What are the side effects of menthol. How can menthol affect the body. Is menthol safe for topical use. Can menthol cause systemic toxicity. Are menthol cigarettes more addictive than regular cigarettes. How does menthol interact with the body’s sensory receptors.

The Origins and Uses of Menthol

Menthol, a compound found naturally in peppermint and other mint plants, has been widely used for its cooling and soothing properties. But where does it come from, and how is it used in everyday products?

Menthol is the primary component of peppermint oil, which is derived from the Mentha piperita plant. It can be extracted directly from plants or synthesized in laboratories. This versatile compound finds its way into numerous products we use daily, including:

• Throat lozenges
• Intranasal inhalers
• Topical pain creams
• Skincare lotions
• Food flavorings
• Oral hygiene products

Its popularity stems from the distinct cooling sensation it provides, which many find refreshing and soothing. However, this cooling effect isn’t caused by physical damage from menthol crystals or evaporation, as some might believe. Instead, it’s the result of a complex interaction at the molecular level.

The Science Behind Menthol’s Cooling Sensation

Have you ever wondered why menthol feels cool on your skin or in your mouth? The answer lies in its interaction with our body’s sensory receptors.

Menthol activates specific receptors in our nerve cells that are typically triggered by cold temperatures. These receptors, known as TRPM8 channels, are sensitive to both cooling and menthol. When menthol binds to these receptors, it causes them to open, allowing an influx of calcium and sodium ions into the nerve cells. This ion flow mimics the signals our body receives when exposed to cold temperatures, creating the sensation of coolness without any actual change in temperature.

This mechanism explains why menthol can provide a cooling sensation even in warm environments. It’s not actually lowering the temperature of your skin or mouth; instead, it’s tricking your nerves into perceiving coldness.

Beyond Cooling: Menthol’s Analgesic Properties

Menthol’s effects go beyond just cooling. It also has analgesic (pain-relieving) properties, which is why it’s often included in pain relief creams and ointments. The same mechanism that creates the cooling sensation can also help to numb pain receptors, providing temporary relief from minor aches and pains.

Potential Side Effects and Risks of Menthol Use

While menthol is generally considered safe when used as directed, it’s not without potential risks and side effects. Understanding these can help users make informed decisions about menthol-containing products.

Skin and Eye Irritation

One of the most common side effects of menthol is skin irritation. When applied topically, especially in high concentrations, menthol can cause:

• Redness
• Itching
• Burning sensation
• In severe cases, chemical burns

It’s worth noting that some individuals may be particularly sensitive to menthol, experiencing severe skin reactions even with small amounts. If you experience any unusual or severe skin reactions after using a menthol-containing product, discontinue use immediately and consult a healthcare professional.

Eye irritation is another potential risk. If menthol-containing products come into contact with the eyes, it can cause significant discomfort and potentially damage the delicate eye tissues. Always keep menthol products away from the eyes and wash thoroughly if accidental contact occurs.

Systemic Toxicity

While rare, systemic toxicity from menthol is possible, particularly if large amounts are ingested or inhaled. Calcium and sodium channels, which menthol interacts with, are present throughout our bodies. In cases of significant exposure, this can lead to serious effects, including:

• Seizures
• Coma
• In extreme cases, death

These severe reactions are typically associated with accidental ingestion of concentrated menthol products or excessive use of mentholated products. It’s crucial to use menthol-containing products as directed and keep them out of reach of children to prevent accidental ingestion.

Menthol and Respiratory Health: A Complex Relationship

Menthol’s effects on respiratory health are multifaceted and sometimes counterintuitive. While it’s often used in products meant to relieve respiratory symptoms, its actual impact on respiratory health is complex.

The Illusion of Easier Breathing

Many people use menthol-containing nasal inhalers or other products when they’re congested, believing it helps them breathe more easily. However, this perceived improvement in breathing is largely an illusion. Menthol stimulates cold receptors in the nose and throat, creating a sensation of increased airflow. But does it actually improve congestion?

Contrary to popular belief, menthol doesn’t actually reduce nasal congestion. In fact, some studies suggest it might even increase inflammation in the nasal passages over time. The feeling of easier breathing is just that – a feeling, not a physical improvement in airflow or reduction in congestion.

