Japanese Topical Pain Relief: Salonpas, Feitas, Loxonin Tape, and the Patch Culture

"My back is killing me after this trip. Is this Salonpas the same as the one back home?"

"Can I buy a Loxonin patch over the counter?"

"Hot or cold patches — which one am I supposed to pick?"

These are common questions at the pharmacy counter. Japanese drugstores stock 30+ varieties of OTC topical pain relief, with more brands and more active ingredients than most other countries. This guide sorts them by symptom.

Quick Reference: Symptom → Recommended Type

OTC class affects where and when you can buy a product (Class 1 requires a pharmacist on site). See Types of Pharmacies in Japan for details.

1. Pap (Compress) vs. Tape

The Japanese term shippu (湿布) is loosely translated as "compress" or "patch," but there are actually two distinct formats:

Pap (compress)

• Gel-like, water-rich pad
• Comes in cooling and warming versions; the sensory feedback is part of the experience
• Thicker, easier to apply to large areas
• Examples: Salonpas Ae, Shin Salonpas, warming-shippu

Tape

• Thin, stretchy, fabric-backed patch
• Sticks tightly and holds through movement
• Best for joints, fingers, and bending areas
• Examples: Feitas Zα, Loxonin S Tape, Bantelin Kowa Pap S Tape Type

"Cooling/warming" and "active ingredient" are independent. A cooling patch is not inherently stronger than a warming one — pick by sensory preference.

2. Main OTC Active Ingredients

① Methyl salicylate + menthol (the classic)

Examples: Salonpas, Shin Salonpas

• The internationally recognized "Salonpas" brand by Hisamitsu
• For mild stiff shoulders, bruises, muscle fatigue
• Menthol cooling delivers a clear "it's working" sensation
• Mostly Class 3 medicines — sellable without a pharmacist on site

② Felbinac (mid-strength NSAID)

Examples: Feitas Zα, Salonpas EX, Harix 55 EX

• A phenylacetic-acid-class anti-inflammatory analgesic
• For moderate muscle and joint pain
• Class 2 medicine

③ Indomethacin (strong NSAID)

Examples: Bantelin Kowa Pap S, Salomethyl IDα

• Stronger anti-inflammatory action
• For tougher back pain, shoulder pain, joint pain
• Class 2 medicine

④ Loxoprofen (the same molecule as oral Loxonin)

Examples: Loxonin S Tape / Pap / Gel

• The topical version of the same loxoprofen used in oral Loxonin S
• Designed for transdermal local action
• Class 2 medicine (reclassified from Class 1 after the post-marketing surveillance period) — also sellable by registered sellers

⑤ Diclofenac (potent NSAID)

Examples: Voltaren EX Tape / Lotion, Feitas Z Diclofenac

• Internationally known as Voltaren (also a prescription medicine)
• For arthritis, tenosynovitis, stronger muscle pain
• Class 2 medicine

3. Hot vs. Cold: Does It Matter?

The on-skin sensation and the clinical effect are largely separate.

Cooling type

• Menthol or peppermint oil for a cool sensation
• Often preferred for acute injuries (right after impact, post-exercise inflammation)
• Examples: Salonpas family, Feitas series

Warming type

• Capsaicin (chili extract) or ginger extract for a warming feel
• Often preferred for chronic stiff shoulders, cold-induced back pain
• Examples: warming Salonpas, Bantelin warm-shippu

Conventional advice is "cold for acute, warm for chronic," but in practice, "use whichever feels good" is reasonable for most everyday aches.

4. ⚠ Critical: Ketoprofen and Photosensitivity

The prescription-only patches Mohrus Tape and Sectouch Pap (active ingredient: ketoprofen) carry a unique and important warning.

Photosensitivity

• After applying, exposure to UV light can cause severe rash, blistering, and inflammation at the patch site
• The risk continues for about 4 weeks after removal, not only during use
• Beach, pool, ski, cycling, tennis — outdoor activities especially trigger it

Practical precautions

• Cover the patch site completely with clothing or supports
• Even after peeling off, continue UV protection of the same area for at least 4 weeks
• Ketoprofen is no longer in OTC products in Japan (it was OTC briefly but withdrawn in 2010 after side-effect reports)

If you're using OTC felbinac/indomethacin patches and notice contact dermatitis or sun-triggered redness, stop use and consult a doctor.

5. How to Apply Patches Correctly

Often-skipped basics:

1. Apply to clean, dry skin (wipe off sweat or lotion)
2. Remove 30 minutes before bathing (heat causes peeling and ingredient migration)
3. Don't keep one patch on the same spot for too long (contact dermatitis)
4. On hairy areas, peel along the hair direction to reduce pain
5. Don't refrigerate — too cold weakens the adhesive

Some products are once-daily, others twice-daily — always confirm the usage schedule on the package.

6. Class 1 vs. Class 2 — Check the Box

A "stronger" ingredient is not always a higher class — and the same product may start as Class 1 right after launch and be reclassified to Class 2 later. Always check the label.

7. Frequently Asked Questions

Q. Is overseas Salonpas the same as Japanese Salonpas? A. International Salonpas (made by Hisamitsu Pharmaceutical) is fundamentally the same brand, but the formulation, doses, and regulatory category can differ by country. Japan tends to carry the widest selection of variants.

Q. Is the loxoprofen patch safer than the oral version? A. Transdermal absorption tends to produce less systemic side-effect risk than oral use, but it is not zero. Wide-area or long-term use, and patients with asthma, still need caution. Stop and consult a pharmacist or doctor if you notice anything concerning.

Q. Can I use these while pregnant or breastfeeding? A. NSAID-containing patches — like the oral versions — should generally be avoided in late pregnancy. While pregnant or breastfeeding, always consult a pharmacist or doctor before use.

Q. Can children use these? A. Age limits vary by product. Many are labeled not for use under 15, especially the loxoprofen and diclofenac versions. Don't self-treat children's pain — see a pediatrician.

Q. How long should I wait between bathing and using a patch? A. Remove patches 30 minutes before bathing, and after bathing, wait until skin redness has settled (about 30–60 minutes) before applying a new one.

Q. What if it irritates my skin? A. Remove immediately, rinse with mild soap, and observe. If you see blisters, severe itching, or pigmentation, see a dermatologist. Don't reapply the same product.

8. When to See a Doctor

Stop self-treating with OTC patches and seek care if:

• Pain lasts more than a week or is getting worse
• Pain comes with numbness, weakness, or trouble walking (possible nerve issue)
• A joint is fevered, swollen, and red
• After a fall or impact, pain is severe and not subsiding (possible fracture)
• The same area has been hurting chronically for 3+ months
• A patch caused severe rash or blistering

An orthopedic clinic or your usual primary care doctor is the next step.

Sources

• Ministry of Health, Labour and Welfare (MHLW) — OTC drug risk classification
• Pharmaceuticals and Medical Devices Agency (PMDA) — package insert database
• Hisamitsu Pharmaceutical — official product information (Salonpas)
• Daiichi Sankyo Healthcare — official product information (Loxonin S topical line)
• Lion Corporation / Kowa — official product information (Bantelin)
• MHLW — notice on photosensitivity from topical ketoprofen

Disclaimer: This article is for informational purposes only and does not constitute medical advice. If pain persists, or if a patch causes any unusual skin reaction, please consult a licensed pharmacist or physician.