Peru Balsam

Generic name: Myroxylon Balsamum (L.) Harms Var. Pereirae (Royle) Harms.
Brand names: Balsam Of Peru, Balsamo Blanco, Baumier Du Perou, Black Balsam, Indian Balsam, Peru Balsam, Perubalsambaum, Peruvian Balsam

Usage of Peru Balsam

Wound healing

Animal data

Combined with zinc oxide and bismuth oxide, Peru balsam was used in the management of a wound following the removal of squamous cell carcinoma in a white rhinoceros.Goodman 2007

Clinical data

Studies have evaluated the use of Peru balsam as a treatment of partial-thickness wounds. Some benefit has been shown for the use of a castor oil–balsam of Peru–trypsin ointment as treatment for skin graft donor sites, moist desquamation after radiation, wound care after tissue debridement, and skin tissue damage from heparin-induced thrombocytopenia, but only in small studies or case reports.Beitz 2005, Carson 2003, Glenn 2006, Gray 2004, McDougall 2005, Thomas 2008

Other

Antimicrobial properties have been described for the balsam, and applications such as use against mosquito larvae and pathogenic bacteria have been investigated.de Barros Machado 2005, Seo 2012

Peru Balsam side effects

Peru balsam is a contact allergen, and contact dermatitis occurs frequently with the product.Balato 2011, Krob 2004, Nijhawan 2009, Thyssen 2009 In a systematic review of 34 studies covering a 15-year period, it was found to be among the top 10 most common allergens in adolescents and a less common antigen in children. Equivocal data prevented an association being made with atopic vs non-atopic individuals.Rodrigues 2016 It may cause dermatitis in individuals who have a sensitivity to benzoin resinoids. The main contact sensitizers in Peru balsam have been identified and include cinnamates, benzoates, and terpenoids. Additional patch testing is recommended in Peru balsam–sensitive individuals to trace the origins of sensitization.Hausen 2001, Srivastava 2009 As a basic screening tool to improve detection and management of allergic contact eyelid dermatitis cases, balsam of Peru 25% in petrolatum has been recommended as a standard patch-test component based on data supporting its high frequency as a relevant antigen.Herro 2012

The importance of recognizing food items that contain balsam of Peru-associated constituents was highlighted in a case series of 7 children with systemic manifestations of recalcitrant dermatitis. Thorough questioning revealed that all 7 patients had significant ketchup intake (from daily to 3 times/week). Instituting a low balsam of Peru diet that included avoidance of ketchup achieved 80% improvement in 5 of the 7 children, 70% in the 6th child, and 60% improvement in the 7th. Cross-reactivity with food sources that naturally contain chemicals similar to the volatile oils and resins in balsam of Peru include orange peel, clove, and tomatoes. The 5 foods listed on the avoidance list for the low balsam of Peru diet were tomatoes and tomato-containing products, peels of citrus fruits, chocolate, cola and spiced sodas, and cinnamon, cloves, and vanilla.Herro 2013 Similarly, initiation of a low balsam of Peru diet improved pruritic allergic dermatitis symptoms in a 48-year-old man within 1 month of dietary changes, which was sustained for several months.Nanda 2016 Cases of cheilitis and perioral dermatitis have been reported in 2 individuals who used Lucas Papaw ointment, which included small amounts of Myroxylon pereirae that was not listed as an ingredient on the labeling but was later confirmed by the manufacturer.Tan 2011

Before taking Peru Balsam

Information regarding safety and efficacy in pregnancy and lactation is lacking. Systemic toxicity following application of Peru balsam to the nipples of breast-feeding mothers has been reported.Duke 2002

How to use Peru Balsam

Peru balsam has been used topically in 5% to 20% formulations for wounds and burns; however, there are no recent, well-controlled clinical studies to support appropriate dosing. Use of the balsam is documented in the Complete German Commission E Monographs for poorly healing wounds, burns, frostbite, bruises, and hemorrhoids.Blumenthal 2000

Warnings

Information is lacking.

What other drugs will affect Peru Balsam

None well documented.

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