Potential Risks for Asthma Sufferers

For individuals with asthma or other respiratory conditions, the use of menthol products may pose additional risks. Some research suggests that menthol can increase airway resistance and potentially worsen asthma symptoms in some people. If you have asthma or another respiratory condition, it’s advisable to consult with your healthcare provider before using menthol-containing products, especially those intended for inhalation.

Menthol in Cigarettes: A Controversial Addition

The use of menthol in cigarettes has been a subject of intense debate and research in recent years. While menthol is often perceived as a harmless flavoring, its presence in cigarettes may have significant implications for public health.

Increased Addiction Potential

Some researchers believe that menthol cigarettes might increase the risk of becoming addicted to smoking. But why would menthol make cigarettes more addictive?

The cooling effect of menthol can mask the harshness of tobacco smoke, making it easier for new smokers to inhale deeply and potentially leading to higher nicotine absorption. This smoother smoking experience might make it more likely for occasional smokers to progress to regular smoking.

Additionally, menthol’s cooling effect may enhance the rewarding sensations associated with nicotine, potentially reinforcing the addictive properties of cigarettes.

Potential for Increased Toxicity

Beyond addiction concerns, some studies suggest that menthol cigarettes might be more toxic than regular cigarettes. The mechanisms behind this potential increased toxicity are not fully understood, but several theories have been proposed:

• Menthol might increase the permeability of cell membranes, potentially allowing more harmful chemicals from cigarette smoke to be absorbed.
• The cooling effect of menthol might lead smokers to inhale more deeply or hold smoke in their lungs longer, increasing exposure to harmful substances.
• Menthol could interact with nicotine or other components of cigarette smoke in ways that enhance their harmful effects.

It’s important to note that while these concerns exist, the overall health risks of smoking are severe regardless of whether cigarettes contain menthol. The best approach for health is to avoid smoking altogether or to quit if you currently smoke.

Safety Precautions and Proper Use of Menthol Products

Given the potential risks associated with menthol, it’s crucial to use menthol-containing products safely and as directed. Here are some important safety precautions to keep in mind:

Proper Application of Topical Menthol Products

When using menthol-containing creams, lotions, or ointments, follow these guidelines:

• Always dilute concentrated menthol products as directed. Many topical menthol products are already diluted in a “carrier oil” or lotion, but if you’re using pure menthol oil, be sure to dilute it properly.
• Perform a patch test before applying menthol products to large areas of skin. This can help identify any potential allergic reactions or sensitivities.
• Avoid applying menthol products to broken or irritated skin unless directed by a healthcare professional.
• Wash your hands thoroughly after applying menthol products to avoid accidentally transferring it to sensitive areas like the eyes or mouth.

Heat and Menthol: A Dangerous Combination

It’s crucial to avoid combining menthol products with heat sources. The FDA has issued warnings against:

• Putting menthol-containing products near a flame
• Placing them in hot water
• Heating them in a microwave oven
• Applying a heating pad over areas where menthol products have been used

Heat can increase the absorption of menthol through the skin, potentially leading to toxic effects. In one reported case, applying a heating pad over a menthol rub resulted in tissue death. Always follow product instructions carefully and avoid any application of heat to areas treated with menthol products.

Keeping Menthol Products Out of Reach

Like any medication or potentially harmful substance, menthol products should be kept out of reach and sight of children. Accidental ingestion can lead to serious health effects. If you suspect someone has ingested a large amount of a menthol-containing product, contact Poison Control immediately.

Natural Doesn’t Always Mean Safe: A Note on Essential Oils

Menthol is often found in essential oils, particularly peppermint oil. While these natural products are often perceived as inherently safe, it’s important to remember that natural substances can be just as potent – and potentially harmful – as synthetic ones.

Essential oils, including those containing menthol, should be treated with the same caution as any other potent substance. They should be used as directed, kept out of reach of children, and never ingested unless under the guidance of a qualified healthcare professional.

When using essential oils containing menthol:

• Always dilute them properly before applying to the skin
• Avoid using them on or near sensitive areas like the eyes, nose, or mouth
• Be aware that some individuals may have allergic reactions to essential oils
• Never use them as a substitute for prescribed medications without consulting a healthcare provider

Remember, the potency of essential oils can vary widely between products and brands. What’s safe in one concentration might be harmful in another. Always read product labels carefully and follow usage instructions.

