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analgesic balm

Generic Exigence
Used for Pain

Menthol/methyl salicylate is a combination medication that's applied to the skin to help relieve minor aches and pains. It's available over the counter (OTC) as brand-name and lower-cost, generic options. Menthol/methyl salicylate comes in many different forms including patches, gel, cream, balm, spray, topical liquid, and topical oil. This medication doesn't cause many side effects, but it can sometimes cause a burning sensation after applying.

Reviewed by:Last reviewed on September 16, 2022
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What is Menthol/methyl salicylate?

What is Menthol/methyl salicylate used for?

Minor aches and pains in muscles and joints related to:

  • Arthritis
  • Backache
  • Strains
  • Sprains
  • Bruises

How Menthol/methyl salicylate works

Menthol/methyl salicylate is a topical analgesic. It's a combination of two medications: menthol and methyl salicylate. These medications relieve pain when applied to the skin by acting as counterirritants. This means that they turn on pain sensors in the skin, which then makes them less sensitive to pain signals. Methyl salicylate also causes the blood vessels in the skin to widen, which allows for more blood flow to the area of skin. This causes a warming sensation, which can help soothe pain.

Drug facts

Common BrandsIcy Hot Original Pain Relieving Cream, Bengay Greaseless Topical Analgesic Cream, Exigence Lotion, Salonpas Pain Relief Patch, Salonpas Pain Relieving Jet Spray
Drug ClassTopical analgesic
Controlled Substance ClassificationNot a controlled medication
Generic StatusLower-cost generic available
AvailabilityOver-the-counter
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Side effects of Menthol/methyl salicylate

The following side effects may get better over time as your body gets used to the medication. Let your healthcare provider know immediately if you continue to experience these symptoms or if they worsen over time.

Common Side Effects

  • Burning sensation

Less Common Side Effects

  • Skin irritation

Menthol/methyl salicylate serious side effects

Contact your healthcare provider immediately if you experience any of the following.

  • Serious skin burns: pain, swelling, blistering of the skin
  • Salicylate poisoning: nausea, vomiting, fast breathing, dizziness, confusion, headache

Source: DailyMed

The following Menthol/methyl salicylate side effects have also been reported

Side effects that you should report to your care team as soon as possible:

Side effects that usually do not require medical attention (report these to your care team if they continue or are bothersome):

  • Mild skin irritation, redness, or dryness
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Pros and cons of Menthol/methyl salicylate

Pros

  • Available OTC as a lower-cost generic
  • Comes in many different formulations
  • Can apply directly to the painful area
  • Generally well tolerated with few side effects
  • Patches can be worn for up to 12 hours.

Cons

  • Can't apply to irritated or damaged skin
  • Can't be used in people who are allergic to aspirin or nonsteroidal anti-inflammatory drugs (NSAIDs)
  • Shouldn't used for more than 7 days at a time
  • Can cause irritation if it makes contact with the eyes
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Pharmacist tips for Menthol/methyl salicylate

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  • Wash your hands with soap and water once you've finished applying or handling menthol/methyl salicylate. This will help you avoid irritating your eyes or other sensitive areas if they accidentally come into contact with this medication.
  • Don't cover menthol/methyl salicylate with a tight bandage. And don't apply a heating pad or other heating device to an area with the medication on it. This can raise your risk for getting skin irritation or burning.
  • You might feel a slight burning sensation after applying a menthol/methyl salicylate product. This sensation usually goes away after several days, but if it continues or gets worse, let your provider know.
  • Some formulations of menthol/methyl salicylate have specific instructions on using the medication before or after taking a shower or bath. For example, don't use the gel form 1 hour before bathing or within 30 minutes after bathing. Hot water from a bath or shower can raise your risk of burns or skin irritation from this medication.
  • Shake the spray can well before using. After applying, you can let the area dry or rub it in. Rubbing the medication into the skin will allow it to work better, but you should wash your hands afterwards. Avoid inhaling any fumes from the spray can, and always spray it away from your face to avoid irritation in your eyes.

Menthol/methyl salicylate patch:

  • Only use one patch at a time to prevent too much medication from getting absorbed into your body and causing side effects. Remove the old patch before applying a new one.
  • Throw menthol/methyl salicylate patches away after a single use. The best way to throw a medicated patch away is to fold it in half (sticky sides together) and then place it in a lidded trash can. This will keep someone from accidentally touching the medicated side of the patch and getting it on their skin.
  • It can take several hours to get pain relief after applying a patch. If your pain lasts after using the first patch, you can remove it and apply a second patch for up to another 8 to 12 hours. Don't use the patches for more than 3 days in a row. If you're still having pain, contact your provider.
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Common questions about Menthol/methyl salicylate

You should only apply menthol/methyl salicylate to healthy skin. Don't apply it to wounds or irritated or damaged skin, and don't bandage the area tightly. This can raise your risk for serious burns. Also don't get the medication in or around your eyes, mouth, genital area, or the inside of your nose since this can lead to irritation. If you experience severe burning or blistering, stop using menthol/methyl salicylate and get medical help right away.

