FAMILY MEDICINE® COLUMN

By John C. Wolf, D.O.Associate Professor of Family Medicine Ohio University College of Osteopathic Medicine

USING PETROLEUM JELLY FOR NASAL DRYNESS CAN RESULT IN PNEUMONIA

Question: For several years, I've been putting a small amount of Vaseline in my nose each night to keep my nostrils from getting too dry. Before I did this, I'd have trouble getting to sleep because my nose felt so dry, and I would wake up each morning with dried blood in my nose. Now, I have neither of these problems, but I've begun to worry if this a good practice.

Answer: A dry and irritated nose certainly is uncomfortable. This is commonly a nighttime problem, just as you describe, because the normal nasal secretions drain differently when we lie down. Also, during the night we don't swallow and drink liquids -- actions that help keep the nasal tissues moist.
The petroleum jelly you have been using coats the delicate nose tissues and helps moisturize them in two related ways. It forms a barrier that keeps the air from getting to the nose tissues, so it can't dry them out. And, it also retains the normal moisture produced by them.

In general terms, petroleum jelly is safe to use. However, there is a potential problem from prolonged use as you describe. This problem arises because the petroleum jelly doesn’t just stay in the nose but rather migrates to other parts of the body.

Petroleum jelly usually drains out of the back of the nose with the normal nasal secretions and is then swallowed. While this is probably not a problem for you because of the small amount involved, petroleum jelly in the digestive system can reduce the number of vitamins that your body absorbs. However, for those that use mineral oil -- a similar type of petroleum -- as a laxative on a frequent basis, the risk is much greater.

The greatest risk from use of petroleum jelly in the nose comes from inhaling the material. This commonly occurs when asleep, so the person is unaware of it. The lungs can't easily eliminate this foreign substance as the digestive tract does. Instead, the lungs react to it, causing scarring and pneumonia- like fluid accumulations.

This lung damage usually begins so gradually that the individual doesn't relate the symptoms to the use of petroleum jelly in the nose (or, in other cases, the chronic use of mineral oil for constipation or the frequent exposure to the spray lubricants used on machinery). Eventually, when chronic shortness of breath develops along with a cough, a chest X-ray will be done. While the lung images may look abnormal, it is usually necessary to obtain a sample of lung tissue to identify the specific type of lung disease. If the cause is petroleum jelly, the diagnosis will be “lipoid pneumonia,” because lipoid is a doctor word meaning an oil-based substance like petroleum jelly.
So, to answer your question, it is dangerous for you to be using petroleum jelly in your nose every night.

Question: Have you had patients with this "dry nose" problem before? What do you recommend for this problem?

Answer: The symptoms of "dry nose" are typically due to one of two common conditions. Very dry air causes the nose to dry out at night. This is often a problem in the winter. The best treatment for it is the use of a vaporizer or humidifier in the bedroom to bring the moisture of the air up to a more comfortable and healthful level. Use of a non-prescription saline nose spray also provides safe although temporary relief from the annoying dryness.

A second common cause is allergies. Since you have been having your symptoms year round, it is likely that this is the cause of your dry nose. Most individuals who have this condition are allergic to house dust, animal dander or feathers that may be in your pillow. Sometimes it is possible to get satisfactory relief by keeping pets out of the bedroom, keeping the bedroom meticulously clean (even under the bed) and using synthetic pillows instead of feather or down ones. For others, specific treatment for allergies is needed to gain relief.

"Family Medicine" is a weekly column.

To submit questions, write to: John C. Wolf, D.O., Ohio University College of Osteopathic Medicine, Grosvenor Hall, Athens, Ohio 45701.

Past columns are available online at http://www.FamilyMedicineNews.org.