Lidocaine, methyl salicylate, hydrocortisone. You probably don''''t think
twice about using over-the-counter creams with these ingredients when
you need to soothe a sore muscle or bug bite, prep your legs before
hair removal, or combat that vaginal itch. If the product''''s available
without a prescription, it can''''t hurt you, right? Wrong. Take Arielle Newman, for instance, a New York City-area high school
track star who died last year from a sports-cream overdose. She''''d used
large amounts of popular OTC pain-relieving ointments like Icy Hot and
Ben-Gay on her sore muscles. The key ingredient in such products is
methyl salicylate, which built up in Newman''''s body, may have interacted
with other aspirin-based meds she was using, and caused her to go into
cardiac arrest. Another case: In 2005, Shiri Berg, 22, of North
Carolina died of a lidocaine overdose. Following the instructions she''''d
been given by the staff at a local hair-removal clinic, she generously
applied a numbing gel to her legs, then covered them in plastic wrap.
On her way to the clinic to get hair lasered from her legs, Berg passed
out. She went into convulsions, then a coma. Eight days later, she was
dead. Women dying in the name of hair removal? Athletes putting
themselves at risk by using mentholated muscle soothers? Extreme
situations, to be sure. But with all the stuff each of us slathers on
our skin (one study estimates that women apply 175 chemicals a day from
cosmetics, creams, and toiletries alone), it''''s no surprise that
potential hazards are lurking. Your skin is designed to protect
you from countless insults: from air pollution to murky lake water,
from dirty gasoline-pump handles to staph. Skin cells provide a
physical barrier, sort of like bricks and mortar, to keep the bad stuff
out -- most of the time, says Francesca J. Fusco, M.D., assistant
clinical professor of dermatology at the Mount Sinai School of
Medicine. "The cells aren''''t as tightly packed as real bricks, though,
which means things can squeeze by and pentrate." That''''s good news if
you want, say, an antiaging wrinkle cream to wage war against your
crow''''s feet or an anti-itch product to tackle that exercise-induced
rash on your inner thighs. Bad news when strong chemicals meet
sensitive or thin skin, cause an allergic reaction, or dangerously
flood your bloodstream. Here, we investigate 14 ingredients commonly found in products you may be using right now -- and we tell you how to stay safe. Methyl salicylate
Most OTC muscle creams (including Ben-Gay, Icy Hot, and Tiger Balm)
contain one or more of three main ingredients: the cooling agents
menthol and camphor, and the pain reliever methyl salicylate. The last
one is similar to topical aspirin, says Matt Zirwas, M.D., director of
The Ohio State University Medical Center Contact Dermatitis Center. And
what happened to track-star Newman is essentially the same thing that
could happen with an aspirin overdose, he says. The safe way to
use muscle creams? Rub a small amount (about the size of a quarter)
into the painful muscle or joint area not more than three or four times
a day to prevent accumulation. If you''''re applying more than a
four-ounce tube a week, that''''s probably too much, Zirwas says. And
watch your aspirin intake -- too much can increase your risk of
overdose (in addition to the creams, Newman may have been using a
pain-relieving patch and taking aspirin), as can wrapping or using a
heating pad on ointment-covered skin. Rubs with methyl
salicylate may also interact with blood-thinning prescription drugs,
such as Plavix or Coumadin, used to prevent blood from clotting, says
Brian J. Krabak, M.D., sports-medicine physician at the University of
Washington''''s department of rehabilitation medicine. Because of its
toxicity, any product containing 5 percent or more of methyl salicylate
(also called wintergreen oil) has to carry a warning label stating it