Benzyl Benzoate — an overview, ScienceDirect Topics

Dermatological medications and local therapeutics

Benzyl benzoate , crotamiton, malathion and permethrin (Section 2.17.13 ) are available for external treatment of scabies. External treatments with lindane are not recommended and have been removed from the market in many countries. Two studies from India found significantly higher concentrations of lindane in maternal and cord blood from pregnancies with intrauterine growth restriction in comparison to control pregnancies ( Sharma 2012 , Pathak 2011 ). Ivermectin – available for example in France – is used orally for scabies ( Chapter 2.6 ).

Apart from irritation of the skin and mucosa, there has not been any indication of appreciable toxicity either in animal experiments or use in humans after external use of benzyl benzoate ( Fölster-Holst 2000 ). In a study in Thailand, 444 pregnant women who had used a 25% benzyl benzoate preparation topically during their pregnancy, showed no increased risk for birth defects. However, treatment was mostly applied in the second and third trimesters ( Mytton 2007 ).

Crotamiton is only absorbed percutaneously to a very limited degree. An accumulation of the substance has, up to now, not been documented. By comparison to other anti-scabies medications it is thought to be less effective ( Fölster-Holst 2000 ). No teratogenic effects have been observed in animal experiments. While studies concerning use during pregnancy are lacking, a substantial risk with topical use is unlikely.

Permethrin is more effective in the treatment of scabies compared to Benzyl benzoate 25%, Crotamiton 10% or Malathion 0.5% lotion. Because in medical treatments the skin is only exposed twice for a short period of time teratogenic effects are not expected.

Recommendation

The treatment of choice for scabies is permethrin because of its better effect. Pump sprays should be avoided because of the danger of higher systemic intake through the air.

Malthion, benzyl benzoate and crotamiton may be used as reserve treatments.

Antiparasitic drugs

Benzyl benzoate

Benzoic acid phenylmethyl ester.

Clinical applications

Benzyl benzoate is used as a pediculicide and scabicide in dogs, although its principal use in humans is as a repellent of ticks, chiggers and mosquitoes. It is generally applied as a spot treatment.

Pharmacokinetics

Benzyl benzoate is rapidly absorbed and is hydrolyzed to benzoic acid and benzyl alcohol, conjugated with glycine or glucuronide and eliminated in urine.

Adverse effects

While generally considered of low toxicity, cats are about 10 times more sensitive than dogs (acute oral LD50 in cats is 2240 and in dogs 22,440 mg/kg) and its use in this species is contraindicated in some countries.

Signs of poisoning include salivation, twitching of treated areas, generalized tremors, convulsions, respiratory failure and death.

Treatment is symptomatic and supportive.

Dermatological medications and local therapeutics

Pharmacology and toxicology

Benzyl benzoate , lindane, and the pyrethroid allethrin are available for external use in treating scabies. Ivermectin is indicated for oral usage. For lice, coconut oil, pyrethrum extract, the pyrethroids allethrin and pyrethrin, and lindane are used. Crotamiton and the pyrithroid permethrin are used for both scabies and lice infestations.

Benzyl benzoate was banned in the USA because its metabolite, benzyl alcohol, was associated with neonatal fatal intoxication (the “gasping syndrome”, with encephalopathy, severe metabolic acidosis, bone marrow depression, and multiple organ failure). However, intoxication occurred only when benzyl alcohol itself was used to rinse central vein catheters. Apart from local skin irritation, there has to date been no substantial toxicity observed after topical application of benzyl benzoate ( Fölster-Holst 2000 ). A prospective study of 113 pregnant women using permethrine shampoo during pregnancy, 31 of them during the first trimester, did not reveal prenatal toxicity ( Kennedy 2005 , 2003 ).

Approximately 10% of lindane is absorbed through the skin (see also Chapter 4.12 ). Lindane is potentially neurotoxic. Animal experience has demonstrated that it is stored in fat tissue and in the testes. Damage of Leydig cells has been observed ( Suwalsky 2000 ). According to European environmental guidelines, its use is not permitted after 2007.

