(BHL) The U.S. Food and Drug Administration (FDA) is alerting the public that certain over-the-counter (OTC) products applied to the skin for the relief of mild muscle and joint pain have been reported to cause rare cases of serious skin injuries, ranging from first- to third-degree burns, where the products were applied. These OTC topical muscle and joint pain relievers are available as single- or combination-ingredient products that contain menthol, methyl salicylate, or capsaicin. The various formulations include creams, lotions, ointments, and patches.
The product are marketed under various brand-names and include, Bengay, Capzasin, Flexall, Icy Hot, and Mentholatum.  They are used to temporarily relieve minor muscle and joint aches and pain
When applied to the skin, the products produce a local sensation of warmth or coolness; but they should not cause pain or skin damage. However, there have been rare cases of serious burns following their use.  Some of the burns had serious complications requiring hospitalization. In many cases, the burns occurred after only one application of the OTC topical muscle and joint pain reliever, with severe burning or blistering occurring within 24 hours of the first application. Based on the reported cases, the majority of second- and third-degree burns occurred with the use of products containing menthol as the single active ingredient, and products containing both menthol and methyl salicylate, in concentrations greater than 3% menthol and 10% methyl salicylate. Few cases reported using a capsaicin-containing product.
Consumers using an OTC topical muscle and joint pain reliever who experience signs of skin injury where the product was applied, such as pain, swelling, or blistering of the skin, should stop using the product and seek medical attention immediately.
You should also be aware of these additional warnings if using these products:
  • When applying OTC topical muscle and joint pain relievers to the skin, do not bandage the area tightly and do not apply local heat (heating pads, lamps, hot water in bags or bottles) because doing so can increase the risk of serious burns.
  • Do not apply OTC topical muscle and joint pain relievers to wounds or damaged, broken, or irritated skin. Also do not allow contact with eyes and mucous membranes (such as the skin inside your nose, mouth, or genitals).
  • Talk to a health care professional if you have any questions or concerns about using OTC topical muscle and joint pain relievers.
  • Report side effects from the use of OTC topical muscle and joint pain relievers to the FDA MedWatch program, using the information in the "Contact FDA" box at the bottom of the page.