When to Seek Medical Attention

While most people use menthol-containing products without incident, it’s important to know when to seek medical attention. Here are some situations that warrant immediate medical care:

• Severe skin reactions: If you experience severe redness, swelling, blistering, or pain after using a menthol product, seek medical attention.
• Eye exposure: If menthol gets into the eyes and irritation persists after thorough rinsing, consult a healthcare provider.
• Accidental ingestion: If someone, especially a child, has swallowed a significant amount of a menthol-containing product, contact Poison Control or seek emergency medical care.
• Respiratory distress: If you experience difficulty breathing, wheezing, or severe coughing after using a menthol product, especially if you have asthma or another respiratory condition, seek immediate medical attention.
• Allergic reactions: Signs of a severe allergic reaction (anaphylaxis) such as difficulty breathing, swelling of the face or throat, or dizziness require emergency medical care.

When in doubt, it’s always better to err on the side of caution and consult a healthcare professional. They can provide guidance based on your specific situation and health history.

Remember, if you suspect menthol poisoning or overdose, immediately call Poison Control at 1-800-222-1222 or use the webPOISONCONTROL® online tool. These resources provide expert assistance 24 hours a day and can guide you on the appropriate next steps.

Can Menthol Have Harmful Effects?

The Full Story

Essential oils are derived from plants. Their purpose is not exactly known, but some experts think that it could be a protective mechanism for the plant; others propose that they might attract pollinators. Peppermint is a popular essential oil used alone and in combination with other essential oils. Menthol is the main component of peppermint oil and is responsible for the noticeable cooling sensation. Menthol is extracted from plants or synthesized and can be found in throat lozenges, intranasal inhalers, lotions, pain creams, foods, and many other products.

Some people think that the cooling sensation from menthol is caused by mechanical damage by menthol crystals or by evaporation (like when you touch rubbing alcohol), but this is not the case. The cooling is an interaction on the molecular level with the calcium and channels in our bodies. Receptors that are responsible for feeling cold are triggered by menthol’s effects on calcium and sodium channels and a cooling sensation occurs. There are calcium and sodium channels in cell membranes throughout our bodies, and that is why we can see systemic toxicity after swallowing or inhaling concentrated amounts of menthol. Serious effects include seizures, coma, and death.

Menthol can cause eye and skin irritation. When used on the skin, menthol is typically diluted into a “carrier oil”, lotion, or other vehicle. If a high-percentage menthol product is applied to the skin, irritation and even chemical burns have been reported. There are a few reports of people being very sensitive to menthol and having severe skin reactions to even small amounts.

Products that contain menthol are flammable. In 2000, the FDA added a warning against putting products with menthol near a flame, in hot water, or in a microwave oven. There is additional warning about applying a menthol product to the skin and placing a heating pad over it.The heat increases absorption through the skin. In one case, putting a heating pad on a menthol rub resulted in tissue death.

Some nasal inhalers contain menthol. The menthol makes us feel as though we are breathing easier, but it does not actually help with congestion. In fact, it appears that more inflammation develops.

Lastly, some researchers think that cigarettes with menthol might increase the risk of becoming addicted to smoking and might be more toxic than regular cigarettes. Nicotine replacement products used to stop smoking work for menthol cigarette smokers as well.

If you think someone might be having adverse effects or have taken too much menthol, immediately call Poison Control at 1-800-222-1222 or check the webPOISONCONTROL^{® online tool for help. Whether you call or log on, expert assistance is available 24 hours a day.}

Pela Soto, PharmD, BSHS, BS

Certified Specialist in Poison Information

Poisoned?

Call


1-800-222-1222


or

HELP ME online

Prevention Tips

• Natural products should be regarded to be potentially as dangerous as drugs.
• Menthol gives the sensation of reducing congestion, but it actually can worsen congestion.
• Menthol flavoring in cigarettes might be associated with a higher rate of addiction to smoking. Smoking of all types of cigarettes, including mentholated cigarettes, is unhealthy.
• Keep all menthol-containing products out of the reach and sight of children.

