Topical Creams For Neuropathy

When nerves in your body get damaged, it's called neuropathy. The condition causes chronic pain. If you have numbness, burning, or tingling in your hands or feet, it's called peripheral neuropathy. The means that occurs in a part of your body away from the center (peripheral), like your limbs.

Many diseases cause neuropathic pain. One of the most common is diabetes.

There are several ways to treat neuropathy. You might take a pill by mouth. You could also get shots of medicine that make inflammation better. These are called steroid injections or "nerve blocks."

Topical creams made with substances that relieve pain can be used to treat neuropathy. The most common ingredients are capsaicin and lidocaine. You can put the creams on the place on your body that hurts.

This article will talk about the topical treatments for neuropathy. You will learn what to look for when shopping for these products. You'll also find out how to use the creams correctly.

Topical Creams for Neuropathy Pain

Topical creams are rubbed on areas of the body that hurt. The medicine in the products is absorbed through the skin.

There are two kinds of topical medications that are used to treat neuropathy: analgesic creams and anesthetic creams. Each one works in a different way.

Analgesic Creams

The word "analgesic" means pain relief. You do not need a prescription from your doctor to use an analgesic cream.

Many of these products have an ingredient in them called capsaicin. It comes from hot chili pepper seeds. The substance seems to make it harder for nerve cells in your body to send pain signals to your brain.

If you rub a cream with capsaicin on a part of your body that hurts, it may take some of the pain away.

Anesthetic Creams

An anesthetic is a medicine that makes it so you can't feel pain. This is called "numbing." An anesthetic cream helps with pain because it numbs the area of your skin that it's rubbed on.

Lidocaine is the medicine in most anesthetic creams. When you rub the cream on, the lidocaine blocks the nerves in that part of your body from sending pain signals to your brain.

You can also get patches with lidocaine in them. You wear the patch on the part of your body that is hurting.

If you need more help with pain, there are prescription anesthetic creams and patches that you can get from your doctor. One is called EMLA. It works fast—usually within an hour of putting it on.

Capsaicin

Capsaicin is a substance in hot chili peppers. It can be used to treat many kinds of pain. You might use a product with capsaicin in it to treat back pain, headaches, rheumatoid arthritis, shingles, and tendonitis.

Some studies have looked at whether capsaicin can help people with neuropathy. A 2012 review showed that a topical cream with 0.075% capsaicin helped some people who were feeling nerve pain after having surgery. The cream also helped some people with diabetic neuropathy.

In 2017, researchers looked at studies that tested capsaicin products. The people in the studies had medical conditions that caused pain, such as HIV neuropathy, peripheral diabetic neuropathy, and post-herpetic neuralgia.

A small number of people in these studies told the researchers that after they used a cream with a lot of capsaicin in it, their pain "much or very much" improved.

However, people in other studies did not find the cream as helpful. Since the research is mixed, we can't say for sure that capsaicin helps everyone with nerve pain.

That said, if other treatments for neuropathy don't work, some people might benefit from at least trying a capsaicin cream.

Over-the-Counter-Creams

You can buy some over-the-counter (OTC) capsaicin creams at your local pharmacy. Here are a few examples:

• Capzasin-P
• Dolorac
• Zostrix

Prescription Creams

Most OTC products only have a little capsaicin in them. If you need a stronger product, you'll have to get a prescription from your doctor.

Qutenza is a high-dose capsaicin product that's usually prescribed for people who have diabetic neuropathy in their feet.

Precautions

Here are a few important things to know before you put on capsaicin cream:

• Keep the cream away from your eyes and mucous membranes. If you get the cream in your eyes, it can be very irritating.
• Do not put the cream on open wounds, cuts, or broken skin.
• Store the cream somewhere safe where children and pets can't get it.

Lidocaine

Lidocaine blocks pain signals in your body. Creams and ointments that have lidocaine in them make you lose feeling in the areas you rub them on. This is also called "numbing" the area.

You can use lidocaine products on injuries like scrapes, insect bites, and minor burns.

Lidocaine may help with nerve pain. A study in 2017 found that topical lidocaine treatments helped people with peripheral neuropathic pain who could not take medicine by mouth or had bad reactions to other treatments.

