Table of ContentsView AllTable of ContentsHow Creams WorkCapsaicinLidocaineMenthol
Table of ContentsView All
View All
Table of Contents
How Creams Work
Capsaicin
Lidocaine
Menthol
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 calledperipheral neuropathy. This means that the pain occurs in a part of your body away from the center (peripheral), like your limbs.
Many diseases causeneuropathic pain. One of the most common isdiabetes.
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.
How Nerve Pain Is Treated
Science Photo Library / Getty Images
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.
Somatic vs. Visceral Pain
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 calledcapsaicin. 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.
Understanding the Pain Gate Control Theory
Anesthetic Creams
Ananestheticis a medicine that makes it so you can’t feel pain. This is called “numbing.” An anesthetic cream helps with pain because itnumbs the area of your skinthat it’s rubbed on.
Lidocaineis 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 your doctor can prescribe, such as creams that combine lidocaine (at a higher dose than available OTC) and prilocaine. These work fast—usually within an hour of putting them on.
Recap
How Pain Relief Patches Work
Capsaicin is a substance in 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, andtendonitis.
How to Handle Pain After Surgery
Some studies have looked at whether capsaicin can help people with 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, andpost-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.
If other treatments for neuropathy don’t work, some people might benefit from trying a capsaicin cream.
Over-the-Counter-Creams
You can buy some over-the-counter (OTC) capsaicin creams at your local pharmacy with names such as Capzasin and Zostrix, as well as generic creams.
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:
RecapCapsaicin is a substance found in chili peppers. It can block your nerves from sending pain signals. You can get creams OTC or as a prescription for your doctor.
Capsaicin is a substance found in chili peppers. It can block your nerves from sending pain signals. You can get creams OTC or as a prescription for your doctor.
Lidocaine blocks pain signals in your body. Creams and ointments that have lidocaine in them numb the areas you rub them on.
You can use lidocaine products on injuries like scrapes, insect bites, and minor burns.
How Your Nervous System Works
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:
For some injuries, an OTC cream might not be enough. If you needstronger pain relief, your doctor can prescribe you a more potent product. A cream with higher-dose lidocaine, combined with prilocaine, numbs your skin within an hour of putting it on.
You may have side effects of lidocaine creams, including:
There are also a few safety tips to keep in mind when you’re using a lidocaine cream:
RecapCreams with lidocaine in them numb your skin. If you can’t feel that part of your body, it won’t be painful. Lidocaine is in many OTC products but you can get a stronger prescription if needed.If you are using a product with lidocaine in it, be careful. If you can’t feel a part of your body, you could get injured without realizing it.
Creams with lidocaine in them numb your skin. If you can’t feel that part of your body, it won’t be painful. Lidocaine is in many OTC products but you can get a stronger prescription if needed.If you are using a product with lidocaine in it, be careful. If you can’t feel a part of your body, you could get injured without realizing it.
Creams with lidocaine in them numb your skin. If you can’t feel that part of your body, it won’t be painful. Lidocaine is in many OTC products but you can get a stronger prescription if needed.
If you are using a product with lidocaine in it, be careful. If you can’t feel a part of your body, you could get injured without realizing it.
What Happens If You Use Too Much Lidocaine?
Mentholis 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 mentholcan relieve minor pain. Research has found that topical menthol products helped people who had nerve pain fromchemotherapy. The American Society of Clinical Oncology calls topical menthol a “promising agent” for treating chemotherapy-induced peripheral neuropathy.
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 over-the-counter menthol creams at your local pharmacy, which means you don’t need a prescription from your doctor. Brand names include Bengay and Absorbine Jr.
Your doctor can also write you a prescription for a cream with menthol and other pain-relieving medicine in it.
According to the 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.
RecapMenthol is a chemical in mint plants. It’s what gives minty mouthwash that “clean” feeling. A cream that has menthol in it may help relieve some kinds of nerve pain. You can get some OTC or have your doctor write you a prescription. Some creams with menthol also have other pain medicine in them.You need to be careful if you are using a product with a lot of menthol in it—more than 3%. It can cause burns.
