Balsam of Peru

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Balsam of Peru, also known and marketed by many other names, is a balsam derived from a tree known as Myroxylon, which is grown in Central America (primarily in El Salvador) and South America.[1]

The natural resinous balsam that comes from the trunk of the tree contains a mix of a number of substances that are generally related to cinnamon, vanilla, and clove fragrances and flavorings.[2]

Balsam of Peru is used in food and drink for flavoring, in perfumes and toiletries for fragrance, and in medicine and pharmaceutical items for healing properties. It has a sweet scent. In some instances, Balsam of Peru is listed on the ingredient label of a product by one of its various names, but it may not be required to be listed by its name by mandatory labeling conventions.

It can cause allergic reactions.[3] A number of surveys have identified Balsam of Peru as being in the "top five" allergens most commonly causing patch test reactions in people referred to dermatology clinics. It may cause inflammation, redness, swelling, soreness, itching, and blisters, including allergic contact dermatitis, stomatitis (inflammation and soreness of the mouth or tongue), cheilitis (inflammation, rash, or painful erosion of the lips, oropharyngeal mucosa, or angles of their mouth), pruritis, hand eczema, generalized or resistant plantar dermatitis, rhinitis, and conjunctivitis.

Collection[edit]

Balsam of Peru is an aromatic viscous resin obtained by scorching or inflicting V-shaped wounds on the bark of the trunk of the tree Myroxylon balsamum var. pereirae.[1][4][5] In response, the Balsam of Peru -- oily, resin-like, aromatic fluid -- exudes to heal the tree's lesions, and the liquid is collected.[1][6][7] An essential oil is distilled from the balsam.

'Balsam of Peru' is a misnomer.[8] In the early period of Spanish dominion in Central and South America the balsam was collected in Central America and shipped to Callao and Lima in Peru, then shipped onward to Europe.[8][9][10] It acquired the name of Peru because it was shipped from there.[8][9] Its export to Europe was first documented in the seventeenth century in the German Pharmacopedia. Today it is extracted under a handicraft process, and is mainly exported from El Salvador.[11]

Composition[edit]

Balsam of Peru smells of vanilla and cinnamon because it contains – among its 25 or so different substances[12]cinnamein, cinnamic acid, cinnamyl cinnamate, benzyl benzoate, benzoic acid, and vanillin.[1][13] It also contains cinnamic acid alcohol and aldehyde, farnesol, and nerolidol.[14] A minority of it, approximately 30–40%, contains resins or esters of unknown composition.[13] It also contains essential oils similar to those in citrus fruit peel. These are all potential allergens.[13]

Uses[edit]

Balsam of Peru is used in food and drink for flavoring, in perfumes and toiletries for fragrance, and in medicine and pharmaceutical items for healing properties.[13] It has aromatic and fixative (i.e., delays evaporation) properties, and mild antiseptic, antifungal, and antiparasitic attributes.[13]

In some cases, it is listed on the ingredient label of a product by one of its various names.[15] Naturally occurring ingredients may contain substances identical to or very closely related to Balsam of Peru.[15]

It has three primary uses:

flavoring in food and drink, such as coffee, flavored tea, wine, beer, gin, liqueurs, apéritifs (e.g., vermouth, bitters), soft drinks including cola, juice, citrus, citrus fruit peel, marmalade, tomatoes and tomato-containing products, Mexican and Italian foods with red sauces, ketchup, spices ( e.g., cloves, Jamaica pepper (allspice), cinnamon, nutmeg, paprika, curry, anise, and ginger), chili sauce, barbecue sauce, chutney, pickles, pickled vegetables, chocolate, vanilla, baked goods and pastries, pudding, ice cream, chewing gum, and candy;
fragrance in perfumes and toiletries, such as perfumes, colognes, deodorants, soaps, shampoos, conditioners, after-shave lotions, cosmetics, lipsticks, creams, lotions, ointments, baby powders, sunscreens, and suntan lotions; and
healing properties in medicinal products, such as hemorrhoid suppositories and ointment (e.g., Anusol), cough medicine/suppressant and lozenges, diaper rash ointments, oral and lip ointments, tincture of benzoin, wound spray (it has been reported to inhibit Mycobacterium tuberculosis as well as the common ulcer-causing bacteria H. pylori in test-tube studies), calamine lotion, surgical dressings, dental cement, eugenol used by dentists, some periodontal impression materials, and in the treatment of dry socket in dentistry.[1][2][11][13][16][17][18][19][20][21]

It also can be found in toothpaste, mouthwash, scented tobacco, cleaning products, pesticides, insect repellants, air fresheners and deodorizers, scented candles, and oil paint.[2][22][23]

Allergy[edit]

A number of national and international surveys have identified Balsam of Peru as being in the "top five" allergens most commonly causing patch test reactions in people referred to dermatology clinics.[18][24][25] A study in 2001 found that 3.8% of the general population patch tested was allergic to it.[26] Many flavorings and perfumes contain components identical to Balsam of Peru.[27] It may cause redness, swelling, itching, and blisters.[28][29]

