I'm sure you already have a handle on site reactions, but thought I'd share what has worked best for me during the 4 months of trial and error. I follow the protocol for 5 minutes of heat to the injection site before injecting, followed immediately with about 1-2 minutes of cold pack application. Instead of waiting until problems begin and then trying to treat it, I've started applying a cortisone cream within 5 minutes of injecting and at least once more later in the day. It's made a huge difference in the redness and nasty itching. I tried Benadryl spray without improvement, though Benadryl gel has helped me when I've had poison oak. The gel wasn't available when I tried to restock my supply, so I used the spray. Has anyone had better relief from the gel as opposed to the gel?