Menthol is a chemical in mint plants. It’s what gives minty mouthwash that “clean” feeling. A cream that has menthol in it may help relieve some kinds of nerve pain. You can get some OTC or have your doctor write you a prescription. Some creams with menthol also have other pain medicine in them.You need to be careful if you are using a product with a lot of menthol in it—more than 3%. It can cause burns.
Menthol is a chemical in mint plants. It’s what gives minty mouthwash that “clean” feeling. A cream that has menthol in it may help relieve some kinds of nerve pain. You can get some OTC or have your doctor write you a prescription. Some creams with menthol also have other pain medicine in them.
You need to be careful if you are using a product with a lot of menthol in it—more than 3%. It can cause burns.
Other Herbs
There are other natural substances that may help relieve neuropathy pain. Manyherbal treatmentscan make inflammation better. They are said to have anti-inflammatory properties.
A 2018 review of studies found that common plants may help fight inflammation, including:
Herbs for Natural Pain Relief
Some of these plants may help treat neuropathic pain because they have other qualities. For example, they may:
RecapYou can find many herbal pain remedies at a pharmacy or health store. However, always ask your doctor before using a herbal product. Some can interact with medications you might already be taking or might not be safe to use if you have certain medical conditions.
You can find many herbal pain remedies at a pharmacy or health store. However, always ask your doctor before using a herbal product. Some can interact with medications you might already be taking or might not be safe to use if you have certain medical conditions.
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.
How to Deal With Breakthrough Pain
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.
The 13 Best Pain Relief Creams of 2022
12 SourcesVerywell Health uses only high-quality sources, including peer-reviewed studies, to support the facts within our articles. Read oureditorial processto learn more about how we fact-check and keep our content accurate, reliable, and trustworthy.Sommer C, Cruccu G.Topical treatment of peripheral neuropathic pain: applying the evidence.J Pain Symptom Manage. 2017;53(3):614-629. doi:10.1016/j.jpainsymman.2016.09.015Casale R, Symeonidou Z, Bartolo M.Topical treatments for localized neuropathic pain.Curr Pain Headache Rep. 2017;21(3):15. doi:10.1007/s11916-017-0615-yFattori V, Hohmann MS, Rossaneis AC, Pinho-Ribeiro FA, Verri WA.Capsaicin: current understanding of its mechanisms and therapy of pain and other pre-clinical and clinical uses.Molecules. 2016;21(7):844. doi:10.3390/molecules21070844Derry S, Rice AS, Cole P, Tan T, Moore RA.Topical capsaicin (high concentration) for chronic neuropathic pain in adults.Cochrane Database Syst Rev. 2017;1(1):CD007393. doi:10.1002/14651858.CD007393.pub4National Library of Medicine: DailyMed.Qutenza—capsaicin kit[drug label].Drugs.com.Lidocaine topical.Hershman DL, Lacchetti C, Dworkin RH, et al.Prevention and management of chemotherapy-induced peripheral neuropathy in survivors of adult cancers: American Society of Clinical Oncology clinical practice guideline.J Clin Oncol. 