Painkilling creams and ointments can contain ingredients ranging from numbing agents to the substance that makes chili peppers hot.
Topical medications are creams or gels applied to your skin. Some of these drugs penetrate the outer layer of skin and affect underlying nerves and tissues. Others act only on your skin's surface. Pain relief ointments can occasionally help relieve nerve pain and inflammation just below the surface of your skin.
Pain medicines applied to skin can be grouped into categories, according to how they work.
Numbing agents
- EMLA. The letters EMLA stand for eutectic (a mixture of two solids that becomes a liquid) mixture of local anesthetics. EMLA is a prescription pain relief cream made from two anesthetics — lidocaine and prilocaine. Your skin becomes numb within an hour after you apply the drug, which reaches its peak effect in one to two hours. EMLA is commonly used — especially for children — to reduce pain before giving a shot, drawing blood, inserting an intravenous line or treating a wart.
- Lidocaine patch. A lidocaine patch (Lidoderm) may be prescribed for relief of pain caused by nerve damage, which sometimes occurs with such conditions as shingles, diabetes or stroke.
- Over-the-counter products. Several numbing agents are available without a prescription. Some are designed to numb very specific types of pain — for example, from teething, hemorrhoids or sunburn. Nonprescription numbing agents include lidocaine (Solarcaine, Xylocaine), benzocaine (Lanacane, Ora-jel) and pramoxine (Itch-X).
Corticosteroids
Corticosteroid creams and ointments are used to relieve the redness, swelling, itching and discomfort of a variety of skin disorders. Examples include:
- Alclometasone (Aclovate)
- Clocortolone (Cloderm)
- Desonide (DesOwen)
- Hydrocortisone (Cortizone-10, Cortaid)
Most of these medications require a prescription, although some products containing hydrocortisone are available over the counter. Use topical corticosteroids for only short periods of time, because they can increase skin sensitivity.
Counterirritants
- Chili peppers. Capsaicin is the chemical in chili peppers that makes them hot. Capsaicin is purified from the seeds of peppers and is available without a prescription. When you apply capsaicin to your skin, it causes a burning sensation. It's thought that this burning depletes nerve cells of a chemical called substance P, which has a role in transmitting pain messages.
It usually takes a few weeks of daily applications before you feel noticeable pain relief. Capsaicin is most effective for temporary relief of arthritic pain in joints close to your skin's surface, such as your fingers, knees and elbows. It may also help relieve pain from nerves damaged by shingles or diabetes.
Nonsteroidal anti-inflammatory drugs (NSAIDs)
Trolamine salicylate is a drug closely related to aspirin and a member of the NSAID family of medications. It is available in over-the-counter products such as Aspercreme and Sportscreme. It can be applied directly to the skin where it may reduce local inflammation and relieve pain.
A 2004 study indicated that topical NSAIDs helped arthritis pain only during the first two weeks of use. After two weeks, these ointments worked no better than placebo. The Food and Drug Administration (FDA) lists these drugs as safe, but not necessarily effective for pain relief.
Last Updated: 11/19/2004
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