after the ingestion. 

Case 3: A 77-year-old woman sustained a severe combined chemical and thermal burn from microwave-heated Vicks VapoRub®. The woman had transferred the ointment to a glass bowl and placed it in her microwave. When she removed the dish from the microwave, it exploded in her face. She developed glaucoma and required extensive eye surgery and corneal transplantation.

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What does Vicks VapoRub® do and what are the uses of Vicks VapoRub®?

Vicks VapoRub® is an ointment primarily marketed to temporarily relieve coughing when applied to the chest or neck. Vicks VapoRub® contains menthol and camphor, which create a cooling sensation in the nose. It also contains eucalyptus oil, a cough suppressant. When applied to the skin, the ingredients in Vicks VapoRub® cause a sensation of cleared nostrils and improved breathing, relieving stuffy noses and other signs and symptoms of nasal congestion. 

In addition to relieving nasal congestion, the ingredients in Vicks VapoRub® can also be used to treat other conditions. Menthol reduces the skin’s sensitivity to pain, and Vicks VapoRub® can be used as a topical pain reliever (analgesic) for muscle and joint aches. The main ingredients in Vicks VapoRub® have antifungal properties and have been studied as a treatment of  toenail fungus, although the product is not FDA-approved as a treatment for this condition.

What are the side effects of Vicks VapoRub®?

Vicks VapoRub® may cause redness and irritation when applied to the skin. In rare cases, allergic reactions, including hives or rashes, may occur after use of Vicks VapoRub® on the skin. Thermal and chemical burns can occur if heated Vicks VapoRub® is applied to the skin. To reduce the risk of burns, do not heat Vicks VapoRub®, put it into a microwave, add it to hot water, or use it near open flames. Skin lightening is a rare complication that may occur if Vicks VapoRub® is applied to the face.

Is Vicks VapoRub® safe for pregnancy? 

When used as directed, Vicks VapoRub® is safe to use during pregnancy. Studies of people who used camphor (an active ingredient in VapoRub®) on the skin during pregnancy did not show evidence of fetal harm. However, camphor can cause miscarriage when swallowed. Because of this, pregnant people should wash their hands after using Vicks VapoRub® to avoid accidentally swallowing the product. To avoid accidental consumption by nursing infants, this product should not be applied to the chest during lactation.

VapoRub® inhalation: Can Vicks® hurt your lungs?

While inhaling small amounts of Vicks VapoRub® is unlikely to damage the lungs, excessive use of Vicks under the nose is associated with a rare form of pneumonia called lipoid pneumonia. The ointment base in Vicks VapoRub® contains a petroleum product (petrolatum). When applied in or under the nose every day for many months or years, petrolatum can travel through nose and lodge into lung tissue, causing lipoid pneumonia. This is more common in very young children and older adults who may not have the ability to protect their airways from the dangerous effects of petrolatum. Symptoms of lipoid pneumonia include cough, chest pain, fever, and chills. These signs and symptoms often disappear within months to a year of stopping use of the product. 

Can you eat Vicks VapoRub®?

Vicks VapoRub® is not safe to eat. When swallowed, the camphor in Vicks VapoRub® can cause nausea,  vomiting, seizures, and death. Small children are at increased risk for toxicity after consumption of camphor-containing products.

Is Vicks VapoRub® dangerous? What to do if Vicks gets in your eye, ear or nose

While Vicks VapoRub® is safe when used on the skin and for short durations of time, using too much or eating it can lead to severe toxicity. Application to the face and around the eye can result in eyelid swelling, blisters, and damage to the cornea (the outer layer of the eyeball). At least two people have developed permanent eye damage after accidentally applying Vicks VapoRub® into their eyes.  

Vicks VapoRub® is flammable and should not be heated. There are two published cases that describe severe eye injuries that occurred after people heated Vicks VapoRub® in a microwave oven. In one case, the individual placed the ointment in a glass container, added water, and placed it in the microwave to heat. In the other case, ointment without water was heated. In both cases, the product exploded, and both patients required surgery to repair the damage. 

Vicks VapoRub® should not be used in the ear. If Vicks VapoRub® gets in your ear, you should immediately rinse the ear with room-temperature tap water.

