Ethyl Chloride Spray Pattern for the Head and Neck

Ethyl chloride is a prescription medication that Dr. Hirschinger uses, in his Beverly Hills facial pain and headache practice, as a topical skin refrigerant to reduce head and neck muscle pain. It is a liquid but once it hits the skin, it evaporates. A great aspect to ethyl chloride is that it can greatly reduce head and neck muscle pain for several hours even though it is applied topically.

Ethyl chloride comes in a bottle and a can. Dr. Hirschinger strongly prefers the bottle in the medium jet spray since it is colder than the can. Here are the directions:

• Hold the bottle 12-18 inches away from the skin.
• Hold the bottle upside down on an angle so that the liquid flows toward the stopper like the image on the left. The less liquid in the bottle, the more the bottle will need to be tipped.
• Place a cotton roll in your ear, and close your eyes so that the medication does not get into either your ear or eyes.
• Open the nozzle very quickly and the liquid will flow out of the stopper without dripping. If the liquid drips, you are not opening the stopper all of the way and/or quickly enough.
• Spray in the direction of the arrows starting with the shoulder, followed by the neck, then the jaw and, ending in the temple.
• The pattern for the shoulder (1), neck (2), two jaw muscles (3 and 4), and temples (5) are close to the same for each of the four sprays per side but since the temporalis muscle is shaped like a fan, you want to spray the entire muscle so follow the ​numbers in the image to the right.
• Each spray should take about 4 seconds, which is longer than you think.
• After spraying, stretch the jaw for 30 seconds preferably with the gentle jaw, a passive jaw stretching device invented by Dr. Hirschinger, which is availabe on Amazon and at www.gentlejaw.com.
• The spray can be applied every 3 to 4 hours.

Caution: ethyl chloride is flammable so do not use it near an open flame, or smoke when using the medication.