The synthetic pyrethroids, allethrin, permethrin, and pyrethrin, have longer half-lives than the “natural” pyrethrum. About 2% of permethrin is absorbed after topical application ( Fölster-Holst 2000 ).

Less than 1% of crotamiton is absorbed after dermal application.

No teratogenic effects have been observed with any of the substances mentioned after normal usage.

Scabies should be treated with benzyl benzoate or crotamiton, and lice infestation with coconut oil or pyrethrum extract. Synthetic pyrethroids are the drugs of second choice during pregnancy. Lindane should be avoided; however, if there has been acute topical treatment, no action need be taken.

Sarcoptes scabiei and Scabies

7.1.2 Benzyl Benzoate

Benzyl benzoate was first used in the form of “balsam of Peru”, of which it forms the active constituent and which is still used in some countries with the attendant risk of contact irritancy ( Temesvart et al., 1978 ). The first real trials of benzyl benzoate itself were performed by Kissmeyer (1937) , but its use was largely established by the trials conducted by Mellanby and co-workers ( Mellanby et al., 1942a; Mellanby, 1972, 1973 ). At therapeutic concentrations it is a skin irritant and may cause severe stinging, especially of excoriated skin, and consequently was soon not recommended for use on children ( Bradshaw, 1944 ). Dilution to make it more acceptable seriously reduces its efficacy, as does incomplete application or not making the generally accepted two or three applications ( Alexander, 1984 ; Bums, 1991). In contrast, Mellanby et al. (1942a) obtained nearly 100% effectiveness with a single application. This treatment has made a brief come-back in some parts of eastern Europe and countries of the former Soviet Union in recent years ( Levkov, 1980; Fedorovskaia et al., 1986 ) as part of more concentrated efforts to control the disease.

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Dermatological medication and local therapeutics

4.12.6 Medications for lice and scabies

For topical treatment of pediculosis (lice infestation), dimeticone, coconut oil, pyrethrum, permethrin, malathion and allethrin I are used. For topical treatment of scabies, benzyl benzoate , crotamiton and permethrin are available. Scabies may be treated systemically with ivermectin which is not licensed for this indication in all countries ( Chapter 4.4 ). Topical medications containing lindane have been removed from the market in many countries.

Knowledge about the passage of medications for parasites into the mother’s milk is scarce and is practically only available for the now obsolete lindane, an insecticide which is widespread in the environment. Our environment is widely contaminated with lindane; it can be detected in the mother’s milk due to contaminated food, without therapeutic usage ( Chapter 4.18 ). Studies with a 0.25% lindane solution showed dermal absorption of barely 10%. In one case, after a 3-day scabies treatment, 0.9 mg/kg (ppm) lindane was measured in the milk fat (1 liter of milk has, on average, 30–35 g of milk fat). After another one-time application it was 2.0 mg/kg. Compared to the average environmental contamination load of mother’s milk, this was more than a 60-fold increase ( Senger 1989 ). Lindane is neurotoxic; cerebral seizures after repeated topical applications in children are reported ( Daud 2010 ). However, nothing is published on clinical effects after exposure through the mother’s milk.

For the rest of the above-mentioned substances, no toxic effects by exposure via the mother’s milk are expected. Pyrethrum has a shorter half-life than the synthetic pyrethroids. In the USA, permethrin is approved from the age of 3 months. The experience to date on therapeutic use in infants does not indicate any appreciable side-effects after breast feeding ( Fölster-Holst 2000 ).

Recommendation

Lice infestation should be treated with dimeticone during breastfeeding. The medication of choice for scabies during breastfeeding is permethrin.

14.5.11 Antiparasitic

Powdered fennel seeds are used to keep fleas and other parasites away. The acaricidal activity of components derived from fennel seed oils against Tyrophagus putrescentiae adults using direct contact application, and compared with compounds such as benzyl benzoate , dibutyl phthalate and N,N-diethyl-m-toluamide, was reported ( Lee et al., 2006 ). The bioactive constituent of the fennel seeds was characterized as (+)-carvone by spectroscopic analyses. The most toxic compound to T. putrescentiae was naphthalene, followed by dihydrocarvone, (+)-carvone, (−)-carvone, eugenol, benzyl benzoate, thymol, dibutyl phthalate, N,N-diethyl-m-toluamide, methyl eugenol, myrcene and acetyleugenol, on the basis of LD50 values, and reviewed by Shamina (2008) .

