Efficacy of a Topical Aromatic Rub (Vicks VapoRub<sup>®</sup>)-Speed of Action of Subjective Nasal Cooling and Relief from Nasal Congestion

Abstract

Vicks VapoRub ® (VVR) is a pharmaceutical preparation containing a combination of levomenthol, eucalyptus oil, turpentine oil and camphor as active ingredients, and thymol, cedarwood oil, and white soft paraffin as excipients. VVR is a petrolatum-based ointment to be either applied topically to the chest, throat, and back or added to hot water and the aromatic vapours inhaled. When used topically, the actives are evaporated by body temperature and inspired. The main therapeutic effects are the feeling of relief from nasal congestion and relief from cough. These were primarily experienced by patients as the trigeminal and olfactory impact of the aromatics and were hypothesized to be experienced within minutes. This was a randomized, single-(Investigator) blind, controlled, 2-arm (VVR vs. petrolatum), parallel design pilot study in 50 otherwise healthy adult patients suffering from common cold and experiencing nasal congestion. Speed to detection of a sensation of nasal cooling and nasal decongestion was assessed following application of the recommended amount of product. The time to first experience of a sensation of nasal cooling was significantly (p < 0.001) faster for patients who received VVR compared to control (median times of 23 and 99 seconds respectively). VVR delivered a statistically significant sensation of nasal cooling at all times from 12 seconds to 15 minutes after product application. The time to first experience of a sensation of nasal decongestion was significantly (p = 0.0102) faster for patients who received VVR compared to control (median times of 62 and 126 seconds respectively). VVR delivered a statistically significant sensation of nasal decongestion at all times from 62 seconds to 15 minutes after product application. No adverse events were reported during the study. Conclusion: Patients using Vicks VapoRub ® as directed experienced significant differences from control for sensation of nasal cooling in 12 seconds and the sensation of nasal decongestion in 62 seconds. R. Eccles et al.

Efficacy of a Topical Aromatic Rub (Vicks VapoRub&lt;sup&gt;&#174;&lt;/sup&gt;) on Effects on Self-Reported and Actigraphically Assessed Aspects of Sleep in Common Cold Patients

“…Recent data suggest that the transient receptor potential receptors TRPM8, TRPV1 and TRPA1 are up-regulated in respiratory virus infected cells [13] [14]. TRPM8 mediates the feeling of coolness associated with menthol and eucalyptus oil [15], [16] and so is likely the main mediator of the sensation of cooling and nasal decongestion associated with menthol and eucalyptus oil [9]. Camphor, eucalyptus oil and menthol have been shown to interact with the TRPV1 and TRPA1 receptors [17] [18] [19] which are implicated in the neurophysiology of cough [13] [14].…”

“…In the UK and many other countries, Vicks VapoRub® (VVR) is indicated for the reduction in cough frequency [8] and feeling of relief from nasal congestion [9]. As cough and nasal congestion (regardless of aetiology) are recognised barriers to restful and restorative sleep [10], [11], [12], their relief using a topical ointment like VVR can be predicted to improve elements of sleep quality.…”

Aromatic ointments for the common cold: what does the science say?

“…A randomized, single-blind (investigator), controlled, two-arm, parallel design pilot study assessing an aromatic ointment containing levomenthol, eucalyptus oil and camphor versus petrolatum was conducted to detect the sensation of nasal cooling and nasal decongestion in 50 otherwise healthy adult patients who were suffering from common cold with nasal congestion. 62 There was a significantly faster time to the first sensation of nasal cooling for patients who received the ointment compared with control ( p <0.01), which remained statistically significant at all times from 12 seconds to 15 minutes after application of the product. Furthermore, the time to the first sensation of nasal decongestion was also significantly faster for patients who received the ointment compared to control ( p <0.05), which remained statistically significant at all times from 62 seconds to 15 minutes after application of the product.…”

“… 71 In addition, proprietary preparations of aromatic ointments that contain menthol, eucalyptus oil and camphor have been assessed in well-conducted clinical trials, demonstrating clear beneficial effects in the alleviation of localized cold symptoms, including the sensation of nasal congestion, nocturnal cough and cold-associated associated sleep difficulties, whilst having no impact on objective measurements. 57 , 62 , 71 …”

“…58,59 The cooling sensation associated with menthol and eucalyptus oil is mediated by TRPM8, 60,61 making this receptor the primary candidate for the sensation of nasal decongestion associated with menthol and eucalyptus oil. 62 The TRPV1 and TRPA1 receptors, which are expressed in the larynx and involved in triggering cough, 58,59 interact with menthol, eucalyptus oil and camphor, [63][64][65] suggesting they may have a role in the mitigation of cough sensitivity reported for these aromatics.…”