Camphor

Camphor is the sharp-smelling white compound in chest rubs, muscle balms and anti-itch creams — first distilled from the wood of the camphor laurel tree, and today mostly made synthetically from turpentine. On the skin it does something real but modest: it switches on the skin’s sensors for cold and warmth, and in a 2010 randomized trial parents rated a camphor-menthol-eucalyptus chest rub better than petroleum jelly for one night of their child’s cold-related cough and sleep. Swallowed, camphor is a poison that causes seizures — in young children, about 500 mg, the camphor in a single teaspoon of a 10% liquid, has been linked to deaths — so this page puts safety first: outside of the body only, never by mouth, never in or under a child’s nose, and never on broken skin.


Table of Contents

  1. First, the Safety Facts
  2. What Camphor Is
  3. Traditional, Ritual & Historical Use
  4. How It Works on the Skin: Cool, Then Warm
  5. Chest Rubs for Cough and Congestion
  6. Muscle Aches, Joint Pain & Itch
  7. US Rules: The 11% Ceiling & the Camphorated-Oil Ban
  8. How to Use Camphor Products Sensibly
  9. Myths & Overclaims
  10. Safety: Poisoning, Who Should Avoid It & What to Do
  11. Key Research Papers
  12. Connections
  13. Featured Videos

First, the Safety Facts

Camphor rubs sit in almost every pharmacy, and camphor tablets and blocks are sold in many grocery and religious-goods shops, so it is easy to forget that camphor is one of the classic household poisons of early childhood. Six facts matter more than anything else on this page:

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What Camphor Is

Camphor is a single small molecule — a terpene ketone with the formula C₁₀H₁₆O, ten carbon atoms folded into a compact double ring. It is a waxy white or see-through solid with an unmistakable smell. At room temperature it slowly turns straight from solid into vapour (which is why a camphor block shrinks in a drawer), and it barely dissolves in water but dissolves readily in alcohol and other solvents (Chen 2013). That is why camphor comes in ointments, oils, gels and alcohol-based liniments rather than in watery solutions.

Where it comes from. Natural camphor is distilled from the wood of the camphor laurel (Cinnamomum camphora), a large evergreen native to Japan, Taiwan and China; every part of the tree carries the smell (Chen 2013). Most camphor today, though, is synthetic. Manufacturers start from alpha-pinene, obtained from turpentine oil, and convert it to camphor in several chemical steps; PubChem’s hazardous-substances record describes camphor as “primarily manufactured from pinene” (PubChem: Camphor). Natural camphor is one mirror-image form of the molecule, while the synthetic route produces a 50:50 mix of both forms; how that difference affects biological activity has not been worked out (Chen 2013). For safety purposes, treat them the same: the poison-centre guideline makes no distinction between natural and synthetic camphor.

It is also in common herbs. Camphor is a major component of the essential oils of many aromatic plants. The way plants build it was worked out in garden sage (Salvia officinalis), and some rosemary and sage oils are dominated by camphor (Chen 2013). A pinch of dried rosemary or sage in the cooking pot is a very different thing from a concentrated essential oil; it is the oils that deserve the same caution as any camphor product around children.

What you will find it in. In US pharmacies camphor comes at set strengths (details in US Rules): chest rubs for coughs (about 5% camphor, often combined with menthol and eucalyptus oil), muscle and joint balms (more than 3% and up to 11%), numbing and anti-itch lotions (0.1% to 3%), liquids for hot-steam vaporizers (6.2%), and some cold-sore preparations (Love 2004). Outside pharmacies it is sold as solid tablets, cubes and blocks for religious rituals and for keeping moths out of stored clothes — concentrated camphor with none of the dilution of an ointment.

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Traditional, Ritual & Historical Use

Camphor is one of the oldest traded aromatics. A 2013 review traces it as a coveted fragrant wood in ancient Egypt and Babylon, an ingredient in perfumes and embalming fluids, and a fumigant during the Black Death in 14th-century Europe and later during smallpox and cholera outbreaks; rosewater mixed with camphor was sprinkled over the dead before shrouding (Chen 2013).

The long history reflects effects people could genuinely feel on the skin. The rest of this page sorts those real effects from the claims — and from the dangers.