Volatiles from herbs and spices

Cinnamon

Cinnamomum verum (Syn. C. zeylanicum) yields mainly leaf and bark oils, that are used in perfumery and flavouring. The major component of the leaf oil is eugenol while that of bark oil is cinnamaldehyde. Senanayake et al. (1978) identified 32 components in cinnamon oil, of which eugenol (70.1%) and cinnamaldehdyde (75.0%) were the major compounds in leaf and bark respectively. The oil from its root bark contained camphor (56.2%) and 1,8-cineole (11.7%) as chief components. The cinnamon varieties Navashree and Nithyasree, recorded 2.7–2.8% bark oil, 10% bark oleoresin and 3% leaf oil contents ( Krishnamoorthy et al. 1996 ). Two types of Cinnamomum zeylanicum leaf oils exist, the main constituent of one being eugenol and that of the other benzyl benzoate . Nath et al. (1996) reported a variety of C. verum growing in Brahmaputra valley (India) with benzyl benzoate as a major constituent in both leaf and bark oils. The essential oil of the leaves of C. zeylanicum from Cameroon contained eugenol (85.2%), (E)-cinnamaldehyde (4.9%), linalool (2.8%) and β-caryophyllene (1.8%) ( Jirovetz et al. 1998 ).

A chemotype of Cinnamomum zeylanicum with 85.7% linalool in leaf oil was reported from Calicut (South India) by Jirovetz et al. (2001) ( Table 11.8 ). Cinnamon leaf oils of Indian origin contained 81.43–84.5% eugenol ( Mallavarappu et al. 1995 ) ( Table 11.9 ). Syamasundar et al. (2000) reported variation in the composition of unripe and ripe fruits of cinnamon. The oil from unripe fruits was dominated by δ-cadinene (19.15%), α-pinene (11.47%), β-pinene (10.51%), E-cinnamyl acetate (7.11%) and γ-cadinene (8.05%) whereas the ripe fruits contained γ-cadinene (23.48%), α-pinene (11.52%), E-cinnamyl acetate (8.62%) and α-muurolene (8.22%) as chief components. The fruit oil from South India was dominated by α-pinene (11.2%), β-pinene (9.2%), β-caryophyllene (11.0%), α-muurolene (6.1%), δ-cadinene (20.2%) and α-muurolol (9.8%) ( Mallavarapu and Ramesh 2000 ) ( Table 11.10 ). Volatile oil from cinnamon flowers was dominated by (E)-cinnamyl acetate (41.98%), trans-α- bergamotene (7.97%), caryophyllene oxide (7.29%) and α-cadinol (6.35%) ( Jayaprakasha et al. 2000 ).

Table 11.8 . Composition of oil from Cinnamomum zeylanicum leaves from Calicut, India

(E)-2-Hexenol (0.1%) Borneol (0.1%)
(Z)-3-Hexenol (0.1%) Terpinen-4-ol (0.3%)
1-Hexen-3-ol (0.1%) α-Terpineol (1.1%)
Hexanol (0.1%) Dihydrocarveol (t)
α-Pinene (t) Linalyl aetate (0.1%)
(Z)-3-Hexenyl acetate (0.1%) (E)-Cinnamaldehyde (1.7%)
(E)-2-Hexenyl acetate (0.1%) Safrole (t)
p-Cymene (t) (E)-Cinnamyl alcohol (0.1%)
β-Phellandrene (t) Eugenol (3.1%)
(E)-β-Ocimene (t) (E)-Cinnamyl acetate (0.9%)
1,8-Cineole (0.1%) β-Caryophyllene (2.4%)
Limonene (0.2%) α-Humulene (0.2%)
Cis-Linalool oxide *(0.1%) Eugenyl acetate (0.1%)
Terpinolene (0.1%) Caryophyllene oxide (0.1%)
Trans-Linalool oxide* (0.1%) Spathulenol (0.2%)
Linalool (85.7%)
Nonanol (0.3%)
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Note: * furanoid form; t = trace ( Source: Jirovetz et al. 2001 . Source: Jirovetz et al. 2001 .

