Does vapor rub help a stuffy nose at night?

Vapor rub can make a stuffy nose feel clearer at night, and for many people that feeling is enough to help them settle. The studies are consistent on one point, though: menthol and camphor change how airflow feels, not how much air actually gets through. Used on the chest as the label directs, a rub is a reasonable comfort measure for adults and children 2 and older. It should never go in or under the nose, and it should never be swallowed.

What's in a vapor rub?

A vapor rub is an ointment that usually combines camphor, menthol and eucalyptus oil in a petroleum jelly base. A typical generic chest rub label lists 4.8% camphor, 2.6% menthol and 1.2% eucalyptus oil, and describes all three as cough suppressants. Its stated use is to relieve cough from minor throat and bronchial irritation with a cold.

Notice what the label doesn't say. Nasal congestion isn't listed as a use. The directions are to rub a thick layer on the throat and chest, keep clothing loose so the vapors can reach the nose and mouth, and use it up to three times a day. People use it for a blocked nose because of how the vapor feels when you breathe it in.

Does vapor rub open a stuffy nose?

Vapor rub doesn't measurably open a stuffy nose, but it does make breathing through one feel easier. Researchers have tested this by measuring nasal resistance, the physical effort air needs to pass through the nose, alongside how open the nose feels to the person breathing. The two results come apart every time.

The first clear test was in 1983. Volunteers breathed camphor, eucalyptus or menthol vapor for five minutes. None of the three changed nasal resistance to airflow, yet most people reported a cold sensation in the nose and the feeling that air was moving more freely. The authors concluded that all three stimulate cold receptors in the nose.

A 1990 trial looked at people who actually had colds. Sixty-two people with congestion took either an 11 mg menthol lozenge or a plain candy lozenge. Measured nasal resistance rose a little in both groups over two hours, with no difference between them. But the menthol group reported a marked improvement in the sensation of nasal airflow within 10 minutes, and the placebo group didn't.

A 2008 study in Germany repeated the idea with 18 healthy adults inhaling menthol vapor. It found no change in nasal airflow or in the temperature of the nasal lining. Even so, 16 of the 18 said their nasal breathing felt better afterward.

So the honest summary is that a rub is a sensation, not a decongestant. That doesn't make it pointless. If you're lying awake with a blocked nose, feeling like you can breathe can help you relax. It just won't shrink swollen tissue inside the nose.

What did the children's vapor rub study find?

The best-known study of vapor rub and sleep is a 2010 trial in children published in Pediatrics. It enrolled 138 children aged 2 to 11 with cold symptoms and nighttime cough. Parents were randomly assigned to put a vapor rub or plain petrolatum on their child's chest and neck at bedtime, or to use nothing.

On the night after treatment, parents rated the vapor rub best for cough, congestion and sleep difficulty, and no treatment worst. The rub beat no treatment on every outcome except runny nose, and it beat petrolatum on cough severity, sleep difficulty for both child and parent, and the combined symptom score. Petrolatum on its own wasn't significantly better than no treatment for anything.

There are limits worth knowing. The results came from parent surveys after a single night, and the authors noted that parents whose children felt burning were likely to guess which ointment they'd been given. The study was supported by an unrestricted grant from the company that makes the rub tested, along with NIH research grants. Even with those caveats, it's one of the few controlled trials showing a home remedy helped children and parents sleep better on a sick night.

The study also recorded side effects. Parents of 28% of children given the rub reported a burning feeling on the skin, 16% reported burning in the eyes and 14% in the nose. Nobody in the other two groups had these. The authors described them as mild irritant effects.

Is vapor rub safe for children?

Vapor rub is labeled for adults and children 2 years and over, and labels say not to use it on children under 2. The 2010 study only included children 2 and older, and its authors noted that serious problems such as seizures linked to skin exposure have mostly been reported in young infants, for whom the rub isn't recommended. The trial also excluded children with seizure disorders because of camphor's link to seizures.

NCCIH gives a related warning about menthol in general. It says menthol should not be inhaled by or applied to the face of an infant or small child, because it may affect their breathing. For a baby with a blocked nose, ask your pediatrician what to use instead.

If your child often breathes through their mouth at night even when they're well, that's worth raising with a doctor. Our article on mouth breathing in children explains why, and nasal strips for kids covers what's known about strips for younger sleepers.