Over-The-Counter Creams

You can buy some products with lidocaine in them over-the-counter (OTC) at your local pharmacy. Here are a few examples:

• Xylocaine
• Anestacon
• Lidoderm
• Senatec
• LidoRx

Prescription Creams

For some injuries, an OTC cream might not be enough. If you need stronger pain relief, your doctor can prescribe you a product that has more lidocaine in it. EMLA is a common prescription lidocaine-based cream. It numbs your skin within an hour of putting it on.

Precautions

You may have side effects of lidocaine creams, including:

• Allergic reactions like a skin rash
• Trouble breathing
• Dizziness and drowsiness
• Fever and chills
• Nausea
• Vomiting
• Headaches

There are also a few safety tips to keep in mind when you're using a lidocaine cream:

• Products with lidocaine numb the part of your body you use them on. If you can't feel an area of your body, you might hurt it by accident and not know it.
• Do not put lidocaine cream on any part of your skin that has an open wound, cut, or sore on it.
  

Menthol

Menthol is a chemical naturally found in mint plants. It can also be made in a lab. Menthol is what gives minty gum or mouthwash a cool, refreshing feeling.

Skin creams made with menthol can relieve minor pain. One study found that topical menthol products helped people who had nerve pain from chemotherapy. In fact, many major cancer centers recommend menthol creams to treat neuropathy in people living with cancer.

There are several benefits to menthol creams: They work fast and well; they don't cost much; and they are easy for people to get.

Over-the-Counter Creams

You can get some creams with menthol in them at your local pharmacy. They are sold over-the-counter, which means you don't need a prescription from your doctor. Here are a few examples:

• Absorbine Jr.
• Bengay

Prescription Creams

Your doctor can also write you a prescription for a cream with menthol and other pain-relieving medicine in it.

DicloStream is a topical cream that has diclofenac, a nonsteroidal anti-inflammatory drug (NSAID), and menthol in it. People usually use this cream for pain caused by knee osteoarthritis. Research has shown that DicloStream can also treat neuropathic pain.

Precautions

According to the U.S. Food and Drug Administration (FDA), products with a lot of menthol in them can cause burns. The burns can be severe in some cases (second or third degree).

If a product has more than 3% menthol in it—either as the only ingredient or combined with another ingredient like methyl salicylate—use it carefully.

Always talk to your doctor before using any kind of topical treatment for pain.

Other Herbs

There are other natural substances that may help relieve neuropathy pain. Many herbal treatments can make inflammation better. They are said to have anti-inflammatory properties.

Some herbal products can be purchased over-the-counter at your local pharmacy or at a health store. Here are a few examples:

• Biofreeze
• Capsin
• Minagin
• Tiger balm
• Trixaicin

A 2018 review of studies found that common plants may help fight inflammation, including:

• Acorus calamus
• Artemisia dracunculus
• Butea monosperma
• Citrullus colocynthis
• Curcuma longa
• Crocus sativus
• Elaeagnus angustifolia
• Ginkgo biloba

Some of these plants may help treat neuropathic pain because they have other qualities. For example, they may:

• Have substances in them that can prevent cells from being damaged (antioxidants)
• Can relieve inflammation (anti-inflammatory)
• Help prevent cells from dying (anti-apoptotic)
• Protects the structures of the brain and nervous system (neuroprotective)

Summary

Products with menthol, capsaicin, and lidocaine work in different ways to block nerve signals and relieve pain. Creams and ointments can go directly on an area of skin that hurts and start working quickly.

These products are safe and may work, but be careful. Using too much of a product with menthol in it can cause burns. Lidocaine numbs your skin, so you could hurt yourself and not feel it. Capsaicin can be very irritating if you get it in your eyes.

A Word From Verywell

Pain from neuropathy can make it hard, if not impossible, for you to go about your daily life. However, there are some ways that you can treat nerve pain.

Creams and ointments can be an easy, low-cost way to manage neuropathy. While you can get many of these products over-the-counter, they might not be strong enough to help you manage your pain. You can talk to your doctor about prescription options.