My Child Won’t Stop Coughing — Is Vicks VapoRub Safe for Children?

I can’t tell you how many exasperated parents come to the ER in the middle of night because their child won’t stop coughing. Every so often, one child comes in coughing and smelling very distinctly of Vicks VapoRub. The American Academy of Pediatrics tells us that over the counter (OTC) cough suppressants are ineffective and sometimes potentially dangerous. For now I tell parents of children who don’t have asthma that their cough will likely go away in a week or so and, if they are over one year, they can try buckwheat honey as an effective natural cough suppressant.

So is Vicks VapoRub safe for children?

Vicks VapoRub is a topical agent (you apply it to your skin), that contains these active ingredients:

Camphor(synthetic) 4.8% (Cough suppressant and topical analgesic)

Eucalyptus oil 1.2% (Cough suppressant)

Menthol 2.6% (Cough suppressant and topical analgesic).

Vicks also contains these inactive ingredients: cedar leaf oil, nutmeg oil, petrolatum, thymol, turpentine oil.

I will say that I personally am reluctant to apply turpentine or petrolatum to my chest or my child’s chest but let’s discuss the active ingredients.

Camphor; Camphor is an aromatic compound that has been shown to decrease chemically induced cough in guinea pigs. Camphor is also responsible for causing seizures in children. Vicks contains 4.8% camphor which is below the threshold of 11% enforced by the FDA. This means that your child would have to eat a significant amount of Vicks to reach toxic camphor levels (Yuck!).

Menthol; Menthol is the active ingredient in peppermint oil and has many physiologic effects. Menthol is responsible for that cool feeling that you experience when you use Vicks. It tricks your upper airway receptors into thinking that your body is experience a cold sensation and gives the impression of acting as a decongestant. That being said, menthol has no effect on decreasing mucus production. Animal studies in ferrets actually show increased mucus production when exposed to menthol.

Eucalyptus oil smells great. There are no great studies on its role in alleviating cough symptoms.

What’s the Evidence?

A paper published in Pediatrics in 2010 suggests that children ages 2 to 11 years had improved cough symptoms and better sleep than those who had plain petrolatum applied to their chest. While this was a randomized control trial, this study had some issues, namely:

1. the author was funded by Proctor and Gamble who manufactures Vicks VapoRub

2. it was impossible for study subjects not to figure out that they were receiving Vicks since the smell is very distinctive.

In the meantime, I would say Vicks VapoRub is OK to apply to your child’s chest if you are willing to accept the risk of skin irritation, contact dermatitis and nasal irritation. Do not apply Vicks VapoRub near your child’s face. There are cases of kids who suffer real respiratory difficulties when Vicks was applied to the nostrils. Also menthol (found in Vicks) has been associated with respiratory arrest in infants. Vicks VapoRub should not be used in kids under 2 years of age.