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How It Works on the Skin: Cool, Then Warm

Camphor belongs to a group of medicines the FDA calls counter-irritants: products applied to the skin that cause “irritation or mild inflammation of the skin” in order to relieve aches in muscles and joints (definition in FDA’s 1983 proposed rules for external pain relievers, 48 FR 5852). The old explanation was simply that one sensation distracts from another. Research since 2005 has identified the actual switches camphor flips — a family of temperature-sensing ion channels in the skin and its nerve endings called TRP channels.

What happens in real people. In a small laboratory study, nine adults had petroleum jelly containing 5%, 10% or 20% camphor spread on the forearm. Every strength produced an immediate cold feeling — stronger at higher strengths — that faded within about 10 minutes and was replaced by warmth. Menthol at 2%, by contrast, stayed cold and never turned warm. Both camphor and menthol increased blood flow in the skin and in the muscle beneath it (Kotaka 2014). That matches what people describe — cool, then warm — and it is where the “improves circulation” claim comes from. It shows a sensation and a local blood-flow change in nine people; it does not show that pain eases or injuries heal faster.

In the nose. Breathing camphor, menthol or eucalyptus vapour for five minutes did not change the actual resistance to airflow through volunteers’ noses, yet most felt a cold sensation and reported that air seemed to flow more freely (Burrow 1983). The “opened-up” feeling is real as a sensation — camphor stimulates cold receptors in the nose — but it is not a physically clearer airway. In guinea pigs, breathing camphor vapour at the highest concentration tested cut cough frequency by about a third, an animal finding summarised in Chen 2013.

Evidence tier: the receptor findings are cell and animal studies; the cool-then-warm sensation and the nasal sensation come from small human laboratory studies. They explain why camphor feels the way it does. They are not clinical trials of treatment.

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Chest Rubs for Cough and Congestion

The strongest human study of a camphor product we found is a 2010 randomized trial of a chest rub for children, published in Pediatrics (Paul 2010).

How much weight to put on it. This was one night, in one study, with parents rather than a measuring device judging the result. Blinding was hard: parents in both ointment groups dabbed the camphor rub under their own noses so the smell would not reveal which ointment their child got, yet 86% of parents in the rub group and 89% in the petroleum-jelly group correctly guessed what their child had received. The study was funded partly by an unrestricted grant from the rub’s manufacturer and partly by the US National Institutes of Health. And because the rub contained three active ingredients, it cannot say how much of the effect came from camphor rather than menthol or eucalyptus oil. The fair summary is modest, short-term relief of night-time symptoms, as rated by parents, in children aged 2 and older. A rub eases how the night feels; it does not treat the virus. (Evidence tier: one randomized trial in humans.)

Children under 2. The trial did not include them, US labels tell parents to ask a doctor first, and the case reports in the safety sections involve babies and toddlers. For an infant, skip camphor entirely. For children over 1, honey has its own evidence for night-time cough (see Honey as a Cough Suppressant); honey must never be given to babies under 1. For the bigger picture see Common Cold, Chronic Cough and Cold and Flu Natural Treatments.

Using a chest rub as labelled. US directions for camphor chest ointments (4.7% to 5.3% camphor) are: adults and children 2 and older, rub a thick layer on the throat and chest, cover with a warm, dry cloth if desired, keep clothing loose so the vapour reaches the nose and mouth, and use up to three times a day (21 CFR 341.74). Never put it in or under the nose, and never heat it.

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Muscle Aches, Joint Pain & Itch

Muscle and joint rubs. Camphor at more than 3% and up to 11% is the classic cooling counter-irritant in balms and liniments. FDA’s 1983 proposal describes such products as being “for the temporary relief of minor aches and pains of muscles and joints” associated with simple backache, arthritis, strains, bruises and sprains, and allows camphor to be combined with menthol and other counter-irritants (48 FR 5852).

The trial evidence is thin. The one randomized trial of a camphor-containing cream for joint pain that we found tested a mixture: 63 people with knee osteoarthritis used either a cream containing glucosamine, chondroitin and camphor or a placebo cream, as needed, for 8 weeks. On a visual pain scale measured in centimetres, pain fell by an average of 3.4 cm with the active cream and 1.6 cm with placebo — a difference of 1.8 cm at 8 weeks (Cohen 2003). The authors credited the glucosamine and chondroitin. The published summary does not say whether the placebo cream also contained camphor, so the trial cannot tell us how much of the benefit, if any, came from camphor. (Evidence tier: one small randomized trial of a combination product.)