People allergic to Balsam of Peru, or other chemically related substances, may experience typical allergic contact dermatitis reactions to it.[13] If they have oral exposure, they may experience stomatitis (inflammation and soreness of the mouth or tongue), and cheilitis (inflammation, rash, or painful erosion of the lips, oropharyngeal mucosa, or angles of their mouth).[13][18][24] If they ingest it, they may experience pruritis and contact dermatitis in the perianal region, possibly due to unabsorbed substances in the feces.[18][30] If they use or consume products containing Balsam of Peru or related allergens, they may experience a flare-up of hand eczema.[13] Among the other allergic reactions to Balsam of Peru are generalized or resistant plantar dermatitis, rhinitis, and conjunctivitis,[18][31] In a case study in Switzerland, a woman who was allergic to Balsam of Peru was allergic to her boyfriend's semen following intercourse, after he drank large amounts of Coca Cola.[32]

Patch testing using 25% Balsam of Peru in petrolatum is used to confirm the allergy.[13][17][30] A Balsam of Peru and Fragrance Mix (a mixture of 8 commonly used individual fragrances) is usually used.[13] A positive result to Balsam of Peru presents in 50% of fragrance allergy cases.[13] Positive patch test results also indicate that the person may have problems with certain flavorings, medications, and perfumed products.[13] Among foods, the most commonly implicated were spices, citrus, and tomatoes.[33]

People allergic to Balsam of Peru may benefit from a diet in which they avoid ingesting foods that contain it.[18] Naturally occurring ingredients may contain substances identical to or very closely related to Balsam of Peru, and may cause the same allergic reactions.[15] In some instances, Balsam of Peru is listed on the ingredient label of a product by one of its various names, but it may not be required to be listed by its name by mandatory labeling conventions (in fragrances, for example, it may simply be covered by an ingredient listing of "fragrance").[15][34][35][36][37] To determine if Balsam of Peru is in a product, often doctors have to contact the manufacturer of the products used by the patient.[38]

Before 1977, the main recommended marker for perfume allergy was Balsam of Peru, which is still advised. The presence of Balsam of Peru in a cosmetic will be denoted by the INCI term Myroxylon pereirae.[14]

Because of allergic reactions, since 1982 crude Balsam of Peru has been banned by the International Fragrance Association from use as a fragrance compound, but extracts and distillates are used up to a maximum level of 0.4% in products, and are not covered by mandatory labeling.[27]

In March 2006, the European Commission, Health and Consumer Protection Directorate-General, Scientific Committee on Consumer Products, issued an Opinion on Peru Balsam.[39] It confirmed that crude Peru Balsam should not be used as a fragrance ingredient, because of a wide variety of test results on its sensitizing potential, but that extracts and distillates can be used up to a maximum level of 0.4% in products.[39]

Alternate names[edit]

Among the alternate names used for Balsam of Peru are: Balsamum peruvianim, Black balsam, China oil, Honduras balsam, Indian balsam, Peruvian balsam, Peru balsam, Surinam balsam, Balsams Peru, Balsam Peru oil, Oil balsam Peru, Peru balsam oil, Balsamum Peruvianum, Bálsamo del Perú, Baume du Pérou, Baume Péruvien, Baume de San Salvador, Myroxylon pereirae klotzsch resin, Myroxylon balsamum var. pereirae, Myroxylon pereirae klotzsch oil, Myrospermum pereirae, Myrosperum pereira balsam, balsam fir oleoresin, balsam fir oil, hyperabsolute balsam, Quina, Balsamo, Tolu, Quina quina, Santos Mahogany, Toluifera pereirae, and Toluifera Pereira balsam.[13][28][40]

References[edit]

  1. ^ a b c d e Alexander A. Fisher (2008). Fisher's Contact Dermatitis. PMPH-USA. Retrieved March 5, 2014. 
  2. ^ a b c "Dermatology; Allergy to Balsam of Peru". bedfordhospital.nhs.uk. October 2009. Retrieved March 5, 2014. 
  3. ^ "Balsam of Peru induced contact allergy", DermatitisFacts.com. Accessed: October 11, 2007
  4. ^ "Peru balsam, Tolu balsam", British Pharmacopoeia 3, 2009 
  5. ^ Ikhlas A. Khan, Ehab A. Abourashed (2011). Leung's Encyclopedia of Common Natural Ingredients: Used in Food, Drugs and Cosmetics. John Wiley & Sons. Retrieved March 6, 2014. 
  6. ^ Avi Shai, Howard I. Maibach (2004). Wound Healing and Ulcers of the Skin: Diagnosis and Therapy – The Practical Approach. Springer. Retrieved March 6, 2014. 
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  8. ^ a b c Murray Galt Motter, National Institutes of Health (U.S.), Martin Inventius Wilbert (1908). Digest of Comments on The Pharmacopoeia of the United States of America and The National Formulary for the Calendar Year Ending December 31 (79-82). Treasury Department, Public Health and Marine-Hospital Service of the U.S. Retrieved April 28, 2014. 
  9. ^ a b The Pharmaceutical Journal ...: A Weekly Record of Pharmacy and Allied Sciences. J. Churchill. 1864. Retrieved April 28, 2014. 
  10. ^ Encyclopaedia Perthensis; Or Universal Dictionary of the Arts, Sciences, Literature, &c. Intended to Supersede the Use of Other Books of Reference 4. John Brown. 1816. Retrieved April 28, 2014. 
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  40. ^ "Peru Balsam: Uses, Side Effects, Interactions and Warnings". WebMD. Retrieved March 13, 2014.