Susan Millard, MD, Pediatric Pulmonology
Spectrum Health Medical Group
Helen DeVos Children’s Hospital

If you’re of a certain generation, the scent of Vicks VapoRub can have the same effect as a Snickerdoodle cookie my mom used to make—sending you hurtling back to your childhood when mom rubbed the goop on your chest to “loosen” up congestion during coughs and colds. And as long as the mentholated gel remains on the chest—and isn’t used in children under 2—there may not be a problem.

But in the past few years, I have heard and read reports from colleagues throughout the country about respiratory distress and hypoxemia in infants and toddlers who aspirated the salve after it was placed under their nose. In fact, a case published in Chest in 2009 highlighted this very situation, in which a grandmother rubbed Vicks under her toddler grandchild’s nose. The child recovered after hospital observation.¹

The physicians who treated that child then conducted studies in ferrets, whose airways mimic those of humans. Their work found that nasal Vicks exposure induced inflammation and mucus hypersecretion, increasing mucus production 63 percent compared to controls while reducing the function of hair cells in the lining of the airways (cilia) by 35 percent. In other words, it was counterproductive to improving the health of the nose and other air passages.¹

I expect this effect is not unique to Vicks, but could be induced by other volatile aromatics, particularly those that contain menthol. In addition to menthol, Vicks contains turpentine oil, eucalyptus oil, and cedar leaf oil. There is at least one published report of a child who developed contact dermatitis while using the salve, and another of a skin color change in an elderly woman after its use.^2,3

The other potentially harmful household product parents should be aware of is petroleum jelly. Parents often put it in a child’s nose to relieve irritation during cold or allergy season. We also see parents of children who are on oxygen using it to relieve dried mucus inside the nose. However, there have been published case reports of lipoid pneumonia resulting from long-term aspiration of this substance.⁴ Instead, we recommend that parents use an over-the-counter water-based product. These are made by the same companies that make the salt water nasal sprays. 

Bottom line: remind parents that they should check with you before using over-the-counter products, particularly when using them in very young children.

References 

1. Abanses JC, Arina S, Rubin BK. Vicks VapoRub induces mucin secretion, decreases ciliary beat frequency, and increases tracheal mucus transport in the ferret trachea. Chest. 2009;135:143-148.
2. Noiles K, Pratt M. Contact dermatitis to Vicks VapoRub. Dermatitis. 2010 Jun;21(3):167-9.
3. Boyse KE, Zirwas MJ. Chemical Leukoderma Associated with Vicks VapoRub. J Clin Aesthet Dermatol. 2008; 1(4): 34–35.
4. Brown AC, Slocum PC, Putthoff SL, et al. Exogenous lipoid pneumonia due to nasal application of petroleum jelly. Chest. 1994;104:968-969.