This Really Happened

Case 1. A mother called Poison Control because an older child poured peppermint oil on her 3-month-old baby’s head. She thought that it likely got into the baby’s eyes and maybe into the mouth as well. The baby was not opening his eyes, the skin looked irritated and red, and the baby was crying. Poison Control recommended washing the baby’s skin with soap and water, gently irrigating the eyes with water, and giving the baby something to drink, either by nursing or by giving formula.

About an hour later, mom brought the baby to an ER because she was worried. The ER physician called Poison Control to review the toxicity of peppermint oil and menthol. The physician reported that although the infant looked well, there was concern that some of the product might have been aspirated (leaked into the lungs). Poison Control said that when aspiration is suspected, a chest x-ray should be done about 6 hours after the substance was swallowed. The x-ray was done, and it was normal. The skin irritation went away with no additional treatment beyond washing with soap and water.

Case 2. A 26-year-old woman suffered for 2 years from mild, scaly, red patches that would appear periodically on her upper lip, around her mouth, and on the top of two of her fingers. She already knew that she had some chemical sensitivities because she was unable to handle any type of adhesive tape (she would get a red itchy rash).

She was referred to a contact dermatitis specialist who did some skin patch testing and found that she was sensitive to some commonly found substances. She was given a long list of things to avoid. Her symptoms got better, but she would still have the breakouts. The doctors did a study with 100 patients, and she was the only one who reacted to two products that had one thing in common – they both contained menthol. She admitted that she regularly smoked menthol cigarettes, but did not stick with a particular brand. She did not use any other products that contained menthol. She figured out which brand was causing the problem and stopped smoking that type of cigarette. She remained symptom free after that. (from Camarasa and Alomar, 1978)

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For More Information

Peppermint oil. Bethesda MD: National Center for Complementary and Alternative Medicine; 2016 [accessed Nov 16, 2017].

Poison Post June 2014. Essential oils: poisonous when misused. Poison Post; Jun 2014.

References

Camarasa G, Alomar A. Menthol dermatitis from cigarettes. Contact Dermatitis 1978:4:169-170.

Cold, cough, allergy, bronchodilator, and antiasthmatic drug products for over-the-counter human use; amendment of final monograph for OTC antitussive drug products. Fed Regist 2000;65:46864-8.

Eccles R. Menthol and related cooling compounds. J Pharm Pharmacol 1994;46:618-30.

Gaudioso C, Hao J, Martin-Eauclaire MF, Gabriac M, Delmas P. Menthol pain relief through cumulative inactivation of voltage-gated sodium channels. Pain. 2012 Feb;153(2):473-484.

Halcomb S. Essential oils: oil of peppermint. In: Hoffman R, Howland M, Lewin NA, Nelson LS, Goldfrank L, editors. Goldfrank’s toxicologic emergencies. 10^th ed. New York: McGraw Hill; 2014. p. 627.

Heng, MCY. Local necrosis and interstitial nephritis due to topical methyl salicylate and menthol. Cutis 1987;39:442-4.

Kumar A, Baitha U, Aggarwal P, Jamshed N. A fatal case of menthol poisoning. Int J App Basic Med Res 2016;6:137-9.

Nakagawa S, Tagami H, Aiba S. Erythema multiforme-like generalized contact dermatitis to l-menthol contained in anti-inflammatory medical compresses as an ingredient. Contact Dermatitis 2009;61:178-9.

Noiles K, Pratt M. Contact dermatitis to Vicks VapoRub. Dermatitis 2010;21:167-9.

Wickham RJ. How menthol alters tobacco-smoking behavior: a biological perspective. Yale J Biol Med 2015;88:279-87.

Wilkinson SM, Beck MH. Allergic contact dermatitis from menthol in peppermint. Contact Dermatitis 1994;30:42-3.

Poisoned?

Call


1-800-222-1222


or

HELP ME online

Prevention Tips

• Natural products should be regarded to be potentially as dangerous as drugs.
• Menthol gives the sensation of reducing congestion, but it actually can worsen congestion.
• Menthol flavoring in cigarettes might be associated with a higher rate of addiction to smoking. Smoking of all types of cigarettes, including mentholated cigarettes, is unhealthy.
• Keep all menthol-containing products out of the reach and sight of children.