Table 11.9 . Volatiles from Cinnamomum verum leaves

Compound % Composition
Leaf
α-Thujene 0.04–0.06
α-Pinene 0.38–0.49
Camphene 0.17–0.18
Sabinene t
α-Pinene 0.16–0.18
Myrcene 0.09–0.13
n-Octanal t
α-Phellandrene 0.50–1.03
Δ-3-Carene 0.05
α-Terpinene 0.03
p-Cymene 0.16–0.28
1,8-Cineole 0.23–0.38
β-Phellandrene t
(z)-β-Ocimene t
(E)-β-Ocimene 0.05
γ-Terpinene 0.05
cis-Linalool oxide (furanoid) t
trans-Linalool oxide (furanoid) t
0.05–0.11
Terpinolene 1.57–3.70
Linalool t
2-Phenylethanol 0.10
Camphor 0.39
Citronellal 0.12
Borneol 0.04–0.05
Terpinen-4-ol 0.10–0.14
α-Terpineol 0.19
Methylchavicol t
(Z)-Cinnamaldehyde 0.26
Nerol t
Cuminaldehyde 0.03
Piperitone 0.63–1.51
(E)-Cinnamaldehyde 0.52
Linalyl acetate 0.19
Safrole t
(E)-Cinnamyl alcohol t
2-Phenylethyl propionate 81.43–84.50
Eugenol t
(E)-Methyl cinnamate t
(Z)-Cinnamyl acetate 0.25–0.28
β-Elemene t
(Z,E)-α-Farnesene 0.73
(E)-Cinnamyl acetate 2.49
β-Caryophyllene 0.47–2.25
(Z)-Methyl isoeugenol t
α-Humulene 0.12–0.46
(E)-Methylisoeugenol t
β-Selinene t
Eugenyl acetate 0.14–2.85
γ-Cadinene

Note: t = trace ( Source: Mallavarapu et al. (1995) .

Table 11.10 . Composition of Cinnamomum zeylanicum fruit oil

(E)-2-Hexenol (t) (E)-Cinnamyl acetate (0.4%)
Tricy clene β-Caryophyllene (11.0%)
α-Pinene (11.2%) (E)-β-Farnesene (0.8%)
Camphene (0.6%) α-Humulene (2.2%)
β-Pinene (9.2%) γ-Muurolene (0.2%)
Myrcene (1.6%) Germacrene D (0.2%)
α-Phellandrene (0.7%) α-Muurolene (6.1%)
α-Terpinene (0.2%) δ-Cadinene (7.1%)
p-Cymene (0.1) δ-Cadinene (13.1%)
Limonene (2.8%) Cis-Calaminnene (2.2)
1,8-Cineole (0.1%) α-Cadinene (1.2%)
(Z)-β-Ocimene (0.1%) Elemol (1.9%)
(E)-β-Ocimene (0.2%) (E)-Nerolidol (0.1%)
γ-Terpinene (0.1%) Isocaryophyllene oxide (0.2%)
Tepinolene (0.5%) Spathulenol (0.8%)
Linalool (0.2%) Caryophyllene oxide (0.4%)
α-Fenehyl alcohol (0.5%) Globulol (0.4%)
Isoborneol (t) Humulene epoxide 1 (0.5%)
Borneol (0.5%) Humulene epoxide 11 (0.6%)
Terpinen-4-ol (0.1%) 1-Epi-cubenol(0.1%)
α-Terpineol (0.5%) T-Cadinol (0.2%)
Nerol (t) Cubenol (0.9%)
Geraniol (t) α-Muurolol (9.8%)
Isobornyl acetate (0.1%) Selin-11-en-4a-ol (0.1%)
(Z)-Cinnamyl acetate (0.1%) α-Cadinol (3.1%)
α-Copaene (2.1%) 4-Hydroxy-3,4-dihydrocalacorene* (0.2%)
β-Elemene (0.4%) 4-Hydroxy-3,4-dihydrocalacorene* (0.1%)

Notes: * correct isomer not identified; t = trace ( Source: Mallavarapu and Ramesh, 2000 .

