How Do Topical Analgesics Work?

Topical analgesics are medications that are applied on the skin to relieve muscle, joint or nerve pain. Topical analgesics get absorbed by the skin and act on the tissue beneath. There are many types of topical analgesics and each works in a unique way to relieve pain.

Many of the topical analgesics relieve pain by reducing inflammation and locally numbing the area. Some topical analgesics such as capsaicin and menthol reduce pain by counterirritation of nerve endings under the skin. These topical analgesics initially stimulate the nerve endings, but continued exposure desensitizes the nerve endings and decreases pain sensitivity.

Capsaicin, a compound found in chili peppers, stimulates transient receptor potential vanilloid-1 (TRPV1) receptor, a protein on nerve cells (neurons) in nerve endings that detects heat and pain. Capsaicin produces a burning sensation initially, followed by reduced TRPV1 sensitivity and pain perception.

Menthol provides pain relief by stimulating the transient receptor potential melastatin-8 (TRPM8) receptor, a protein on neurons in nerve endings that detects the sensation of cold.

Topical analgesics are applied on or gently massaged into the skin in several forms such as:

• Sprays
• Creams and gels
• Lotions and liquids
• Aerosol sprays and foams
• Powders
• Transdermal skin patches that are placed on the skin and left in place for a few hours

Topical analgesics are used for pain relief from the following conditions:

• Minor muscle/joint pain
• Skeletomuscular pain
• Diabetic neuropathy (nerve damage from diabetes)
• HIV-associated neuropathy
• Morton’s neuroma (thickening of tissue around nerves under the toes)
• Postherpetic neuralgia (persistent pain from shingles)
• Erythromelalgia (a condition that causes redness, warmth and burning pain in the extremities)

Side effects of most topical analgesics may include the following:

• Stinging/burning/tingling sensation of skin
• Hypersensitivity reaction

Side effects of capsaicin may include:

• Transient increased pain at the application site
• Application site erythema (redness)
• Burning sensation at the application site
• Pain in extremity
• Nausea
• Vomiting
• Hypertension (high blood pressure)
• Skin dryness
• Swelling
• Pruritus (itching)
• Papules (bumps in the skin)
• Blisters
• Edema
• Sinusitis (inflammation of sinus)
• Bronchitis (inflammation of bronchial passage)
• Nasopharyngitis (inflammation of nasal passage and pharynx)
• Upper respiratory tract infection
• Exfoliation
• Excoriation (skin-picking)
• Dizziness
• Cough
• Skin odor
• Headache
• Dysgeusia (taste disorder)
• Palpitations
• Tachycardia (rapid heart rate)
• Eye pruritus
• Application site reactions such as:
  • Urticaria (hives)
  • Paresthesia (prickling sensation)
  • Dermatitis (skin inflammation)
  • Hyperesthesia (heightened skin sensitivity)
  • Dysesthesia (abnormal sensation)

Information contained herein is not intended to cover all possible side effects, precautions, warnings, drug interactions, allergic reactions, or adverse effects. Check with your doctor or pharmacist to make sure these drugs do not cause any harm when you take them along with other medicines. Never stop taking your medication and never change your dose or frequency without consulting your doctor.

Generic and brand name of topical analgesic drugs include:

• Air Salonpas
• Arthritis Formula Bengay
• Arthritis Hot
• Aspercreme Cream
• Aspercreme Heat Pain Relieving Gel
• Aspercreme Max
• Axsain
• Bayer Muscle and Joint Cream
• Bengay Cold Therapy
• Bengay Original Ointment
• Bengay Ultra Strength Cream
• Bengay Zero Degrees
• capsaicin topical
• capsaicin transdermal
• capsaicin/menthol topical
• Capzasin P
• Capzasin Quick Relief
• Capzasin-HP
• Deep Down Rub
• Flex-Power Performance Sports
• Flexall Ultra Plus
• Gold Bond Foot Powder
• Greaseless Bengay Pain Relieving Cream
• Icy Hot Advanced Relief Patch
• Icy Hot Balm
• Icy Hot Chill Stick
• Icy Hot Cream
• Icy Hot Naturals
• Maximum Strength Flexall 454
• Menthac
• menthol topical
• Mentholatum Deep Heating Rub Extra Strength
• Mentholatum Sports Pain Relief Cold
• Mentholatum Sports Pain Relief Hot
• Mentholatum Sports Pain Relief Warm
• methylsalicylate/menthol topical
• methylsalicylate/menthol/camphor topical
• Muscle Rub
• Myoflex Cream
• No Pain-HP
• Pain Doctor
• Pain-X
• Qutenza
• Rid-A-Pain
• Salonpas Arthritis Pain
• Salonpas Gel Patch
• Salonpas Hot
• Salonpas Pain Relief Patch
• Salonpas Pain Relieving Patch
• Salonsip Gel Patch
• Sportscreme
• Theragesic Cream
• Trixaicin
• trolamine salicylate
• Tylenol PRECISE Pain Relieving Cream
• Zostrix