Balsam of Peru or Peru balsam, also known and marketed by many other names, is a balsam derived from a tree known as Myroxylon balsamum var. pereirae; it is found in El Salvador, where it is an endemic species. Balsam of Peru is used in food and drink for flavoring, in perfumes and toiletries for fragrance, and in medicine and pharmaceutical items for healing properties. It has a sweet scent. In some instances, balsam of Peru is listed on the ingredient label of a product by one of its various names, but it may not be required to be listed by its name by mandatory labeling conventions. It can cause allergic reactions, with numerous large surveys identifying it as being in the "top five" allergens most commonly causing patch test reactions. It may cause inflammation, redness, swelling, soreness, itching, and blisters, including allergic contact dermatitis, stomatitis (inflammation and soreness of the mouth or tongue), cheilitis (inflammation, rash, or painful erosion of the lips, oropharyngeal mucosa, or angles of the mouth), pruritus, hand eczema, generalized or resistant plantar dermatitis, rhinitis, and conjunctivitis. Harvesting and processing Balsam of Peru is obtained by using rags to soak up the resin after strips of bark are removed from the trunk of Myroxylon balsamum var. pereirae, boiling the rags and letting the balsam sink in water. The balsam is an aromatic dark-brown oily fluid. Composition Balsam of Peru contains 25 or so different substances, including cinnamein, cinnamic acid, cinnamyl cinnamate, benzyl benzoate, benzoic acid, and vanillin. It also contains cinnamyl alcohol, cinnamaldehyde, farnesol, and nerolidol. A minority of it, approximately 30–40%, contains resins or esters of unknown composition. Uses Balsam of Peru is used in food and drink for flavoring, in perfumes and toiletries for fragrance, and in medicine and pharmaceutical items for healing properties. In some cases, it is listed on the ingredient label of a product by one of its various names. Naturally occurring ingredients may contain substances identical to or very closely related to balsam of Peru. It has four primary uses: flavoring in foods and drinks such as: caffeinated -- coffee, flavored tea alcoholic -- wine, beer, gin, liqueurs, apéritifs (e.g. vermouth, bitters) soft drinks, including cola juice citrus -- citrus fruit peel, marmalade tomatoes -- tomato-containing products, Mexican and Italian foods with red sauces, ketchup spices, e.g. -- cloves, Jamaica pepper (allspice), cinnamon, nutmeg, paprika, curry, anise, ginger sauces --