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Benzyl benzoate ointment: instructions for use, composition, which helps, review of analogues and patient reviews

In the 21st century, when progress is not kept up, not only looks but also looksthoughts, many people, like several centuries ago, continue to struggle with such an unpleasant and very painful ailment, like pediculosis. Once lousiness was categorized as «disease of the poor», and for treatment people’s( and often unsafe for the patient’s health) methods were used: tincture of wormwood, dust soap, kerosene. But those distant and to some extent «wild» times are in the past.

Mankind throughout its existence suffered from small bloodsuckers. The first documented references to lice are found in the works of Aristotle( 2-3 century BC).The dried parasites were found even in Aztec and Egyptian mummies.

Modern pharmacology produces a wide range of specialized products designed to combat tiny bloodsuckers. Of particular note is the preparation Benzyl benzoate, the instructions for its use will be discussed below. Let’s try to answer the main question: how effective is this antiparasitic agent?

Description of the drug

This ointment is used to combat subcutaneous mites, parasites and related disorders. Today, the status of one of the most effective and affordable acaricides has been fixed for Benzyl benzoate. Active components of liniment inhibit the processes of vital activity of pathogenic parasites.

In the Soviet period liniment was actively used for the therapy of acne, scabies. In modern dermatology, the drug is practically not used, despite the high efficiency. Buyers prefer the more expensive Western counterparts.

Pharmacological group and the action of

Benzyl benzoate is a pharmaceutical antiparasitic agent with pronounced acaricidal properties. Liniment components are characterized by directed activity against lice, regardless of the species, as well as itchy prurines, mites.

Mechanism of action of the preparation:

  • After contact of the parasite with the medicament, the active components of the ointment overcome its chitin protection.
  • Active elements accumulate inside mites and lice.
  • After 3-5 hours, the parasite is killed by the toxic concentration of benzyl benzoate.

The medicinal product effectively saves not only from adults, but also from larvae. Resistance to the pharmacological product is demonstrated only by eggs of parasites, due to the lack of direct contact with the active components.

Form and composition

In pharmacies, the medication is available in several dosage forms:

  • ointment Benzyl benzoate 10% for external use — a homogeneous white color with a pronounced odor, delivers in 25 g aluminum tubes, each of which is placed in a cardboard box;
  • liniment Benzyl benzoate 20% for surface treatment;
  • emulsion 10% — homogeneous consistency of white color, packed in 200, 100 and 50 g bottles, glass bottles.

The listed forms of the preparation differ little in composition. The emulsion consists not only of the main active ingredient, but also distilled water, medical wax and laundry soap. As for the ointment, here the company benzyl benzoate is only an emulsion-water base.

Instructions for use

According to the official instructions, Benzyl benzoate cream is used only externally. For treatment of pediculosis or getting rid of scabies in adults, 20% liniment is prescribed. Children are treated with 10% ointment. The average duration of the course therapy is 4-5 days.

Instructions for Use:

  1. The first treatment is carried out in the evening after taking a warm shower or steaming problem areas of skin( preferably — before going to bed).
  2. To get rid of lice( pediculosis), you need to treat the head of a person, eliminating the contact of the drug with the mucous membranes of the eyes. To eliminate skin infections caused by the activity of parasites, a thin layer of ointment covers the whole body( to the feet, except for the face).
  3. Bedding and linen are changed, and clothes are smoothed on both sides.
  4. Ingredients from lice are washed off after 1.5 hours. The hair is rinsed in acetic acid( 5%), then the residual products of the vital activity of the parasites are washed and combed.
  5. It takes up to 10 days to get rid of subcutaneous mites. After the first application of the ointment, it is rinsed for 2 days under warm running water.
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If it is a question of small lesions, one course of treatment is sufficient to eliminate pathogenic bloodsuckers. In case of detection of live individuals( lice or mites), the therapeutic course should be repeated.

Indications and contraindications

This ointment with benzyl benzoate has been successfully used for several decades to treat a number of diseases associated with complications. I prescribe the drug with the following ailments:

  • dermatitis in the acute phase;
  • seborrhea;
  • infectious skin lesions of parasitic etiology;
  • scabies;
  • pediculosis;
  • demodicosis;
  • pink pimples;
  • pityrious lichen.

