Counterpain 4% w/w Cool Gel

Counterpain 4% w/w Cool Gel is a topical cooling gel manufactured by Taisho Pharmaceutical under the Counterpain brand, a name that has been sold in Malaysia and across Southeast Asia for many years. Its active ingredient is menthol at a strength of 4% w/w, a cyclic terpene alcohol obtained from mint oils that produces a distinct cool sensation when it contacts the skin. The gel base is built from carbopol, propylene glycol, isopropyl alcohol, and purified water, with thymol crystal included in the formulation and a small amount of brilliant blue colouring that gives the gel its tint.

This product is sold over the counter as an external-use topical and is intended for application to intact skin only. Because it is a water-based gel rather than a cream or a balm, it spreads easily and leaves a lighter, less greasy feel on the skin once it has been rubbed in. The cool sensation comes from menthol acting on cold-sensitive nerve endings in the skin rather than from any real drop in skin temperature, which is why it is described as a cooling gel and not a warming rub.

Preservatives including methylparaben, propylparaben, and imidazolidinyl urea are part of the formula to keep the gel stable throughout its shelf life, and triethanolamine and sodium edetate act as supporting excipients. People who know they react to parabens, thymol, or menthol should check the ingredient list before use. Like other menthol-based topicals, it should be kept away from the eyes, mucous membranes, and any broken or irritated skin.

Apply a thin layer of the gel to clean, dry, intact skin over the area of application, then rub in gently and thoroughly until the gel has been absorbed. Wash your hands with soap and water after applying the gel, unless your hands are the area of application; in that case, wait at least 30 minutes after applying before washing them. Do not apply the gel to the face, eyes, lips, genital area, or any broken or irritated skin.

Do not cover the treated area with a tight bandage or apply heat pads, hot water bottles, or other heating devices over it, as combining menthol with heat or occlusion can increase the chance of skin irritation. Close the cap tightly after each use.

Apply a thin layer up to 3 to 4 times a day, or as directed by a doctor or pharmacist. Do not exceed the recommended frequency, and do not use more than a thin layer at each application. Confirm with a doctor or pharmacist before using this gel on children.

Store in a dry place below 25°C, away from direct sunlight, heat, and naked flames, as the gel contains isopropyl alcohol. Keep the cap tightly closed when not in use.

• Do not use if allergic to menthol, thymol, parabens, or any other ingredient in the gel.
• Do not apply to broken, cut, irritated, sunburnt, or infected skin.
• Do not use under tight bandages or together with heat pads or other heating devices.
• Avoid contact with the eyes, mouth, and other mucous membranes.

• No systemic drug interactions are widely reported for topical menthol used as directed on intact skin.
• Avoid applying other topical products, such as creams, balms, or heat rubs, to the same area at the same time without checking with a pharmacist, as combined use can increase skin irritation.
• Do not use together with heat pads or heating devices on the same area.

• Apply only a thin layer; a thicker layer does not change how the gel sits on the skin and can increase the chance of irritation.
• Wash your hands after every application so the gel does not reach your eyes or mouth.
• Keep the gel away from naked flames, as it contains isopropyl alcohol.
• Check the skin after the first application if you have sensitive skin, and stop use if redness or discomfort develops.
• Keep the cap tightly closed and store the pack away from heat and out of reach of children.
• Do not apply immediately before or after a hot shower or bath, as heat can increase skin sensitivity.

Precautions: For external use only. Do not apply to broken or irritated skin, and avoid contact with the eyes and mucous membranes; if contact occurs, rinse thoroughly with water. Do not use with tight bandages or heating devices. Discontinue use if skin irritation develops. Consult a healthcare professional before use if you are pregnant or breastfeeding, and before using the gel on children. Keep out of reach of children.

When to See a Doctor or Pharmacist: Seek medical advice if skin irritation or a rash develops and does not settle after stopping the gel, if signs of an allergic reaction appear, or if the area of concern becomes swollen, bruised, or increasingly painful, or does not improve after a reasonable period.