Topical Creams For Neuropathy

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Neuropathy, or damage to one or more nerves, can leave you with persistent chronic pain. Also called peripheral neuropathy, it's often marked by numbness, burning, or a tingling sensation in your hands or feet. It is difficult to pinpoint the exact source since hundreds of diseases are linked to neuropathic pain, including diabetes. While oral medications and nerve blocks like steroid injections can be administered to relieve pain, topical creams containing the capsaicin and lidocaine are common, accessible treatments for your neuropathy. These can be applied directly on the area of discomfort.

treating neuropathy

 

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How Topical Creams Relieve Neuropathy Pain

Topical creams to treat neuropathy are applied directly to the skin over sites of localized pain. The drugs in these creams are absorbed into the skin to relieve inflammation and pain. There are two kinds of topical medications that are used to treat neuropathy:

Analgesic Creams

These refer to nonprescription topical pain relief drugs that are rubbed on the skin. These medications contain the ingredient capsaicin, which actually comes from hot chili pepper seeds. This substance may limit nerve cells' ability to relay pain signals back to the brain, ultimately bringing some relief to minor pain that may be throbbing close to the surface of the skin.

Anesthetic Creams

These drugs relieve and block localized pain by numbing the area where they are administered. Lidocaine is an example of an ingredient for these topical creams. EMLA is a common prescription anesthetic cream that numbs your skin within just an hour of application, while a lidocaine patch is something that could also be used to relieve this kind of pain.

Capsaicin

Found in the seeds of hot chili peppers, capsaicin is used to relieve pain from a wide variety of sources, including back pain, headaches, rheumatoid arthritis, shingles, and tendonitis, among many others.

When it comes to treating neuropathy, multiple studies have examined capsaicin's effectiveness. A 2012 review found that a 0.075% capsaicin topical cream demonstrated statistically significant benefit in postherpetic neuralgia, post-surgical neuropathies, and diabetic neuropathy, compared to placebo.

Another review found that this kind of topically applied capsaicin treatment only led to moderate to poor efficacy, but that it might be the best course of treatment for people who are either unresponsive or intolerant of other kinds of treatment for their neuropathic pain.

Additionally, another review looked at eight published clinical trials that involved a total of 2,488 participants who were being tested to study the efficacy of a high-concentration capsaicin patch in people with neuropathic pain that stemmed from HIV neuropathy, peripheral diabetic neuropathy, and postherpetic neuralgia. A small number of those who were on the patch reported that their pain "much or very much" improved.

Over-The-Counter-Creams

Some over-the-counter capsaicin creams you can find at your pharmacy include:

Prescription Creams

Most over-the-counter forms of capsaicin provide a fairly low dose. Qutenza is a prescription-only, high-dose (8%) form of the drug that is given by a healthcare professional, usually to treat diabetic neuropathy of the feet.

How to Apply Capsaicin

Here are some things to keep in mind when applying capsaicin:

  • Keep it away from your eyes and mucous membranes.
  • When using the lotion or cream, avoid applying it anywhere on open cuts, wounds, or broken skin.
  • Make sure this cream is safely out of reach of small children and any household pets.

Lidocaine

Lidocaine is an anesthetic that blocks transmission of pain signals as they travel along the sensory nervous system. Topical creams and ointments that contain lidocaine cause a loss of feeling in the skin around areas of localized pain, and can be used to treat a range of injuries from scrapes and insect bites to minor burns.

Research has shown that lidocaine can help relieve nerve pain. One study in 2017 found that topical lidocaine treatments were effective for people experiencing peripheral neuropathic pain who either were unable to tolerate oral treatments or found that those treatments had an adverse impact on their health.

Over-The-Counter-Creams

Common over-the-counter lidocaine-based creams include:

  • Xylocaine
  • Anestacon
  • Lidoderm
  • Senatec
  • LidoRx

Prescription Creams

EMLA is a common prescription lidocaine-based cream. It numbs your skin within an hour of application.

What to Keep in Mind With Lidocaine

Healthcare providers suggest that you take care to avoid injury while the area the cream was applied to is still numb since you might not be aware of any new pain. Be sure to avoid applying this medication to areas with open wounds, cuts, or sores. This could increase the risk of negative side effects, which include:

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

Menthol

Menthol is an organic compound that is either derived from mint oils or created synthetically. Topical skin creams containing this substance are used to relieve minor pain, and have been shown to be effective as an agent to combat peripheral neuropathy induced by chemotherapy.

Recent research has shown that menthol creams used to treat chemotherapy-induced neuropathy are beneficial in their rapid efficacy, low cost, and easy accessibility and because they are non-drugs.

Major cancer centers like the Dana-Farber Cancer Institute have stated that menthol creams can be effective topical treatments for neuropathy.

Over-The-Counter-Creams

Some common over-the-counter topical creams and ointments that contain menthol include:

  • Absorbine Jr.
  • Bengay

Prescription Creams

DicloStream is a topical cream that consists of diclofenac, a nonsteroidal anti-inflammatory drug (NSAID), and menthol. It's usually prescribed to treat osteoarthritis of the knee. Research has shown that this medication can be used to effectively treat neuropathic pain.

Menthol Safety

The U.S. Food and Drug Administration (FDA) warns that products that contain menthol at concentrations greater than 3% as either a single ingredient or when combined with methyl salicylate can actually result in burns on the skin. In extreme instances, there can be second- and third-degree burns. As always, consult your medical provider before going on any new pain relief regimen.

Other Herbs

Beyond menthol, there are other organic compounds that can help relieve the pain that comes from neuropathy. Many herbal treatments naturally possess anti-inflammatory properties. Some common herbal products you can purchase over the counter include:

While it's easy to look skeptically at herbal remedies, research has delved into how these substances can relieve nerve pain. A 2018 review cites some common plants that contain properties suitable for combatting neuropathy, such as Acorus calamus, Artemisia dracunculus, Butea monosperma, Citrullus colocynthis, Curcuma longa, Crocus sativus, Elaeagnus angustifolia, and Ginkgo biloba, among others. This review suggests that some herbal plants can be suitable candidates for the treatment of neuropathic pain because these natural substances possess antioxidant, anti-inflammatory, anti-apoptotic, neuroprotective, and calcium inhibitory properties.

A Word From Verywell

The pain that comes from chronic neuropathy can be damaging, even debilitating. That constant irritation and soreness can impede your ability to carry out everyday activities with ease. This is why seeking easily applied, accessible treatments like topical creams and ointments might be the best solution for easing your chronic pain. Whether seeking over-the-counter products, prescribed medications, or herbal remedies, be sure to consult your healthcare provider or healthcare provider to determine what might be the best course of treatment for you.

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20 Sources
Verywell Health uses only high-quality sources, including peer-reviewed studies, to support the facts within our articles. Read our editorial process to learn more about how we fact-check and keep our content accurate, reliable, and trustworthy.
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