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Benzoin - Some Benefits on Usage of Benzoin

Taxonomic Class

Styracaceae

Common Trade Names

Multi-ingredient preparations: Balsam of the Holy Victorious Knight, Friar's Balsam, Jerusalem Balsam, Pfeiffer's Cold Sore Preparation, Turlington's Balsam Of Life, Ward's Balsam

Common Forms

Available as compound benzoin tincture USP, which contains 10% benzoin, 2% aloe, 8% storax, 4% tolu balsam, and 75% to 83% alcohol. Benzoin is also an ingredient in cold sore creams, lotions, and ointments.

Source

Benzoin is a balsamic resin usually obtained by wounding the bark of Styrax benzoin trees that are at least 7 years old. It can also be obtained from the bark of Styrax paralleloneurus and Styrax tonkinensis.

Chemical Components

Sumatra benzoin (S. benzoin) is composed primarily of benzoic and cinnamic acids and their esters. It also contains small quantities of benzaldehyde, phenylpropyl cinnamate and benzyl cinnamate, styracin, styrene, and vanillin. Sumatra benzoin yields at least 75% of alcohol soluble extract; Siam benzoin (S. tonkinensis) yields at least 90%. In the United States, either extract can be used in compound benzoin tincture.

Actions

Benzoin tinctures possess mild bactericidal properties, but the efficacy and spectrum of these properties are poorly described. Benzoin, which has a characteristic balsamic aroma, also has adhesive properties and mucosal protectant activity.

Reported Uses

Benzoin has been used for more than 100 years, but most uses are anecdotal and have not been systematically studied. The agent has been applied topically as an antiseptic and a wound adhesive. A comparative trial of compound benzoin tincture and gum mastic found mastic to be a superior wound adhesive that was better tolerated than benzoin tincture . Benzoin tincture has been painted on the skin before applying adhesive tape for supportive dressings.

The American Dental Association accepts benzoin tincture as a topical mucosal protectant and for symptomatic relief of pain from canker sores, gingivitis, and oral herpetic lesions .

Benzoin has been used in cough and cold products for its claimed expectorant properties. Compound benzoin tincture has been added to hot water to create a volatile steam inhalation, but this may be no more effective than unmedicated water vapor .

Dosage

For mucosal protection, in adults and children older than age 6 months, a few drops applied topically no more than once every 2 hours. The tincture should be used in infants only under medical supervision.

For steam inhalation, about 5 ml of compound benzoin tincture added to 1 pt of hot water. Alternatively, place the tincture on a handkerchief for inhalation.

Adverse Reactions

  • GI: gastritis, GI hemorrhage if ingested .

  • Respiratory: asthma (inhalation).

  • Skin: contact dermatitis, urticaria.

  • Other: allergic reactions.

Interactions

None reported.

Contraindications And Precautions

Inhalation of benzoin products is contraindicated in patients with reactive airway diseases, such as asthma. Benzoin is toxic if taken internally. Use products that contain benzoin cautiously in atopic patients or in those who are prone to contact dermatitis.

Special Considerations

Monitor closely for gastritis and GI hemorrhage in patients taking benzoin internally. Advise against oral consumption.

Monitor use of benzoin in infants closely.

Alert Observe for signs and symptoms of allergic reaction, particularly in atopic patients.

Inform the patient that topical use can discolor the skin and cause contact dermatitis.

Advise the patient with asthma, atopy, or contact dermatitis to avoid using benzoin.

Inform the patient that volatile steam inhalation of benzoin is not effective; unmedicated water vapor may be used instead.

Commentary

Most clinical data regarding the use of benzoin products come from case reports and a long history of use in numerous specialities. As a wound adhesive, alternative products are superior to benzoin . As a skin and mucosal protectant, other agents are at least as effective as benzoin and cause fewer allergic reactions . The inhalation of compound benzoin tincture has been used for many years but has never been systematically studied. Inhaled steam is probably at least as effective . Antiseptics with extensively studied effectiveness are preferred over benzoin tinctures. Health care providers should be aware of the potential risk of allergic reactions, especially in atopic patients.

   

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