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Uses of friars balsam

Discussion in 'General Issues and Discussion Forum' started by Richie, Feb 11, 2010.

  1. Richie

    Richie Member

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    Hi the clinic I work at has bottles of the stuff and I have heard tales from patients of it being used from fungal infections to ulcers. When I trained at Brighton we never touched the stuff. Does any one still use it and if so what for?
  2. Cameron

    Cameron Well-Known Member


    The trend has been to replace these with synthetic materia medica. Variety of reasons most of which relate to supply, cost and audit. Still used by many independent practitioners however and I am sure they would argue very effectively too. Interesting to note the popularity of these products has increased of late with the upsurge in alternative therapies.

  3. Richie

    Richie Member

    cool, what kind of conditions is it used for?
  4. markjohconley

    markjohconley Well-Known Member

    T.B.Co., extremely useful for securing tape/dressings to skin, works better than 'skin-prep' though I'd imagine the skin-prep would actually protect the skin from the adhesive, it's major job, better, though i've never had a problem using TBCo, mark
  5. markjohconley

    markjohconley Well-Known Member

    Also, we used to make 'coccoons' out of it and free felt, to insulate digits, very messy and i'd be really surprised if any one still did it, mark
  6. Tuckersm

    Tuckersm Well-Known Member

    I also use to use it, with alternate layers of iodine for treatment of Chilblains
  7. Cameron

    Cameron Well-Known Member


    Friars Balsam or Compound tincture of benzoin is a spirit based paint which is incompatible with water when in its fluid state - hence messy. On intact skin it is antiseptic and its spirit base has an astringent action with mild styptic properties. When dried it forms an occlusive film on the skin surface so useful as a paint on unbroken skins. Combined with other active ingredients it could be used as a daily paint for chilblains (usually half and half with weak iodine soln); combined with 3-5% sal acid as a daily paint for fissures. Prior to the introduction of better adhesives Compound tincture of benzoin was used to enhance sticky properties of skin however this is no longer thought necessary. A variety of other uses were made primarily because of the stickyness of the compound this included nail packs and false nails.

    The demise of Friars balsam came with the plastic skins which are thought more useful.

    If you watch old movies you may see a character suffering flue symptoms with their head under a sheet inhaling aromatic fumes - that is Friars Balsum.

    One other claim to fame it has is some schools namely Glasgow and Edinburgh had different names for it. In Glasgow they called it TBCo (tincture benzoin composita) and in Edinburgh it was called C T B (Compound Tincture of Benzoin).
    You could always tell which school the pod had trained at by the way they referred to Friars Balsam.

    the bilingual toeslayer
  8. Craig Payne

    Craig Payne Moderator

    I use to use it a lot to 'paint' skin before applying strapping - it stuck real well!
  9. Cameron

    Cameron Well-Known Member

    Craig et al

    My understanding was the improved hypoallergic adhesives intorduced after the 70s were less likely to work on wet surfaces.

    T B Co was at one time preferred to help adhere padding which may well have been passed its shelf life.

  10. sister

    sister Active Member

    Hi Richie,
    We were still using friars balsam in the early 90's in A&E! Other uses include;- abrasions, cellulitis and minor skin ulcers. It also used to be recommended [years ago] to breast feeding mothers with cracked nipples! [YUK]
    It can work very well but if you haven't used it before as others have said it gets VERY sticky also it sets hard and needs soaking off.
    Wiki, BmJ and Herbal sites have more info.
    Another oldie but goldie;- especially for wounds that won't heal with modern methods, cod liver oil and honey tulle.
    hope that helps you find the information you wanted.
  11. DTT

    DTT Well-Known Member

    So do I Ive found it to be one of the best remedies around in fact just used some on a patient this week but had a lot of trouble getting the iodine mitis from the chemist. He said the suppliers don't stock it anymore but managed to get me some mitis tincture.
  12. malaligned

    malaligned Member

    Also great when using steri strips as it helps to secure strips to either side of skin and keeps split tightly held together.
  13. digit

    digit Member

    TBCo is an absolute favourtie of mine and one that I use very regularly in my clinic. Works fastastically on ID maceration/Tinea Pedis to help dry out the area whilst still providing antiseptic qualities. Also great as a post toenail surgery solution and for inflammed ingrown toenails. I too use it as a skin prep before strapping. Allows the strapping to stick well to skin but also allows easy removal after a few days.

