Arthritis Osteoarthritis Living With Using Icy Hot for Muscle Pain Product Variations and How They Work By Carol Eustice Carol Eustice LinkedIn Twitter Carol Eustice is a writer who covers arthritis and chronic illness. She is the author of "The Everything Health Guide to Arthritis." Learn about our editorial process Updated on October 13, 2022 Medically reviewed by David Ozeri, MD Medically reviewed by David Ozeri, MD LinkedIn David Ozeri, MD, is a board-certified rheumatologist. He is based in Tel Aviv, Israel, where he does research at Sheba Medical Center. Previously, he practiced at New York-Presbyterian Hospital. Learn about our Medical Expert Board Print Table of Contents View All Table of Contents Uses Ingredients Before Using Forms/Dosages Frequently Asked Questions Given how Icy Hot works, this topical, over-the-counter pain reliever is well-named. Icy Hot causes the skin to feel cool and then warm with active ingredients like menthol and methyl salicylate (wintergreen oil). These ingredients simultaneously stimulate nerve receptors in the skin and block pain signals to the brain, dulling minor aches and pain. Icy Hot's cooling/warming sensations kick in immediately when applied to the skin. Depending on the formulation and the severity of your pain, the pain relief can last for anywhere from a few hours to up to 12. This article explains how Icy Hot works and what conditions it can help treat. It also describes the different Icy Hot formulations, including how it is applied and the possible risks. IAN HOOTON / Getty Images Icy Hot Uses Icy Hot topical pain relievers use counterirritants, which act on pain receptors to dull minor aches and pains. Icy Hot products are approved for: Minor arthritis painSimple backacheMuscle sorenessStrains and sprainsBruisesCramps Icy Hot Ingredients The active ingredients in Icy Hot vary from product to product. Some common compounds include: Menthol alone Menthol and methyl salicylate Menthol and camphor Menthol and lidocaine (a topical anesthetic) Icy Hot is for external use only. The ingredients cause a cool sensation followed by warmth. So first it's "icy," then it's "hot." Few studies have investigated the effect of pain patches like Icy Hot's. Most of them have been of poor quality. How Topical Creams Can Relieve Pain Before Using Icy Hot Always follow the instructions on the label of Icy Hot products. Each product has its own instructions. Some forms are stronger than others. All Icy Hot products say they're for adults. They shouldn't be used by children under 12 unless a healthcare provider approves. Precautions The warnings on Icy Hot labels say: Use only as directed. Avoid contact with eyes or mucous membranes. Do not apply to wounds or irritated, broken, or damaged skin. Do not bandage tightly or use with a heating pad. If you're prone to aspirin or salicylate allergies, ask a doctor before using products containing methyl salicylate. Do not apply to skin folds. Do not expose the treated area to direct sunlight or heat. Stop use right away if you have a severe burning sensation. FDA Warning Topical pain relievers may cause first-to-third degree chemical burns, the U.S. Food and Drug Administration (FDA) warns. This applies to topical pain relievers—creams, ointments, lotions, and patches—including menthol, methyl salicylate, lidocaine, or capsaicin. Icy Hot Formulations and Dosages You can buy a wide range of over-the-counter (OTC) products under the Icy Hot brand. They include: PatchesSleevesBalmsRoll-onsDry spraysGelsCreams They come in various strengths and combinations of ingredients. Icy Hot Back Patch Icy Hot offers three patches: the Icy Hot Back Patch, Advanced Relief Patch, and Lidocaine Patch. They all have medication on an adhesive pad. But they have different ingredients, strengths, and instructions. Icy Hot Back Patch Contains 5% menthol.Comes in regular and extra-large (XL) sizes.Apply to your back or other large areas.Wear for up to eight hours.Repeat up to three times daily. Icy Hot Advanced Relief Patch Contains 7.5% menthol.Wear for up to 12 hours.Use only one per day. Icy Hot Lidocaine Patch Contains 4% lidocaine and 1% menthol.Wear for up to 12 hours.Use only one at a time. Salonpas: OTC Pain Patches Icy Hot Sleeve The Icy Hot Sleeve comes in one form and dosage. Contains 16% menthol lotion on a flexible sleeve pad.Fits anything between 8 inches and 24 inches in circumference.Generally used for ankle, elbow, and knee joints.Use for up to eight hours.Use up to three per day. Follow the directions for applying the sleeve correctly. Icy Hot Balm Icy Hot Balm is an "extra strength" product. The dosages are higher than other Icy Hot products. Contains 7.6% menthol and 29% methyl salicylate.Apply to the affected area and massage until it's absorbed.Repeat up to four times daily. The balm is available in a 3.5-ounce jar. Icy Hot No Mess Three forms of Icy Hot No Mess come in a roll-on applicator. They're quick-drying and don't stain. Icy Hot No Mess Contains 16% menthol.Apply to the affected area and massage in.Repeat up to four times a day. Icy Hot Lidocaine No Mess Contains 4% lidocaine and 1% menthol.Apply to the affected area every six to eight hours.Use up to three times