Pharmaceutical is not suitable for all patients, so it is important to carefully consider contraindications before use.

The drug is not prescribed for:

  • dermatological diseases, accompanied by the formation of pustules;
  • violation of the integrity of the epithelial layer;
  • of an individual intolerance to the active substance or auxiliary ingredients;
  • pregnancy or breast-feeding a child.

Despite the relative safety of the drug, it is important to consult a dermatologist in advance.

Method of administration and dose

The drug assumes only an external application, the doses vary depending on the nature of the course of the disease, the age of the patient. To obtain a stable and long-lasting effect, it is recommended to conduct simultaneous treatment of all patients.

According to the instruction, the composition is recommended to be used as follows:

  1. Ointment from mange Benzyl benzoate is applied to the steamed skin with a thin layer. Untreated leave only the head. Liniment is left on the body for the next day, washed off on the second day. Duration of treatment is 10 days. The multiplicity of renewal of the composition is every 2 days. Adults are prescribed only 20% remedy, children — benzoate ointment 5-10% or emulsion.
  2. Pediculosis is treated with an emulsion, which is distributed over the head and hair with a cotton swab. After treatment, a headscarf or bandana is fixed on the head for 30 minutes. After this time, the medicine is washed off.

Liniment is recommended to be used after prior approval or prescription of a doctor. Only the specialist determines the appropriate dosage and treatment regimen.

Side effects and special instructions

In the vast majority of patients, this formulation does not cause side effects. With high sensitivity of the skin, it is possible for the occurrence of individual allergic reactions:

  • itching, burning, redness;
  • contact type dermatitis;
  • drying of the epidermis.

In 99% of cases with repeated application of the ointment, the listed symptoms do not appear. In cases where adverse reactions do not pass, it is necessary to abandon the use of the drug, contact the doctor for correcting the treatment regimen.

  • the average dosage of liniment for an adult is 10-15 g;
  • sensitive parts of the body are processed without rubbing the composition into the epithelial layer;
  • when the composition gets into the mouth, it is rinsed with a solution of activated charcoal and burnt magnesia;
  • course therapy involves the use of 60 to 90 g of ointment.

Before treatment of pubic lice, consult a dermatologist. On sale is a wide range of highly specialized medicines to eliminate intimate problems.

Pregnancy and lactation

Pediatricians emphasize — Benzyl benzoate is strongly contraindicated in pregnancy, or breast-feeding a child. Active components of the ointment overcome the placental barrier, can harm the fetus.

Application in childhood

For children, 10% formulation is prescribed for scabies or 10% emulsion for the treatment of pediculosis. The method of application is similar to that discussed above. Doctors do not recommend the use of medication for patients under the age of 3 years.

Drug Interaction

Medication does not interact with other drugs. Nevertheless, dermatologists do not recommend the use of several external emulsions or ointments. The use of corticosteroids neutralizes the symptoms of disease, but does not relieve the invasion as a whole. Part of the bacteriostatic properties of the drug is lost when taking medications that contain cetylpyridinium chloride.

Analogues

The pharmacies offer a wide range of substitutes for benzyl benzoate with a similar active ingredient, as well as similar mechanisms for parasite action.

The nearest analogues of the drug:

  • «Spregal»;
  • «Belogent»;
  • «Benzyl benzoate Rusfar»;
  • «Sodium thiosulfate».

Despite the similar mechanism of action, the listed drugs differ in composition, contraindications and recommendations for use. Before use, it is important to carefully read the attached annotation.

Reviews

Nikita, 35 years old, KrasnoyarskUse ointment Benzyl benzoate from demodicosis on the shoulder. When I bought, I strongly doubted that such a cheap drug is capable of at least some therapeutic effect. But in the end was pleasantly surprised. After the first application, a slight burning sensation was felt on the skin, and on the second day it passed. If you ever come across( God forbid, of course) with scabies, be sure to buy this ointment, do not regret it.
Source of the

medhelpsis.com

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