    Couldn't live without the stuff!
  14. Cameron

    Cameron Well-Known Member


    One of the drawbacks to compound tincture of benzoine according to Reid's Therapeutics was it should only be used on unbroken skin surfaces. The paint could, he warned, impede healing by first intention. His logic was sound but written at a time when there would be little actual evidence to support the claim other than the author's personal experience.

  15. Lucy Hawkins

    Lucy Hawkins Active Member

    Friars Balsam was used at Brighton up until 2000, I don't know why thy stopped.

    I use it for nail packing. Cotton wool + TBCo packing for mildly ingrowing nails. Friars Balsam is a hard resin which is dissolved in alcohol to make the tincture. After cotton wool packing has been placed in the nail fold the TBCo is introduced. The alcohol evaporates leaving a sticky resin which holds the packing in place. This will easily last for six weeks or more without coming out alowing the nail to grow out, at least in theory. Caution needs to be observed as if there is infection present it may block drainage and exacerbate the situation.

    When doing this for one patient she remarked "That's just what my chiropodist in Lugano does". So I suppose we are not alone in using this procedure.

    I have also heard of TBCo being used as a pre op prep for surgery in Continental Europe as it is both mildly antiseptic and said to promote healing as opposed to delaying it.

  16. Canuk

    Canuk Active Member

    I was trained using Friars Balsam and was part of medicaments at chair side. I believe it has anit- viral, bacterial and Fungal properties. Also it helps wth itch. I use it for interdigitial t/t of suspected Fungus or bacterial infections and on fissures. It is all natural and I rate it up there with the use of Tea Tree oil that I commonly use for Nail Fungus. I will always remember treating a REF froma GP on a Diabetic Patient with left limb previously being amputated due to her Diabetes. She had a fungal infection of the interdigits and dorsum of the remainig foot and was spreading. The Rx type antifungal cream did not help and infact patient was allergic to it. In fear of losing her renmaing limb we tried the daily application of Friars Balsam and in followup appt one week later all was resolved. I have since used it on interdigital infections or fissures, or moisture problems recommending 1 x day for 3-5 days.

  17. Cameron

    Cameron Well-Known Member


    Sorry to disagree but I would seriously doubt Friars Balsum was viricidal and fungacidal. A quick check of the British Pharmacodea Index (used for older medications) would confirm this. It has certainly been known since antiquity and is a galenical which can be used as an antiseptic paint (with a narrow spectrum of activity). The vehicle i.e. the base, is probably what enhanses its use in podiatry (by occluding the skin surface it disadvantages aerobic micro-organisms).

    There is an arguement we bombard the skin surface with antiseptic wipes and lesion washes suffice by the time post operative agents are used they are almost negated.

    Tea tree oil is in rather a unique catagory with some exceptional properties that are only just being discovered. At one point just prior to the discovery of antibiotics it was likely tea tree oil would have become a widely used miracle healing agent.

  18. W J Liggins

    W J Liggins Well-Known Member

    Ah Toeslayer, well do I remember P J Reid's book. I recall that his explanation of inflammation followed the child's song 'London's Burning'. The same gentleman also asserted (in a letter to the Society journal) that one of the advantages of TBCo. was that students had the 'pleasure' of learning the constituents thereof! Mind you, there was no mention of antibiosis, anti-arrhythmic drugs, lipid regulating drugs, anti-hypertensives and steroids, to mention only the obvious; and we wonder why it has taken until now to have our demands for POMs looked at seriously? I agree that the alcoholic base is probably the major effective antiseptic, but it is still a messy, though useful skin adherent. (It smells also, so patients will be convinced that it is 'powerful'!)

    All the best

  19. Cameron

    Cameron Well-Known Member

    Hi Bill

    Aways avoided the use of TBCo because it stuck to your fingers. The Glasgow crowd called it T. B Co (Tincture of Benzoin Composita) and the Edinburgh folks had it a C T B (Compound tincture of benzoin) . Wars were fought over it. You could always tell where a Scottish pod trained by the name they used for Friars Balsam.