2014;32(18):1941-1967. doi:10.1200/JCO.2013.54.0914Cortellini A, Verna L, Cannita K, et al.Topical menthol for treatment of chemotherapy-induced peripheral neuropathy.Indian J Palliat Care. 2017;23(3):350-352. doi:10.4103/IJPC.IJPC_23_17National Library of Medicine: DailyMed.Diclostream—diclofenac sodium 1.5% solution and menthol 10% topical liquid kit[drug label].Ahmed SU, Zhang Y, Chen L, et al.Effect of 1. 5% topical diclofenac on clinical neuropathic pain.Anesthesiology. 2015;123(1):191-198. doi:10.1097/ALN.0000000000000693Food and Drug Administration.FDA Drug Safety Communication: Rare cases of serious burns with the use of over-the-counter topical muscle and joint pain relievers.Forouzanfar F, Hosseinzadeh H.Medicinal herbs in the treatment of neuropathic pain: a review.Iran J Basic Med Sci. 2018;21(4):347-358. doi:10.22038/IJBMS.2018.24026.6021
12 Sources
Verywell Health uses only high-quality sources, including peer-reviewed studies, to support the facts within our articles. Read oureditorial processto learn more about how we fact-check and keep our content accurate, reliable, and trustworthy.Sommer C, Cruccu G.Topical treatment of peripheral neuropathic pain: applying the evidence.J Pain Symptom Manage. 2017;53(3):614-629. doi:10.1016/j.jpainsymman.2016.09.015Casale R, Symeonidou Z, Bartolo M.Topical treatments for localized neuropathic pain.Curr Pain Headache Rep. 2017;21(3):15. doi:10.1007/s11916-017-0615-yFattori V, Hohmann MS, Rossaneis AC, Pinho-Ribeiro FA, Verri WA.Capsaicin: current understanding of its mechanisms and therapy of pain and other pre-clinical and clinical uses.Molecules. 2016;21(7):844. doi:10.3390/molecules21070844Derry S, Rice AS, Cole P, Tan T, Moore RA.Topical capsaicin (high concentration) for chronic neuropathic pain in adults.Cochrane Database Syst Rev. 2017;1(1):CD007393. doi:10.1002/14651858.CD007393.pub4National Library of Medicine: DailyMed.Qutenza—capsaicin kit[drug label].Drugs.com.Lidocaine topical.Hershman DL, Lacchetti C, Dworkin RH, et al.Prevention and management of chemotherapy-induced peripheral neuropathy in survivors of adult cancers: American Society of Clinical Oncology clinical practice guideline.J Clin Oncol. 2014;32(18):1941-1967. doi:10.1200/JCO.2013.54.0914Cortellini A, Verna L, Cannita K, et al.Topical menthol for treatment of chemotherapy-induced peripheral neuropathy.Indian J Palliat Care. 2017;23(3):350-352. doi:10.4103/IJPC.IJPC_23_17National Library of Medicine: DailyMed.Diclostream—diclofenac sodium 1.5% solution and menthol 10% topical liquid kit[drug label].Ahmed SU, Zhang Y, Chen L, et al.Effect of 1. 5% topical diclofenac on clinical neuropathic pain.Anesthesiology. 2015;123(1):191-198. doi:10.1097/ALN.0000000000000693Food and Drug Administration.FDA Drug Safety Communication: Rare cases of serious burns with the use of over-the-counter topical muscle and joint pain relievers.Forouzanfar F, Hosseinzadeh H.Medicinal herbs in the treatment of neuropathic pain: a review.Iran J Basic Med Sci. 2018;21(4):347-358. doi:10.22038/IJBMS.2018.24026.6021
Verywell Health uses only high-quality sources, including peer-reviewed studies, to support the facts within our articles. Read oureditorial processto learn more about how we fact-check and keep our content accurate, reliable, and trustworthy.