What should I do if my child eats Vicks VapoRub®

If someone develops unexplained or unexpected symptoms after using Vicks VapoRub®, use the webPOISONCONTROL® online tool to get help, or call your poison center at 1-800-222-1222. Whether online or by phone, expert guidance is always free, confidential, and available 24 hours a day.

References

Kilaru H, Prasad S, Radha S, Nallagonda R, Kilaru SC, Nandury EC. Nasal application of petrolatum ointment a silent cause of exogenous lipoid pneumonia: Successfully treated with prednisolone. Respiratory Medicine Case Reports. 2017;22:98-100. doi:10.1016/j.rmcr.2017.07.003 

Rabl W, Katzgraber F, Steinlechner M. Camphor ingestion for abortion (case report). Forensic Sci Int. 1997 Sep 19;89(1-2):137-40.

Phelan WJ 3rd. Camphor poisoning: over-the-counter dangers. Pediatrics. 1976 Mar;57(3):428-31. 

Khine H, Weiss D, Graber N, Hoffman RS, Esteban-Cruciani N, Avner JR. A cluster of children with seizures caused by camphor poisoning. Pediatrics. 2009 May;123(5):1269-72. 

Dosoky NS, Setzer WN. Maternal Reproductive Toxicity of Some Essential Oils and Their Constituents. Int J Mol Sci. 2021 Feb 27;22(5):2380.

Patel VM, Schwartz RA, Lambert WC. Safety of topical dermatologic medications in pregnancy. J Dugs in Dermatology. 2016;15(7):830-834.

Santhi, Nayantara & Ramsey, David & Phillipson, Gill & Hull, David & Revell, Victoria & Dijk, Derk-Jan. (2017). Efficacy of a Topical Aromatic Rub (Vicks VapoRub ® ) on Effects on Self-Reported and Actigraphically Assessed Aspects of Sleep in Common Cold Patients. Open Journal of Respiratory Diseases. 7. 83-101. 10.4236/ojrd.2017.72009.

Snell, Mariea & Klebert, Michael & Nur, Ferdinal & Hubert, Sara. (2015). A Novel Treatment for Onychomycosis in People Living With HIV Infection: Vicks VapoRub™ is Effective and Safe. Journal of the Association of Nurses in AIDS Care. 27. 10.1016/j.jana.2015.10.004.

Farooqui MO, Ochani RK. VapoRub - An economical alternate - Letter to the Editor. J Pak Med Assoc. 2018 Oct;68(10):1551.

Derby R, Rohal P, Jackson C, Beutler A, Olsen C. Novel treatment of onychomycosis using over-the-counter mentholated ointment: a clinical case series. J Am Board Fam Med. 2011 Jan-Feb;24(1):69-74.

Boyse KE, Zirwas MJ. Chemical Leukoderma Associated with Vicks VapoRub. J Clin Aesthet Dermatol. 2008 Nov;1(4):34-5.

Jaiwal A. Vick's VapoRub induced dermo kerato conjunctivitis--a case report. Indian J Ophthalmol. 1989 Jul-Sep;37(3):154.

Sahay P, Saluja G, Maharana PK, Titiyal JS. Topical ayurvedic ointment-induced chemical injury presenting as bilateral acute keratitis. BMJ Case Rep. 2017 Aug

Ruha AM, Graeme KA, Field A. Late seizure following ingestion of Vicks VapoRub. Acad Emerg Med. 2003 Jun;10(6):691.

Smith A, Matthews O. Aromatic ointments for the common cold: what does the science say? Drugs Context. 2022 Aug 1;11:2022-5-6.

Subramanian S, Kherdekar SS, Babu PG, Christianson CS. Lipoid pneumonia with Cryptococcus neoformans colonisation. Thorax. 1982 Apr;37(4):319-20.

Fung AE, Oxford KW. Microwave-superheated Vics Vapo Rub: an ocular public health danger. Am J Ophthalmol. 2004 Feb;137(2):379-80.

Gagnon MR, Walter KA. Ocular surface injury from a microwave superheated liquid. Cornea. 2004 Mar;23(2):204-6.

Al Aboud K. The founder of Vicks: Lunsford Richardson (1854-1919). Skinmed. 2010 Mar-Apr;8(2):100-1.

Noiles K, Pratt M. Contact dermatitis to Vicks VapoRub. Dermatitis. 2010 May-Jun;21(3):167-9.

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