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ObjectiveTo determine whether topical menthol 6% gel will relieve a migraine attack.Materials and MethodsA single-center, open-label pilot trial of 25 patients with at least one year of diagnosed episodic migraine and < 15 headache days per month. Patients treated one migraine attack with STOPAIN topical menthol 6% gel to skull base within 2 hours of headache onset. Headache pain severity was assessed prior to and after gel application. ResultsThirty-two patients enrolled and 25 completed the study. Prior to treatment, seven patients had mild pain, 13 moderate pain, and five severe pain. Two hours following gel application, 7 patients had no pain, 7 mild pain, 6 moderate pain and 5 severe pain. The majority of patients had similar pain intensity (8; 32 %) or improvement (13; 52%). At 24-hour, only 2 non-rescued patients still had mild headache. Of the 25 completers, two patients took rescue medication prior to the 2-hour period, and an additional 10 patients rescued between 2 and 24 hours. ConclusionStudy results showed a significant improvement in headache intensity by 2 hours after gel application. This pilot study shows STOPAIN gel may be effective in treating an acute migraine attack.