Topical creams or gels sold over-the-counter to relieve pain in muscles and joints may cause chemical burn, some of which have required medical attention, the Food and Drug Administration (FDA) warns.
OTC topical pain relievers include creams, lotions, ointments and patches sold under brand names such as Icy Hot, Bengay, Capzasin, Flexall, and Mentholatum. The products are applied to the skin. The FDA cautions consumers that it has received reports of serious skin injuries with these products, and people who experience burning pain or blistering after using the products should seek medical attention immediately.
The injuries, while rare, have ranged from mild to severe chemical burns. In many cases, the burns where the product was applied occurred after just one application, with severe burning or blistering occurring within 24 hours. Some had complications serious enough to require hospitalization.
“There is no way to predict who will have this kind of reaction to a topical pain reliever for muscles and joints,” says Jane Filie, M.D., a medical officer in the FDA’s Division of Nonprescription Regulation Development.
There have been 43 cases of burns associated with the products to date. The products contain active ingredients such as menthol, methyl salicylate, and capsaicin. These ingredients create sensations of local warmth or coolness, but should not burn.
According to the FDA’s data, a majority of the severe burns occurred with the use of a menthol or menthol/methyl salicylate combination product. Most of the cases involved products that contain higher concentrations of menthol and menthyl salicylate (greater than 3 percent menthol or 10 percent methyl salicylate).
People who use OTC topical painkillers should follow precautions, including
- Not applying the products to damaged or irritated skin
- Not applying bandages to the area where the product has been applied
- Not applying heat to the area in the form of heating pads, hot water bottles or lamps. Doing so increases the risk of serious burns.
- Not letting the product to come in contact with eyes and mucous membranes, such as areas around the nose, mouth or genitals.
If pain is felt after applying the product, look for signs of burning such as blistering or redness. If you see any of these signs stop using the product and seek medical attention immediately.