Menthol

Menthol is a cyclic monoterpene alcohol with well-known cooling properties and a minty scent. Because of its unique properties, menthol is a common ingredient in various products ranging from chewing gum to toothpaste. Menthol is also used in different medicinal products for its cooling and biological effects.1,2,3

Menthol is extracted from plants that are members of the genus Mentha (mint). Apart from natural extraction, menthol is also produced artificially through chemical procedures.4

Menthol in skin preparations

Skin products containing menthol causes both a localized cooling sensation and has analgesic or pain relief activities. In various studies, menthol has exhibited diverse biological activities such as antibacterial, antifungal, antipruritic, anticancer, and analgesic effects. Menthol is also used to enhance the dermal penetration of pharmaceuticals.1,5

Menthol - A topical pain reliever

Topical products containing menthol are commonly used in the management of pain. Topically applied menthol gels result in a cooling sensation and are reported to act as a counterirritant to reduce pain sensation.6,7

Menthol creates a cooling sensation by attaching to a neuronal receptor called TRP melastatin 8 receptor (TRPM8), a low temperature-sensing receptor in the skin and mucosa. TRP’s are present throughout the body, but TRPM8 is found mainly within thermosensitive neurons, which, apart from responding to temperature reductions, are specifically sensitive to menthol. Stimulation of these thermosensitive neurons is associated with pain relief or an analgesic effect.6,7

In a study of 10 healthy male volunteers, menthol was applied topically in three concentrations (0.5%, 4.6%, and 10.0%) to the left thigh. The skin‐cooling effects were measured using a digital infrared camera and were also collected as patient self‐reports. The study found that all three concentrations of menthol gel significantly decreased skin temperature for at least one hour.8

Ice or cold packs have been an effective pain reliever for years. Like ice or cold packs, menthol gel decreases arterial blood flow and provides pain relief. In a clinical study, 19 healthy volunteers were randomly assigned to four treatment groups – ice, menthol, ice-plus-menthol, and no treatment. The treatments were randomly applied for 20 minutes to the right forearm on four different days. The study found that ice, menthol, and ice-plus-menthol treatments all resulted in reduced blood flow compared with the control. The ice-plus-menthol treatment resulted in a more rapid and more significant reduction in blood flow. Menthol was associated with significantly less discomfort than the ice at 5, 10, and 20 minutes following application.9

Menthol - Widely used as a penetration enhancer in dermatological preparations

Menthol is widely used as a penetration enhancer in dermatological preparations. Stratum corneum, the outermost layer of skin, constitutes the main barrier to the penetration of exogenous substances such as medicines into the human skin. The stratum corneum is made up of various lipid layers; penetration enhancers interact with the skin lipids and aid the delivery of drugs across the stratum corneum. Menthol is commonly used as a penetration enhancer in clinical medicine due to its high efficiency and safety.6

  1. Schnitzler P. Essential Oils for the Treatment of Herpes Simplex Virus Infections. Chemotherapy. 2019;64(1):1-7.
  2. Looker KJ, Magaret AS, May MT, et al. Global and Regional Estimates of Prevalent and Incident Herpes Simplex Virus Type 1 Infections in 2012. PLoS One. 2015;10(10):e0140765.
  3. Schnitzler P, Schuhmacher A, Astani A, et al. Melissa officinalis oil affects infectivity of enveloped herpesviruses. Phytomedicine. 2008;15(9):734-740.
  4. Álvarez DM, Castillo E, Duarte LF, et al. Current Antivirals and Novel Botanical Molecules Interfering With Herpes Simplex Virus Infection. Front Microbiol. 2020;11:139.
  5. Mazzanti G, Battinelli L, Pompeo C, et al. Inhibitory activity of Melissa officinalis L. extract on Herpes simplex virus type 2 replication. Nat Prod Res. 2008;22(16):1433-1440.
  6. Astani A, Reichling J, Schnitzler P. Melissa officinalis extract inhibits attachment of herpes simplex virus in vitro. Chemotherapy. 2012;58(1):70-77.
  7. Koytchev R, Alken RG, Dundarov S. Balm mint extract (Lo-701) for topical treatment of recurring herpes labialis. Phytomedicine. 1999;6(4):225-230.
  8. Wölbling RH, Leonhardt K. Local therapy of herpes simplex with dried extract from Melissa officinalis. Phytomedicine. 1994;1(1):25-31.
  9. Lemon balm. Available at: http://pennstatehershey.adam.com/content.aspx?productid=107&pid=33&gid=000261. Accessed on: 01November 2020.
  10. Miraj S, Rafieian-Kopaei, Kiani S. Melissa officinalis L: A Review Study With an Antioxidant Prospective. J Evid Based Complementary Altern Med. 2017;22(3):385-394.
  11. Bounihi A, Hajjaj G, Alnamer R, et al. In Vivo Potential Anti-Inflammatory Activity of Melissa officinalis L. Essential Oil. Adv Pharmacol Sci. 2013;2013:101759.
  12. Guginski G, Luiz AP, Silva MD, et al. Mechanisms involved in the antinociception caused by ethanolic extract obtained from the leaves of Melissa officinalis (lemon balm) in mice. Pharmacol Biochem Behav. 2009;93(1):10-16.

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