The skin is the largest organ of the human body. It serves as a protective water barrier, regulates temperature, controls fluid loss, and performs many other functions important to healthy internal balance. Skin is comprised of many layers supported by an intricate blood supply. The blood vessels pass below the skin in a framework of connective tissue, fat, and fascia. Below that layer lays the bone and muscle. It also contains nerve endings which carry touch, temperature, and pain signals from the skin to the spinal cord and on to the brain.



The skin also comprised numerous blood vessels that can transmit medicines into the body a great deal faster than the oral counterparts. As such, doctors have now started to recommend topical pain relief medications because it has become a popular way of administering certain kinds of pain relief to the body rapidly and effectively. By introducing pain relievers into the body through the skin, topical pain relief medicines can act quickly and can give an immediate pain relief.

Topical pain relief medications provide an alternative to oral medications for patients. It comes in creams, ointments, gels, lotions, or patches that are applied directly on the skin to provide relief from nerve pain and inflammation. The active drugs in these medications are absorbed through the skin and provide localized pain relief.

Topical pain relief drug applications are used to help reduce inflammation below the skin surface and alleviate nerve pain. Some of these drugs are available only with a doctor's prescription and others can be purchased over-the-counter (OTC).

There are two common types of topical pain relievers: local anesthetics and analgesics.

Local anesthetics are substances used to reduce or eliminate pain in a limited area of the body. These work by blocking the transmission of nerve impulses. It numbs the skin for a period of two to three hours and is helpful in reducing pain prior to injection or insertion of an intravenous line (IV).

Analgesics are non-steroidal anti-inflammatory drugs (NSAIDs) in cream, ointment, or gel form. Topical analgesics are used to reduce swelling and ease inflammation that can cause pain.

Over-the-counter topical pain medications include counter-irritants, salicylates, and capsaicin. Counter-irritants contain menthol, eucalyptus, or oil of wintergreen. These substances work by irritating the skin where it is applied. The skin begins to feel hot or cold which, in turn, signals the body to produce natural pain killers. Topical preparations, however, only offer temporary pain relief. Salicylates are the main ingredient in topical analgesics. Creams which contain salicylates offer pain relief and reduced joint inflammation. Patients who are allergic to aspirin or patients who take blood-thinners should not use salicylate-based creams before discussing potential side effects with their doctor.

Capsaicin creams cause a burning sensation. Capsaicin is derived from chili pepper seeds. Capsaicin works best on joints which are close to the skin (i.e., fingers). Capsaicin depletes substance P from nerve cells. Substance P is a neurotransmitter involved in pain regulation.

Primarily, topical creams are used to soothe aching joints. If a person has more severe pain, he or she may need oral medication as well. Medication classes with lower potency or risk of side effects are available over-the-counter. Stronger dose formulas and controlled drugs are available only with a physician's prescription. Patients must remember that just because a medication is obtainable without a prescription does not mean it is entirely safe. For safety reasons, it is always best to read the label and follow dosing guidelines to the letter.