For most formulations of menthol/methyl salicylate, it's only recommended to use the medication for up to 7 days. If you're using menthol/methyl salicylate patches, it's not recommended to use them for more than 3 days in a row. If you're still having pain in the same area after this time, or if your pain goes away and comes back again a few days later, you should talk to your healthcare provider. There might be something else causing your pain that your provider should examine.

Menthol/methyl salicylate might help relieve inflammation (redness, swelling, or pain). The ingredient methyl salicylate can lower the number of certain chemicals in the body that cause inflammation. This can lead to less inflammation and help relieve pain from problems like arthritis or backaches.

Menthol/methyl salicylate doesn't contain aspirin, but the ingredient methyl salicylate has a similar chemical structure to aspirin. This means that if you're allergic to aspirin or other NSAIDs, you might also be allergic to menthol/methyl salicylate. Ask your healthcare provider before using menthol/methyl salicylate if you're allergic to aspirin or an NSAID.

No, you shouldn't cut menthol/methyl salicylate patches to fit a particular area of your body. This can change the way the medication is released, which can lead to more side effects. You can find menthol/methyl salicylate patches in various sizes, so try to choose one that will best fit the area you're treating.

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Risks and warnings for Menthol/methyl salicylate

Menthol/methyl salicylate can cause some serious health issues. This risk may be even higher for certain groups. If this worries you, talk to your doctor or pharmacist about other options.

Salicylate poisoning

  • Risk factors: Overusing or ingesting the product | Use in young children

Rarely, menthol/methyl salicylate can cause salicylate poisoning. This happens when your body absorbs too much of the medication, mostly through overusing or ingesting the product. It's important to keep products containing more than 5% of methyl salicylate away from young children, since it can be toxic if they're exposed to the medication. Salicylate poisoning is serious and should be treated right away. Get medical help right away if you experience nausea, vomiting, stomach pain, fast breathing, or dizziness.

Risk of serious skin burns

  • Risk factors: Covering the application area | Applying heat to the application area

Although rare, menthol/methyl salicylate can cause serious skin burns, usually occurring within 24 hours of the first use. Sometimes the burns can be so severe that the event requires hospitalization. Stop using this medication if you experience pain, blistering, or swelling at the site of application and get medical help right away.

Flammable products

Some products, like the menthol/methyl salicylate spray, can catch on fire if it's used near heat, a flame, or smoking. Take care to check the packaging to see if it's flammable (can catch on fire). Avoid storing these products long term in temperatures greater than 104ºF, and always keep them out of temperatures greater than 120ºF.

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Menthol/methyl salicylate dosage

The average cost for 28 tubes of 10%/15% of Menthol/methyl salicylate is $3.72 with a free GoodRx coupon. This is 44.81% off the average retail price of $6.74.
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DosageQuantityPrice as low asPrice per unit
10%/15%28 tubes$3.72$0.13

Typical dosage for Menthol/methyl salicylate

Menthol/methyl salicylate is available in different strengths, formulations, and product names. The medication can also be used for different conditions. Make sure you follow the instructions on the package for the product you're using. Some examples include:

Topical cream with 2% menthol and 8% methyl salicylate:

  • Adults and children 12 years and older: Apply to the affected area up to 3 to 4 times daily.
  • Children under 12 years old: Ask your child's provider.

Topical lotion with 3% menthol and 10% methyl salicylate (Exigence brand):

  • Adults only: Apply to the affected area up to 3 to 4 times daily.

Topical patch with 3% menthol and 10% methyl salicylate (Salonpas Pain Relief brand):

  • Adults 18 years and older: Apply one patch to the affected area, and leave it in place for up to 8 to 12 hours. Only use one patch at a time, and don't use more than 2 patches per day.
  • Children under 18 years old: Ask your child's provider.

Topical spray with 3% menthol and 10% salicylate (Salonpas Pain Relieving Jet brand):

  • Adults and children 12 years and older: Spray at least 4 inches away from the affected area. Spray the area for no longer than 1 second, and use no more than 3 to 4 times daily.
  • Children under 12 years old: Ask your child's provider.
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Menthol/methyl salicylate (generic)
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What are alternatives to Menthol/methyl salicylate?

There are a number of medications that your doctor can prescribe in place of Menthol/methyl salicylate. Compare a few possible alternatives below.
Menthol/methyl salicylate
Used for:

Minor aches and pains in muscles and joints related to:

  • Arthritis
  • Backache
  • Strains
  • Sprains
  • Bruises
$3.72Lowest GoodRx priceView prices
Used for:

Minor aches and pains in muscles and joints related to:

  • Arthritis
  • Backache
  • Strains
  • Sprains
  • Bruises
  • Cramps
  • Bursitis (inflamed bursa)
  • Tendonitis (inflamed tendon)
$22.37Lowest GoodRx priceView prices
Used for:

Minor aches and pains in the muscles and joints caused by:

  • Arthritis
  • Backache
  • Strains
  • Sprains
  • Bruises
  • Damaged nerves
$104.88Lowest GoodRx priceView prices

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