Friar’s balsam, or compound benzoin tincture, is a traditional resin‑based preparation that has persisted into modern practice as a niche but useful topical agent for selected foot conditions. In podiatry it is used far less as a “panacea” than in the past, but remains relevant as both an adhesive enhancer for padding and dressings and as a mild antiseptic and protectant for superficial lesions and fissures.
Composition and pharmacological actions
Friar’s balsam is a solution of benzoin resin in ethanol, with additional balsamic resins such as storax, Tolu balsam and aloe, giving it characteristic antiseptic, astringent and film‑forming properties. The alcohol vehicle facilitates rapid evaporation, leaving a thin resinous film that adheres to the stratum corneum and increases surface tack.
The benzoin and related resins contain esters and free cinnamic and benzoic acids, compounds long associated with weak antimicrobial and antiseptic effects. When applied to intact or minimally disrupted skin, the evaporating alcohol has a transient drying, cleansing effect, while the residual film acts as a protectant, reducing minor friction and contamination over small wounds, fissures or chapped skin. However, these same resins are also well‑recognised contact allergens, which places practical limits on widespread use.
Historical and modern indications
Historically Friar’s balsam was promoted as a near‑universal topical remedy for “wounds of all kinds, bruises, and all skin disorders”, and even taken internally for problems as diverse as worms, haemorrhoids and “cardiac disease”. Contemporary regulatory indications are far narrower, with the product listed in Australia, for example, as an antiseptic for minor cuts and abrasions and as a symptomatic treatment for common colds when inhaled as steam.
For foot care, modern over‑the‑counter descriptions emphasise its use as an antiseptic protectant for minor cuts and abrasions, chapped skin, small skin fissures and bedsores, and to relieve itch associated with chilblains and mild eczematous conditions. In practice this translates to typical podiatric scenarios such as superficial heel fissures, minor interdigital splits, small periungual cracks and low‑grade excoriations where a light, protective barrier is useful but heavy occlusion is undesirable.
Role as an adhesive enhancer in foot care
Within podiatry and sports medicine, Friar’s balsam is now best known for its role as an adhesive enhancer under taping and padding on the foot. When applied sparingly to clean, dry, intact skin and allowed to dry for 30–60 seconds, compound benzoin tincture markedly increases the bond strength of adhesive tapes, dressings, felt and foam padding, particularly in high‑friction, high‑sweat environments such as the plantar forefoot and heel.
This property is especially valuable in:
- Management of friction blisters: ensuring that prophylactic tapes and hydrocolloid dressings remain adherent on macerated or sweaty skin during running, hiking or field sports.
- Off‑loading corns and calluses: helping semi‑compressed felt or foam pads remain in situ over bony prominences like metatarsal heads or toe dorsum for longer between changes.
- Securing post‑operative or post‑debridement dressings: improving adherence around toes and plantar surfaces where conforming dressings tend to lift.blister-prevention+1
However, the very stickiness that makes Friar’s balsam useful can also raise local friction if used over too large an area: exposed resin can attract sock fibres and grit as the foot perspires, increasing the coefficient of friction and, paradoxically, the risk of blisters. Clinically, this necessitates highly targeted application limited to the footprint of the intended tape or pad, with any exposed areas dusted with powder or covered to prevent unwanted traction.
Use for fissures, chapping and minor lesions
Product information from several manufacturers highlights Friar’s balsam as a topical protectant for “chapped skin and lips, cracked nipples, small skin fissures and bedsores”, with additional claims of relieving itching in chilblains, eczema and urticaria. Transposing these indications to the foot, potential uses include:
- Small, superficial heel fissures or peri‑fissure skin where a light film may reduce further splitting and contamination once bleeding has ceased.
- Mild periungual cracks or interdigital fissures secondary to irritant dermatitis or cold exposure, if the surrounding skin is otherwise intact.
- Low‑grade chilblain itch on toes, as an adjunct to standard warmth and vascular‑protective measures, noting that the evidence is experiential rather than trial‑based.
Nevertheless, the alcohol base will sting intensely on open blisters, abrasions or actively exuding eczema. Best practice is therefore to restrict application to intact or nearly healed skin around a lesion, and to rely on more conventional emollients, barrier creams and appropriate dressings for substantive fissures, ulcers or dermatitis.
Risks, contraindications and patient selection
The major clinical limitation in using Friar’s balsam on the feet is the risk of dermatitis. Allergic contact dermatitis to the balsamic resins (benzoin, storax, Tolu balsam) is well documented and considered the most important adverse effect, often presenting with delayed pruritic, eczematous eruptions 24–72 hours after exposure. Once sensitised, patients are likely to exhibit cross‑reactivity with other fragrance mixtures and Balsam of Peru, creating persistent difficulties with many cosmetics and topical products.biomedicus
Irritant contact dermatitis is also possible, driven by the high alcohol content and resin load, and typically presents as immediate burning and erythema at the site of application, particularly on already compromised skin. Product information also notes that frequent or widespread application can cause skin dryness and cracking, an undesirable effect on already vulnerable plantar skin.file2.
Other safety considerations include:
- Avoidance on broken or significantly inflamed skin, given stinging, potential irritancy and theoretical risk of increased systemic absorption.
- Caution in atopic patients or those with known fragrance or Balsam of Peru allergy, where the sensitisation risk is high.
- Avoidance of use as an inhalant in individuals with asthma or significant respiratory disease, due to the potential for bronchospasm.
In podiatric settings, patch‑testing a small area before wider use may be prudent in patients with complex dermatological histories, and practitioners should counsel patients to discontinue use and seek review if any rash, intense itching or blistering develops.
Place of Friar’s balsam in contemporary podiatry
In modern evidence‑based foot care, Friar’s balsam occupies a modest, adjunctive role rather than a central therapeutic position. Its primary contemporary value lies in:
- Enhancing the adherence and durability of tapes, dressings and off‑loading pads in challenging high‑moisture, high‑friction environments such as athletic or occupational feet.
- Providing mild antiseptic and protective film effects for minor, superficial lesions and fissures, when used judiciously on nearly intact skin.
Balanced against this are the relatively high rates of irritant and allergic contact dermatitis and the availability of alternative adhesive enhancers and barrier products (such as colourless skin‑prep wipes) that may offer similar benefits with less mess and potentially lower allergenicity. For the podiatric clinician, Friar’s balsam is therefore best considered a specialised tool: useful in selected patients and specific foot‑care scenarios, but always deployed with restraint, targeted application and awareness of its sensitising potential.