Sommer C, Cruccu G.Topical treatment of peripheral neuropathic pain: applying the evidence.J Pain Symptom Manage. 2017;53(3):614-629. doi:10.1016/j.jpainsymman.2016.09.015Casale R, Symeonidou Z, Bartolo M.Topical treatments for localized neuropathic pain.Curr Pain Headache Rep. 2017;21(3):15. doi:10.1007/s11916-017-0615-yFattori V, Hohmann MS, Rossaneis AC, Pinho-Ribeiro FA, Verri WA.Capsaicin: current understanding of its mechanisms and therapy of pain and other pre-clinical and clinical uses.Molecules. 2016;21(7):844. doi:10.3390/molecules21070844Derry S, Rice AS, Cole P, Tan T, Moore RA.Topical capsaicin (high concentration) for chronic neuropathic pain in adults.Cochrane Database Syst Rev. 2017;1(1):CD007393. doi:10.1002/14651858.CD007393.pub4National Library of Medicine: DailyMed.Qutenza—capsaicin kit[drug label].Drugs.com.Lidocaine topical.Hershman DL, Lacchetti C, Dworkin RH, et al.Prevention and management of chemotherapy-induced peripheral neuropathy in survivors of adult cancers: American Society of Clinical Oncology clinical practice guideline.J Clin Oncol. 2014;32(18):1941-1967. doi:10.1200/JCO.2013.54.0914Cortellini A, Verna L, Cannita K, et al.Topical menthol for treatment of chemotherapy-induced peripheral neuropathy.Indian J Palliat Care. 2017;23(3):350-352. doi:10.4103/IJPC.IJPC_23_17National Library of Medicine: DailyMed.Diclostream—diclofenac sodium 1.5% solution and menthol 10% topical liquid kit[drug label].Ahmed SU, Zhang Y, Chen L, et al.Effect of 1. 5% topical diclofenac on clinical neuropathic pain.Anesthesiology. 2015;123(1):191-198. doi:10.1097/ALN.0000000000000693Food and Drug Administration.FDA Drug Safety Communication: Rare cases of serious burns with the use of over-the-counter topical muscle and joint pain relievers.Forouzanfar F, Hosseinzadeh H.Medicinal herbs in the treatment of neuropathic pain: a review.Iran J Basic Med Sci. 2018;21(4):347-358. doi:10.22038/IJBMS.2018.24026.6021
Sommer C, Cruccu G.Topical treatment of peripheral neuropathic pain: applying the evidence.J Pain Symptom Manage. 2017;53(3):614-629. doi:10.1016/j.jpainsymman.2016.09.015
Casale R, Symeonidou Z, Bartolo M.Topical treatments for localized neuropathic pain.Curr Pain Headache Rep. 2017;21(3):15. doi:10.1007/s11916-017-0615-y
Fattori V, Hohmann MS, Rossaneis AC, Pinho-Ribeiro FA, Verri WA.Capsaicin: current understanding of its mechanisms and therapy of pain and other pre-clinical and clinical uses.Molecules. 2016;21(7):844. doi:10.3390/molecules21070844
Derry S, Rice AS, Cole P, Tan T, Moore RA.Topical capsaicin (high concentration) for chronic neuropathic pain in adults.Cochrane Database Syst Rev. 2017;1(1):CD007393. doi:10.1002/14651858.CD007393.pub4
National Library of Medicine: DailyMed.Qutenza—capsaicin kit[drug label].
Drugs.com.Lidocaine topical.
Hershman DL, Lacchetti C, Dworkin RH, et al.Prevention and management of chemotherapy-induced peripheral neuropathy in survivors of adult cancers: American Society of Clinical Oncology clinical practice guideline.J Clin Oncol. 2014;32(18):1941-1967. doi:10.1200/JCO.2013.54.0914
Cortellini A, Verna L, Cannita K, et al.Topical menthol for treatment of chemotherapy-induced peripheral neuropathy.Indian J Palliat Care. 2017;23(3):350-352. doi:10.4103/IJPC.IJPC_23_17
National Library of Medicine: DailyMed.Diclostream—diclofenac sodium 1.5% solution and menthol 10% topical liquid kit[drug label].
Ahmed SU, Zhang Y, Chen L, et al.Effect of 1. 5% topical diclofenac on clinical neuropathic pain.Anesthesiology. 2015;123(1):191-198. doi:10.1097/ALN.0000000000000693
Food and Drug Administration.FDA Drug Safety Communication: Rare cases of serious burns with the use of over-the-counter topical muscle and joint pain relievers.
Forouzanfar F, Hosseinzadeh H.Medicinal herbs in the treatment of neuropathic pain: a review.Iran J Basic Med Sci. 2018;21(4):347-358. doi:10.22038/IJBMS.2018.24026.6021
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