Sounds like a cruel joke: A pain treatment that can actually cause you more pain. According to the FDA, OTC pain-relieving skin creams such as IcyHot, Bengay, Capzasin, Flexall, and Mentholatum can cause chemical burns.

While rare, the FDA issued a recent warning that the risk is real. “In many cases, burns where the product was applied occurred after just one application, with severe burning or blistering occurring within 24 hours,” the agency wrote in a press release.

But there’s no need to panic at any sign of redness. Because your typical pain cream uses counterirritants like capsaicin (an extract of cayenne pepper), a little redness and skin irritation is common because that’s how they work, says Alex Moroz, MD, an associate professor of rehabilitation medicine at New York University Langone’s Center for Musculoskeletal Care. “The creams irritate the skin, and that’s how they reduce the pain. Now, of course, if the cream is used improperly or too much, you can get burns,” he says.

If you have chronic pain, it’s usually fine to use the creams regularly, says Dr. Moroz, as part of your overall treatment plan. (For all-natural remedies to ask your doctor about, see our 8 Surprising—and Natural—Ways to Beat Pain.)

If you’re using a pain cream, here are some key tips experts recommend:

• Don’t apply the creams on damaged or irritated skin.
• Don’t cover the area with a bandage after applying the cream.
• Do use exactly as indicated in the directions—more is not better.
• Don’t use a heating pad or hot water bottle in conjunction with a pain cream.
• Do expect a warming or cooling sensation where you’ve applied the cream. Those sensations are normal; actual pain is not.

Finally, says Dr. Moroz, use common sense and listen to your body. “If something is very uncomfortable, it’s probably not good.”

More from WH:
The Best Fall Allergy Gear
Alternative Medicine: Is It Right for You?
OTC Drugs for Cold & Flu Season

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