This Really Happened

Case 1. A mother called Poison Control because an older child poured peppermint oil on her 3-month-old baby’s head. She thought that it likely got into the baby’s eyes and maybe into the mouth as well. The baby was not opening his eyes, the skin looked irritated and red, and the baby was crying. Poison Control recommended washing the baby’s skin with soap and water, gently irrigating the eyes with water, and giving the baby something to drink, either by nursing or by giving formula.

About an hour later, mom brought the baby to an ER because she was worried. The ER physician called Poison Control to review the toxicity of peppermint oil and menthol. The physician reported that although the infant looked well, there was concern that some of the product might have been aspirated (leaked into the lungs). Poison Control said that when aspiration is suspected, a chest x-ray should be done about 6 hours after the substance was swallowed. The x-ray was done, and it was normal. The skin irritation went away with no additional treatment beyond washing with soap and water.

Case 2. A 26-year-old woman suffered for 2 years from mild, scaly, red patches that would appear periodically on her upper lip, around her mouth, and on the top of two of her fingers. She already knew that she had some chemical sensitivities because she was unable to handle any type of adhesive tape (she would get a red itchy rash).

She was referred to a contact dermatitis specialist who did some skin patch testing and found that she was sensitive to some commonly found substances. She was given a long list of things to avoid. Her symptoms got better, but she would still have the breakouts. The doctors did a study with 100 patients, and she was the only one who reacted to two products that had one thing in common – they both contained menthol. She admitted that she regularly smoked menthol cigarettes, but did not stick with a particular brand. She did not use any other products that contained menthol. She figured out which brand was causing the problem and stopped smoking that type of cigarette. She remained symptom free after that. (from Camarasa and Alomar, 1978)

Menthol Topical (Biofreeze) – Side Effects, Interactions, Uses, Dosage, Warnings

Brand Names:ActivICE, ActivOn Arthritis, ActivOn Joint and Muscle, Arctic Relief Pain Relieving, Aspercreme Heat Pain Relieving, Asperflex Maximum Strength

Reviewed: January 27, 2022

Menthol is either manmade or made from the extracts of mint oil. Menthol provides a cooling sensation when applied to the skin, which helps relieve pain in the tissues underneath the skin.

Menthol topical (for use on the skin) is used to provide temporary relief of minor arthritis pain, backache, muscles or joint pain, or painful bruises.

There are many brands and forms of menthol available. Not all brands are listed on this leaflet.

Menthol topical may also be used for purposes not listed in this medication guide.

uses

What is Menthol Topical (Biofreeze) used for?

• Cough
• Pain
• Pruritus

warnings

What is the most important information I should know about Menthol Topical (Biofreeze)?

Ask a doctor or pharmacist if this medicine is safe to use if you have ever had an allergy to aspirin or salicylate medicine.

Ask a doctor before using this medicine if you are pregnant or breastfeeding.

If you apply menthol to your chest, avoid areas that may come into contact with a nursing baby’s mouth.

Ask a doctor before using this medicine on child 12 years old or younger.

Side Effects

What are the side effects of Menthol Topical (Biofreeze)?

Get emergency medical help if you have signs of an allergic reaction: hives; difficult breathing; swelling of your face, lips, tongue, or throat.

Stop using this medicine and call your doctor at once if you have:

• severe burning, stinging, redness, or irritation after using this medicine; or
• pain, swelling, or blistering where the medicine was applied.

Less serious side effects may be more likely, and you may have none at all.

This is not a complete list of side effects and others may occur. Call your doctor for medical advice about side effects. You may report side effects to FDA at 1-800-FDA-1088.

Pregnancy & Breastfeeding

Can I take Menthol Topical (Biofreeze) if I’m pregnant or breastfeeding?

Ask a doctor before using this medicine if you are pregnant or breastfeeding.

Interactions

What drugs and food should I avoid while taking Menthol Topical (Biofreeze)?

If this medication gets in your eyes, nose, or mouth, rinse with water.

Avoid using other topical pain medications on the areas you treat with menthol.

Dosage Guidelines & Tips

How to take Menthol Topical (Biofreeze)?

Use Menthol Topical (Biofreeze) exactly as directed on the label, or as prescribed by your doctor. Do not use in larger or smaller amounts or for longer than recommended.

