Is menthol and camphor effective for treating rhinorrhea?

Menthol and Camphor Are Not Effective for Treating Rhinorrhea

Menthol and camphor products should not be used as treatment for rhinorrhea, as there is no evidence supporting their efficacy, and menthol may actually trigger or worsen allergic rhinitis symptoms in susceptible individuals. 1

Why Menthol/Camphor Are Not Recommended

Lack of Evidence for Rhinorrhea Treatment

• Major clinical guidelines from the American Academy of Allergy, Asthma, and Immunology do not include menthol or camphor in treatment algorithms for rhinorrhea 2, 3
• No controlled trials demonstrate efficacy of menthol or camphor for reducing nasal secretions 2

Potential to Worsen Symptoms

• Menthol is recognized as a trigger for allergic rhinitis, asthma, and urticaria 1
• Menthol can stimulate histamine release from mast cells in a dose-dependent manner, potentially exacerbating allergic inflammation 1
• Menthol may provoke allergic hypersensitivity reactions in patients with existing allergic disorders 1

Mechanism Creates False Sensation Only

• Menthol stimulates TRPM8 cold receptors on trigeminal nerve branches, creating a subjective sensation of improved airflow without actually reducing nasal secretions or congestion 1, 4
• This cooling sensation provides symptomatic relief of perceived congestion but does not address the underlying pathophysiology of rhinorrhea 4

Evidence-Based Alternatives for Rhinorrhea

First-Line Treatment

• Intranasal corticosteroids are the most effective first-line treatment for ongoing rhinorrhea 3
• These should be used continuously and daily, not intermittently, for optimal efficacy 3

For Persistent Rhinorrhea

• Add ipratropium bromide 0.03% nasal spray to intranasal corticosteroids for persistent rhinorrhea that does not respond adequately to corticosteroids alone 3
• This combination is more effective than either drug alone without increased adverse events 2, 3
• Ipratropium specifically targets cholinergically-mediated nasal secretions and has Level 1a evidence supporting its effectiveness 3, 5

Adjunctive Therapy

• Topical saline is beneficial as sole or adjunctive treatment for chronic rhinorrhea 3
• Second-generation oral antihistamines (cetirizine, loratadine, fexofenadine) can reduce rhinorrhea but are less effective than intranasal corticosteroids 3

Critical Pitfall to Avoid

• Do not use menthol-containing products in patients with known allergic disorders, as they may trigger or worsen symptoms rather than provide relief 1