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ABC NEWS NEW YORK 
(ABC News Photo Illustration)
Of all the drugs young people can use at clubs, the latest trend in New York may be the least hip among all circles: Preparation H. New York bouncer, blogger and author Rob Fitzgerald has noticed a trend among many of the macho young men waiting outside his clubs. He says the guys are slathering up their torsos with the hemorrhoid cream Preparation H to make themselves look "ripped" for the ladies. Fitzgerald asked one of these guys to describe the practice for his blog, Clublife, "The way you use it is to take your shirt off and rub it all over yourself before you go to the club," Peter Minichiello says. "If you want to get [lucky], you have to know how to dance, and if you want girls to dance with you, you have to look ripped." The idea is a bad imitation of a flab spot-treatment secret used by bodybuilders before a competition. But the clubbers who lube up may not like to hear what the medicine in Preparation H actually does to their frame or the real health risks it can pose. Bodybuilders and Posers"The bodybuilders I know use it on their obliques -- their love handles -- to take away any lingering water weight before shows," Fitzgerald told ABC News. "The guys in the clubs heard about this, and the use of it spread virally like some kind of Internet meme." Preparation H contains a medication called phenylephrine HCL that -- when used for the drug's intended purpose -- will shrink the swollen tissues of hemorrhoids. It works by constricting the nearby blood vessels that feed blood and fluid to the area. But the ingredient doesn't discriminate what kind of tissue it will shrink, hence the underground beauty tips of applying Preparation H under the eyes, on love handles or other places. None of which Wyeth, the makers of Preparation H, support. "Applying it to one's chest is an off-label use of Preparation H," said Milicent Brooks, a representative of Wyeth Consumer Healthcare. "We don't approve or endorse any off-label uses." For bodybuilders, amateur contests are a challenge to both build muscle and to showcase it. On a strength contest alone, hefty 300-pound football offensive linemen could enter. But to show muscles, bodybuilders must also thin anything that stands in the way between their brawn and the audience, including fat, skin and fluid. "Some individuals have naturally thicker skin due to their genetics, and even if they become lean and have low body fat, they still don't look shredded," said Steve Downs, vice president of International Natural Bodybuilding and Fitness Federation. "Others have naturally thin skin and require less dieting to get into contest shape, and can look much more ripped and defined," said Downs, who adds he has only heard of a few bodybuilders using Preparation H during his career. Even if Preparation H actually thins skin over the muscles of bodybuilders, it won't turn the clubber with an average build into Popeye. The Real Effect"If anything, it would make your chest smaller," said Dr. Darrell S. Rigel, clinical professor of dermatology at New York University Medical Center in New York City. "Medically, there's nothing in there to make you bigger. If you put cayenne pepper on you, now that would do something -- that would be the opposite of Preparation H." Rigel says the inflammatory chemicals in cayenne pepper would make the skin swell over the muscles, giving the illusion of larger muscles. Yet with the cooling ingredients in Preparation H, and the obvious burning effect of cayenne pepper, men in clubs might choose to look small and sinewy rather than strong and swollen. But Dr. Leslie Baumann, author of Skinguru.com and director of the Institute of Cosmetic Medicine and Research at the University of Miami, warns that Preparation H also can have uncomfortable side effects. "It can work, but you can also get an allergy to it," said Baumann, who knew a friend who applied Preparation H under her eyes the day of her wedding only to break out with a rash on her face. Rigel said Preparation H can have more serious side effects inside the body. Since the active ingredient works by constricting blood vessels, Preparation H has the potential to raise blood pressure. "Probably if you put enough of it on, it would raise your blood pressure," Rigel said. "It's not designed to cover the whole area of your chest. It's designed to cover a small part of your rear end."
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