What should I do if I missed a dose of Menthol Topical (Biofreeze)?

Since this medicine is when needed, you are not likely to miss a dose.

Overdose Signs

What happens if I overdose on Menthol Topical (Biofreeze)?

If you think you or someone else may have overdosed on: Menthol Topical (Biofreeze),  call your doctor or the Poison Control center

(800) 222-1222

If someone collapses or isn’t breathing after taking Menthol Topical (Biofreeze), call 911

911

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Drugs A-Z provides drug information from Everyday Health and our partners, as well as ratings from our members, all in one place. Cerner Multum™ provides the data within some of the Overview, Uses, Warnings, Side Effects, Pregnancy, Interactions, Dosage, Overdose, and Images sections. The information within all other sections is proprietary to Everyday Health. 

Menthol – ingredient description, instructions for use, indications and contraindications
ProWellness

Table of contents

• Description of menthol
• Pharmacological properties of menthol
• Use of menthol
• Contraindications and side effects

Disclaimer

Please note that all information posted on the site
Prowellness is provided for informational purposes only and is not a personal program, a direct recommendation for action, or medical advice. Do not use these materials for diagnosis, treatment, or any medical procedure. Consult your physician before using any technique or using any product. This site is not a specialized medical portal and does not replace the professional advice of a specialist. The Site Owner is not liable to any party who has suffered indirect or direct damage as a result of misuse of materials posted on this resource.

Description of menthol

Menthol is an organic substance isolated from mint essence or produced synthetically. The compound is a secondary metabolite of plants belonging to the Lamiaceae family. It is a colorless crystal with a minty aroma and a cooling taste.

Menthol exhibits weak antiseptic activity, cools the skin and mucous membranes, and has a local anesthetic effect. It is included in the formulation of the vasodilator drug Validol.

Pharmacological properties of menthol

Menthol has the following properties:

• relieves the symptoms of diseases of the mouth and throat;
• exhibits antimicrobial activity;
• suppresses inflammatory processes;
• reduces the severity of pain;
• eliminates itching;
• constricts blood vessels;
• tones the veins;
• is an effective analgesic;
• relieves migraine attacks;
• has a carminative effect;
• lowers pressure;
• calms the central nervous system;
• excites the trigeminal nerve;
• cools at high body temperature, warms at low body temperature.

Attention! Menthol improves potency. However, when the drug is abused, it has the opposite effect. Therefore, you must strictly adhere to the instructions for its use.

The use of menthol

Menthol is used in the complex therapy of gastrointestinal pathologies. It stimulates appetite, normalizes digestion and eliminates nausea. With colds, the drug acts as an anesthetic and reduces the frequency and severity of coughing attacks.

In liquid form, menthol is used to lubricate sore tonsils and gums. Menthol ointment for the joints suppresses inflammation, and for the legs – cools, dulls pain, relieves spasms.

Menthol inhalation helps to cure a runny nose and reduce the viscosity of sputum. When using a solution of menthol in combination with valerian tincture, a calming effect can be achieved. This combination is used for cardiac pathologies, for example, with angina attacks.

Menthol oil is used for weakness, overexcitation. The remedy is indicated for allergic skin reactions, dermatitis and other rashes. The cooling effect of menthol helps to reduce itching and irritation.

Contraindications and side effects

Menthol is contraindicated in the following conditions:

• under 5 years of age;
• complications of varicose veins;
• extensive dermatitis;
• individual intolerance;
• allergy.

Adverse reactions possible. The most common ingestion is nausea, vomiting, pain in the abdomen. When applied externally, drowsiness, dizziness, and impaired coordination of movements may occur.

Disclaimer

Please note that all information posted on the site
Prowellness is provided for informational purposes only and is not a personal program, a direct recommendation for action, or medical advice. Do not use these materials for diagnosis, treatment, or any medical procedure. Consult your physician before using any technique or using any product. This site is not a specialized medical portal and does not replace the professional advice of a specialist. The Site Owner is not liable to any party who has suffered indirect or direct damage as a result of misuse of materials posted on this resource.

Menthol oil instructions for use: indications, contraindications, side effects – description Menthol oil sol. approx. and inhalations 2%: 10 ml or 25 ml vial. or vial-drip. (37848)