Cold Medication—New thoughts about Vapor Rub

January 3, 2011

As many of our parents know, we do not routinely suggest use of over the counter (OTC) cough and cold medications.  Many well designed scientific studies have suggested that they offer little if any benefit and the side effects frequently cancel out any potential positive effects.  Remedies that are very safe and have some benefit include:

1. Saline (salt water) over-the-counter (OTC) nose drops with gentle bulb syringe nasal suction
2. Sinus irrigation for selected children using a Neti-Pot or squeeze bottle
3. Cool mist vaporizer
4. Honey and lemon home made cough and cold syrup using one teaspoon of honey with 3 drops of lemon juice for children over age 1
5. PURE maple syrup and lemon juice as above for children under age one
6. Supervision of the child in a steamed bathroom

For many years we have not recommended vapor rub products (topical products containing menthol, camphor, and eucalyptus oils).  These products were thought to be of doubtful value, could cause significant respiratory irritation and could be a problem if ingested.  A study performed by pediatricians at Penn State in the December 20, 2010 issue of “Pediatrics” suggests that we should reconsider our position.  These researchers found that cough frequency and sleep time were significantly improved in Vapor Rub treated children when compared to no treatment or Vaseline treatment.  They did not see a significant improvement in cough severity or runny nose symptoms.  As expected, parents did notice more irritation in the Vapor Rub treated children (rash, eye, skin and nose burning sensation). 

The dose of Vapor Rub was one teaspoon massaged for one minute to the shoulder, neck, and “mustache” area of the face for 2-5 year old children.  Two teaspoons could be used for the 6-11 year old child.  REMEMBER:  Eating this product can be dangerous!!!  It should be used as a rub only.  Use is not recommended under age 2.