daily. Icy Hot PRO No Mess Contains 16% menthol and 11% camphor.Use the applicator to massage into to the affected area every six to eight hours.Apply up to four times a day. The no-mess products come in a 2.5-ounce bottle. Topical Relief for Muscle Pain Icy Hot Dry Spray Icy Hot Dry Spray comes in three formulations. It's in a continuous spray bottle and dries quickly. These products don't need to be massaged into the skin. Icy Hot Dry Spray Contains 16% menthol.Use up to three or four times daily. Icy Hot Lidocaine Dry Spray Contains 4% lidocaine and 1% menthol.Apply every six to eight hours.Use up to three times daily. Icy Hot PRO Dry Spray Contains 16% menthol and 11% camphorApply to the affected area every six to eight hours.Use three to four times a day. These products are extremely flammable. Do not use them when smoking or near heat or a flame. Read their labels for further instructions. Icy Hot Gels Two Icy Hot gels formulations are available. Icy Hot Power Gel Contains 16% menthol.Fast-acting, quick-drying formula.Apply to the affected area and massage in.Repeat up to three or four times a day. Icy Hot Vanishing Scent Gel Icy Hot Vanishing Scent comes in a 2.5-ounce tube with a sponge-top applicator. Contains 2.5% menthol. Squeezed onto the affected area. Use the sponge applicator to massage in until absorbed.Repeat up to four times a day. The scent disappears quickly after application. Icy Hot Cream Icy Hot Cream is a non-greasy formulation that works immediately on contact. It comes in four versions. Icy Hot Cream Contains 10% menthol and 30% methyl salicylate.Available in 1.25-ounce and 3-ounce tubes.Apply and massage in.Repeat up to four times a day. Icy Hot Advanced Cream Contains 11% camphor and 16% menthol.Available in a 2-ounce tube.Apply and massage in.Repeat up to four times a day. Icy Hot Lidocaine Cream Contains 4% lidocaine and 1% menthol.Available in 1.75-ounce and 2.7-ounce tubes. Icy Hot PRO Cream Contains 16% menthol and 11% camphor.Massage into the affected area every six to eight hours.Use up to four times a day. Topical Creams For Neuropathy Summary Icy Hot is a topical pain reliever that comes in multiple strengths, formulations, and combinations of ingredients. Each type is applied differently. Follow the instructions on the product label. FORM DOSAGE INGREDIENTS HOW OFTEN Back Patch 5% Menthol Up to 8 hours each, up to 3 patches per day Advanced Relief Patch 7.5% Menthol Up to 12 hours each, one only per day Lidocaine Patch 4% 1% Lidocaine Menthol Up to 12 hours each, only one at a time Sleeve 16% Menthol Up to 8 hours each, up to 3 sleeves per day Balm 7.6% 29% Menthol Methyl salicylate Use up to 4 times per day No Mess Roll-On 16% Menthol Use up to 4 times per day Lidocaine No Mess Roll-On 4% 1% Lidocaine Menthol Use up to 3 times per day, every 6-8 hours Dry Spray 16% Menthol Use up to 4 times per day Lidocaine Dry Spray 4% 1% Lidocaine Menthol Use up to 3 times per day, every 6-8 hours Power Gel 16% Menthol Use up to 4 times per day Vanishing Scent Gel 2.5% Menthol Use up to 4 times per day Cream 10% 30% Menthol Methyl salicylate Use up to 4 times per day Advanced Cream 11% 16% Camphor Menthol Use up to 4 times per day Lidocaine Cream 4% 1% Lidocaine Menthol Use up to 4 times per day A Word From Verywell Icy Hot products may change or become unavailable at any time. New products may also become available. Some store brands are similar to Icy Hot. That includes Walgreen's store brand Cool N Heat products. Compare those products for price and ingredients. Always talk to your healthcare provider before trying new medicinal products. Possible concerns include allergies and sensitivities, drug interactions, and effects on other health conditions. Frequently Asked Questions How can you treat a chemical burn from Icy Hot? The best way to treat a chemical burn is to remove the medicine by flushing the area with cool water for 15 minutes. Then wrap the burn with a sterile bandage to protect it. Does Icy Hot help with inflammation? No, Icy Hot does not reduce inflammation. It works by creating cool and warm sensations on the skin that essentially "drown out" the pain. Does Icy Hot contain capsaicin? No. The current Icy Hot product line does not contain capsaicin. The Icy Hot with Capsaicin line of products has been discontinued. 4 Sources Verywell Health uses only high-quality sources, including peer-reviewed studies, to support the facts within our articles. Read our editorial process to learn more about how we fact-check and keep our content accurate, reliable, and trustworthy. Lisi DM. OTC transdermal analgesic patches in pain management. US Pharmacist. 2019;44(3):15-21. U.S. Food and Drug Administration. FDA drug safety communication: Rare cases of serious burns with the use of over-the-counter topical muscle and joint pain relievers. University of Florida Health. Chemical burn or reaction. Atlantic Brain and Spine. Is Icy Hot effective at relieving back pain? Additional Reading Sanofi Consumer Healthcare. Icy Hot. By Carol Eustice Carol Eustice is a writer who covers arthritis and chronic illness. She is the author of "The Everything Health Guide to Arthritis." 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