A 2023 review of camphor- and menthol-containing products found only 15 clinically relevant human studies published between 2010 and 2022. Its authors judged these products “potentially effective” for pain, cold symptoms and itch, but concluded that with so few studies “no definitive recommendation can be made” (Hoang 2023). An earlier emergency-medicine review was blunter, calling camphor’s efficacy in these products “largely unproven” (Love 2004). For approaches that do not rest on a single ingredient, see Pain Management Without a Prescription Pad and Osteoarthritis.

Itch. At lower strengths — 0.1% to 3% — the same 1983 proposal lists camphor as a pain-relieving, numbing and anti-itch ingredient for the temporary relief of pain or itching from problems such as minor skin irritations, insect bites and sunburn, and US rules for hemorrhoid products list camphor, at the same 0.1% to 3% and for external use only, among their pain-relieving, numbing and anti-itch ingredients (21 CFR 346.16). The cooling it produces through TRPM8 is a plausible reason it can take the edge off an itch, but modern trials are scarce (Hoang 2023). It is a comfort measure, not a treatment for the cause — see Itching (Pruritus) for what drives persistent itch. (Evidence tier: regulatory recognition based on older data, plus mechanism; few modern trials.)

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US Rules: The 11% Ceiling & the Camphorated-Oil Ban

Camphorated oil came off the market in 1982. For generations US pharmacies sold camphorated oil, or camphor liniment: 20% camphor dissolved in cottonseed oil, used as a counter-irritant rub. It looked like other household oils, and people kept swallowing it by mistake. When FDA acted, poison-control statistics showed 836 accidental ingestions of camphorated oil from 1974 to 1979 alone. In 32 poisonings where the cause was known, 28 came from confusing it with another product — 20 of them with castor oil — and it had also been mistaken for cod-liver oil, mineral oil, olive oil and cough medicine. Warning labels had not stopped the mix-ups. On 21 September 1982 FDA ruled that any camphorated oil product is misbranded and a “new drug” that may not be sold without an approved application, and asked firms to recall it to the retail level (47 FR 41716). That status stands today (21 CFR 310.502), and camphorated oil is on FDA’s list of drug products withdrawn for reasons of safety or effectiveness (21 CFR 216.24).

Where the 11% ceiling comes from. FDA’s expert panel on topical pain relievers concluded in 1979 that camphor at 3% to 11% is safe and effective as a counter-irritant and recommended that such products contain no more than 11% (as summarised in the 1982 rule). FDA’s 1983 proposal adopted that line — camphor 0.1% to 3% as a pain-relieving, numbing and anti-itch ingredient, and “exceeding 3 percent to 11 percent” as a cooling counter-irritant — stating that “the camphor concentration is being limited to 11 percent or lower” (48 FR 5852). The cough-and-cold rules set chest ointments at 4.7% to 5.3% camphor and hot-steam vaporizer liquids at 6.2% (21 CFR 341.74). None of these US over-the-counter standards allows more than 11%.

Required warnings. Camphor chest rubs must state “For external use only. Do not take by mouth or place in nostrils.” Depending on the formula, the label must also warn not to heat or microwave the ointment or add it to hot water, because it “may cause splattering and result in burns,” and flammable versions must say “Keep away from fire or flame” (21 CFR 341.74). In 1983 FDA also urged makers of liquid camphor products to use child-resistant packaging.

The riskiest products sit outside this system. Camphor sold for pest control must be registered with the US Environmental Protection Agency, yet many imported camphor products fail FDA and EPA requirements for labeling and content. Illegally sold imported camphor was behind the cluster of toddler seizures reported from the Bronx, New York, in 2009; the New York City health department then warned families to keep camphor products away from children, and other state health departments followed (Khine 2009). If a camphor product carries no label you can read, no stated strength and no warnings, do not bring it into a home with young children.

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How to Use Camphor Products Sensibly

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Myths & Overclaims

Popular videos promise a long list of camphor “uses and benefits.” Here is what the evidence says about the most common ones.