Why shouldn't vapor rub go in or under your nose?

Chest rub labels say not to use the product in the nostrils, by mouth, on wounds or damaged skin, or under tight bandages, and to avoid contact with the eyes. Rubbing it under the nose puts a strong ointment right at the nostril edge, close to the eyes and mouth. Even on the chest and neck, some children in the 2010 trial felt burning in the nose and eyes.

The same label has a warning that surprises people: don't heat the rub, microwave it or add it to hot water, because it can splatter and cause burns. Cleveland Clinic also advises against putting decongestant rubs into a humidifier, since they can damage the unit and may contain ingredients that are unsafe for some people. If you want warm, moist air, our article on steam for a stuffy nose covers the safer ways to get it.

What happens if vapor rub is swallowed?

Swallowing a camphor rub can cause real poisoning, particularly in a child. A guideline from the American Association of Poison Control Centers found about 10,000 ingestion exposures to camphor-containing products reported to US poison centers each year from 1990 to 2003. It lists convulsions, lethargy, unsteadiness and severe nausea and vomiting as signs of moderate to severe toxicity, and it says anyone having convulsions after camphor exposure should go to an emergency department by ambulance.

The same guideline says not to induce vomiting after a camphor ingestion, and that skin exposures should be washed thoroughly with soap and water. The label's advice is simple: keep it out of reach of children, and if it's swallowed, get medical help or contact a Poison Control Center right away at 1-800-222-1222 in the US.

The 2010 study authors explained why the FDA allows camphor in rubs at all. The FDA accepted camphor as a cough suppressant but limited its concentration to 11%, and the historical poisoning cases mostly involved swallowing liquid camphor products such as camphorated oil.

How do you use vapor rub safely at night?

The label directions are the safe way to use vapor rub for a stuffy nose. Rub a thick layer on the chest and throat, keep pajamas loose around the neck so the vapor can reach your nose, and use it no more than three times a day. Wash your hands afterward so you don't carry it to your eyes.

A few more points from the label and the research:

• Don't use it on children under 2.
• Ask a doctor first if your cough comes with a lot of mucus or is long-lasting, as with asthma, smoking or emphysema.
• Stop and see a doctor if a cough lasts more than a week, keeps coming back, or comes with fever, rash or a headache that won't go away.
• If you're pregnant or breastfeeding, ask a health professional before using it.
• Stop if the skin, eyes or nose burn more than mildly.

What else helps you breathe at night with a stuffy nose?

A rub pairs well with something that physically opens the nose. Nasal strips lift the sides of the nose and widen the passage just inside the nostrils. In a study of 89 people with nasal blockage, a strip widened the front 3 cm of the nose and gave a gain in nasal airflow comparable to a decongestant spray, along with a similar improvement in how blocked people felt. It had no effect further back, so it helps most when the front of the nose is the tight spot. How nasal strips work explains the mechanics.

So a rub on the chest for the cool, clear feeling and a strip on the nose for actual airflow is a sensible combination. Keep the ointment away from the strip, since strips need clean, dry skin. For other ideas, see how to sleep with a stuffy nose.

Mouth tape is the one thing to put aside while you're congested. Cleveland Clinic's sleep specialist says never to use it with nasal congestion, nasal obstruction or a sinus infection. Wait until you can breathe comfortably through your nose with your mouth closed. We don't recommend mouth tape for children.

Our pick (paid partner): TitanAir Nasal Strips

If you want something that works on the nose itself while a rub handles the cooling feeling, our pick is TitanAir Nasal Strips. Titan says they are drug-free external nasal dilators with flexible, spring-loaded bands, so they add no menthol or camphor to the mix.

Titan says to put the strip just above the flare of the nostrils, on the soft part of the nose rather than the bony bridge, on clean, dry skin with no moisturizer. That's one more reason to keep the rub on your chest. For removal, Titan says to loosen the strip with warm water and peel slowly from the ends inward. Titan says the strips are third-party tested and certified PFAS-free, and they come with a 30-night guarantee.

Read next

• Do nasal strips help a stuffy nose from a cold?
• How to unblock your nose before bed

* This content is for informational and educational purposes only and is not medical advice. It is not intended to diagnose, treat, cure or prevent any disease or health condition. Talk to a qualified healthcare provider about your health.