21st Century Children’s Vapor Balm

21st Century Children’s Vapor Balm is a topical aromatic balm formulated for use on a child’s skin, and it is supplied in a 38 g pack. Its active ingredient is menthol crystal at 2.8%, combined with eucalyptus oil in a semi-solid balm base that is rubbed onto the skin. According to the product information, this balm is camphor-free, which sets it apart from many traditional vapour rubs that rely on camphor as a main ingredient.

Menthol and eucalyptus oil are volatile aromatic ingredients, which means they release a strong, cooling scent that is noticeable within moments of application. The balm is meant for external use on the chest, neck and back of children, and it should never be swallowed, applied inside the nostrils or placed under the nose of a young child. Strongly aromatic products can be irritating to the airways of babies and small children, which is why the age shown on the pack label and the advice of a pharmacist are especially important.

The balm is a small, portable pack that can be kept in a bedside drawer or a family medicine box, and it is generally described as having a mild, pleasant scent. The full list of the base ingredients is printed on the carton, so parents of children with sensitive skin or known fragrance allergies should read it before use. As with all OTC products, keep the balm out of reach of children, and speak to a pharmacist or doctor if you are unsure about using it on a baby, on a child with asthma or eczema, or alongside other medicines.

21st Century Children’s Vapor Balm is for external use on the skin only. Wash your hands before and after applying, and keep the balm away from the eyes, mouth, nostrils and broken skin.

• Apply a small amount, spread as a thin layer, on the chest, neck or back of the child, and rub gently into the skin.
• Use 2 to 3 times daily, or as directed on the pack label or by a doctor or pharmacist.
• Do not apply on the face or under the nose of babies and young children, and do not put the balm inside the nostrils.
• Do not heat the balm, add it to hot water, or place it in a microwave, and do not cover the treated area tightly with bandages.
• Do not apply on skin that is cut, scratched, burnt, sunburnt or affected by rash or eczema.
• Seal the cap tightly after use, and keep the pack out of the reach of children so that it cannot be eaten or applied by the child alone.

The usual label directions are to apply a small amount of the balm 2 to 3 times daily on the chest, neck or back.

• Children: a small amount as a thin layer, 2 to 3 times a day, applied by an adult.
• Infants and very young children: speak to a doctor or pharmacist before use. Strongly aromatic products are not generally recommended for infants under 2 years unless advised by a healthcare professional.
• Missed application: apply it when needed, and do not apply extra to make up for a missed one.
• Duration: use for the shortest time needed. If symptoms continue or worsen, stop and speak to a doctor.
• Accidental swallowing or eye contact: do not induce vomiting; rinse the eyes thoroughly with clean water and contact a doctor or poison centre immediately.

Store at room temperature in a cool, dry place, away from direct sunlight and heat sources. Keep the cap tightly closed, and keep the pack out of the sight and reach of children.

• Common: Mild skin redness, warmth or tingling at the application site, which usually fades soon after application.
• Common: Mild skin irritation, dryness or rash in children with sensitive skin.
• Uncommon: Watery eyes or a stinging sensation if the balm or its vapour gets near the eyes.
• Serious: Breathing difficulty, wheezing, coughing fits or choking sensations after application, particularly in babies, young children or those with asthma, because menthol and eucalyptus vapours can trigger airway spasm; remove the balm, get fresh air and seek urgent medical help.
• Serious: Severe allergic reaction with hives, facial swelling or difficulty breathing needs emergency care.
• Serious: Swallowing the balm can cause vomiting, drowsiness, confusion or seizures, particularly with eucalyptus oil, and requires immediate medical attention or a call to a poison centre.

• Known hypersensitivity (allergy) to menthol, eucalyptus oil or any other ingredient in the balm.
• Application to broken, burnt, irritated or inflamed skin, or on skin affected by eczema or rash.
• Application inside the nostrils, on or around the eyes, or on mucous membranes.
• Application to the face or nose area of babies and very young children.
• Use in infants under 2 years of age unless advised by a doctor or pharmacist.

• Other topical products: Avoid applying other creams, ointments or medicated rubs on the same area at the same time without advice from a pharmacist, as this can increase irritation or absorption.
• Heat sources: Do not use heating pads, hot water bottles or very warm bandages over the balm, because heat increases absorption through the skin and may cause burns or irritation.
• Systemic medicines: No significant interactions with oral medicines are expected from normal external use on small areas of intact skin.
• Other aromatic products: Using other strongly aromatic oils or vapour products on the child at the same time may add up to an intense exposure to menthol and essential oils, so avoid combining them.
• Food and drink: No food or drink interactions are known.

• Always wash your own hands before and after applying, so that the balm is not accidentally rubbed into the child’s eyes or mouth.
• Check the age shown on the pack, and ask a pharmacist before using the balm on babies or on children who have asthma or eczema.
• Keep the balm away from the face of a small child, because menthol vapour held close to the nose can be uncomfortable or irritating to the airways.
• Choose loose, breathable clothing over the treated area, and avoid tight wraps or hot compresses.
• Store the pack where children cannot reach it, as the pleasant smell and the soft texture can attract them to taste it.
• Make a note of the date you open the pack and check the expiry date, and replace it if the smell or texture has changed.

Precautions: Speak to a doctor or pharmacist before using the balm on infants, on children with asthma, eczema or a history of seizures, or on children who are taking other medicines. Menthol and eucalyptus vapours can cause breathing problems in some babies and small children, so do not apply the balm on or near the face. Avoid contact with the eyes, mouth, nostrils and broken skin, and avoid heat or tight coverings over the treated area. Do a small test patch on a limited skin area first if the child has sensitive skin or allergies, and stop if redness, itching or rash develops.

When to See a Doctor or Pharmacist: Stop using the balm and see a doctor if the skin becomes red, itchy or blistered, or if the child develops wheezing, noisy breathing or a persistent cough after application. Seek emergency care straight away for difficulty breathing, blue lips, swelling of the face, or if the balm has been swallowed or has entered the eyes. See a doctor if the child’s symptoms last longer than a few days, if the child is very young, or if the child has a high temperature, is unusually drowsy or is feeding poorly.