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Safety: Poisoning, Who Should Avoid It & What to Do

How common poisoning is

Camphor is a routine call for poison centres. US national data from 1990 to 2003 showed roughly 10,000 swallowed exposures to camphor-containing products every year (Manoguerra 2006). Most turn out mild — in 2001, for example, 89 of 8,505 reported camphor exposures had moderate or severe outcomes and none was fatal (poison-centre data summarised in Chen 2013) — but the serious cases are serious, and young children are especially vulnerable because small amounts can harm them (Love 2004).

What it does, and how little it takes

Camphor acts on the brain. Poisoning brings nausea, vomiting, headache, dizziness, muscle twitching and tremor, confusion or delirium, and seizures; a severe overdose can cause hours of continuous seizures, coma and death from suffocation (Chen 2013).

Not only by mouth

Who should avoid camphor

What to do

These steps follow the American Association of Poison Control Centers guideline (Manoguerra 2006):

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Key Research Papers

  1. Chen W, Vermaak I, Viljoen A (2013). Camphor—a fumigant during the Black Death and a coveted fragrant wood in ancient Egypt and Babylon—a review. Molecules. — PubMed PMID: 23666009
  2. Moqrich A, Hwang SW, Earley TJ, Petrus MJ, Murray AN, Spencer KS, et al. (2005). Impaired thermosensation in mice lacking TRPV3, a heat and camphor sensor in the skin. Science. — PubMed PMID: 15746429
  3. Xu H, Blair NT, Clapham DE (2005). Camphor activates and strongly desensitizes the transient receptor potential vanilloid subtype 1 channel in a vanilloid-independent mechanism. The Journal of Neuroscience. — PubMed PMID: 16192383
  4. Selescu T, Ciobanu AC, Dobre C, Reid G, Babes A (2013). Camphor activates and sensitizes transient receptor potential melastatin 8 (TRPM8) to cooling and icilin. Chemical Senses. — PubMed PMID: 23828908
  5. Kotaka T, Kimura S, Kashiwayanagi M, Iwamoto J (2014). Camphor induces cold and warm sensations with increases in skin and muscle blood flow in human. Biological & Pharmaceutical Bulletin. — PubMed PMID: 25451841
  6. Burrow A, Eccles R, Jones AS (1983). The effects of camphor, eucalyptus and menthol vapour on nasal resistance to airflow and nasal sensation. Acta Oto-Laryngologica. — PubMed PMID: 6613544
  7. Paul IM, Beiler JS, King TS, Clapp ER, Vallati J, Berlin CM Jr (2010). Vapor rub, petrolatum, and no treatment for children with nocturnal cough and cold symptoms. Pediatrics. — PubMed PMID: 21059712
  8. Cohen M, Wolfe R, Mai T, Lewis D (2003). A randomized, double blind, placebo controlled trial of a topical cream containing glucosamine sulfate, chondroitin sulfate, and camphor for osteoarthritis of the knee. The Journal of Rheumatology. — PubMed PMID: 12610812
  9. Hoang D, Wong A, Olympia RP (2023). Looking back to move forward: the current state of research on the clinical applications of camphor- and menthol-containing agents. Cureus. — PubMed PMID: 37546095
  10. Derby R, Rohal P, Jackson C, Beutler A, Olsen C (2011). Novel treatment of onychomycosis using over-the-counter mentholated ointment: a clinical case series. Journal of the American Board of Family Medicine. — PubMed PMID: 21209346
  11. Manoguerra AS, Erdman AR, Wax PM, Nelson LS, Caravati EM, Cobaugh DJ, et al.; American Association of Poison Control Centers (2006). Camphor poisoning: an evidence-based practice guideline for out-of-hospital management. Clinical Toxicology. — PubMed PMID: 16809137
  12. Love JN, Sammon M, Smereck J (2004). Are one or two dangerous? Camphor exposure in toddlers. The Journal of Emergency Medicine. — PubMed PMID: 15219304
  13. Khine H, Weiss D, Graber N, Hoffman RS, Esteban-Cruciani N, Avner JR (2009). A cluster of children with seizures caused by camphor poisoning. Pediatrics. — PubMed PMID: 19403490
  14. Uc A, Bishop WP, Sanders KD (2000). Camphor hepatotoxicity. Southern Medical Journal. — PubMed PMID: 10881777

PubMed Topic Searches

  1. PubMed: Camphor poisoning in children
  2. PubMed: Camphor and TRP channels
  3. PubMed: Topical camphor and menthol trials

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Connections

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