    Bob Kidd once told me the only reason Read's book stayed in publication for so long was the Australians insisted in buying it years after it bacame passe in the UK. Very few Australian pods will know it exits now, which is rather ironic since it still contains valuable (anecdotal) information rarely found in other more scholarly tomes.

    I always found it interesting that the two publications to arrrive simultaneously from London were books of therapeutics. Authors came from rival schools.

  20. blinda

    blinda MVP

    Predictably, just a note of caution; If you are going to direct patients to the above website, ensure they download the `safety dossier`. Whilst TTO is anti-microbial we must stress that oxidation of terpenoids (components of TTO) increase its toxicity. That is, oxidized tea tree oil has a greater propensity to cause skin sensitisation - contact dermatitis.

    Good to see that this company state "The tea tree oil industry is
    unanimous in its recommendation that oxidized tea tree oil should not be used.

  21. Mr C.W.Kerans

    Mr C.W.Kerans Active Member

    Compound Tincture of Benzoin was used to improve dressing adhesion in individuals with moist skin (hyperhidrosis) and as an occasional skin mask when using caustics in the treatment of verrucae. I haven't used it for years and think its application is now seen largely as historic in the U.K. and Ireland, although it seems to retain popularity in Australia and possibly elsewhere.
  22. Tessmeg

    Tessmeg Welcome New Poster

    Use of Tinc Benz

    Hi everyone, this is my first post. I've been out of practising for some years however hoping to restart soon.

    My question is do dom fhp's still use 'Tinc Benz' via a 'dropper' to seal wounds?

    As in my recent training, with NHS, patients with small abrasions/wounds were treated with inadine dressing. This seemed wasteful as any unused part was discarded.

    Any suggestions would be much appreciated thanks.
  23. Admin2

    Admin2 Administrator Staff Member

    {Threads merged}
  24. blinda

    blinda MVP

    Re: Use of Tinc Benz

    Hi Tessmeg,

    :welcome: to Pod Arena.

    Hopefully, your question will have been answered by Admin kindly merging threads. Toeslayers` posts in particular should have clarified Friars Balsams` gradual demise in the foot health industry.

    Inadine is a popular choice of dressing, as it is a comparatively cheap disinfectant (NB not anti-microbial). However, susceptibility to iodine hypersensitivity is on the increase. Guidelines state that it should not be used for more than four consecutive dressings as elevated levels of serum iodide have been documented in topical use. Nor should it be used in care for pts with thyroid disorders.

    The choice of dressing for a wound, will depend on classification of the wound. Your assessment of the wound should determine your treatment plan and you need to be in a position to justify your choice of dressing. Is it an abrasion, or a contaminated ulcer? Etc, etc.

  25. Tessmeg

    Tessmeg Welcome New Poster

    Thanks for your reply Bel and to admin for the welcome and their merging of posts.

    It seems that tinc benz is rather outdated and is now only used by devotees of its obvious useful properties. But to fully clarify" the cleansing and closing of small abrasions" should I ideally stick to either dressings of Inadine or prehaps Bactigras. Moreover would it be ok to use a dropper to apply a small amount of Iodine solution. This seems a cheaper solution however could be an outdated method, due to spillage problems.

    Cheers for any advice Tessmeg
  26. davidh

    davidh Podiatry Arena Veteran

    The correct abreviation is obviously T. B Co.

    C T B? Rubbish!
  27. footsiegirl

    footsiegirl Active Member

    Hi folks

    I remember one of my very junior jobs as a student nurse in the early 80s was to clean out the Nelson's inhalers, which were thick with the stuff. It was used as an inhalation for respiratory conditions, but became 'outlawed' with the rising advent of H&S and the risk of scalding a patient with boiling water.

    I do still use Tincture of Benzoin to help retain dressings/paddings, and it works a treat - though it can be messy to work with. I keep surgical spirit to hand to dissolve any that comes in to contact with unwanted areas.

    The literature on it does warn against potential allergy, though I have not seen a case of this.

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