What are they
NSAIDs for topical applications are gels, creams or sprays based on non-steroidal anti-inflammatory drugs. They are used to relieve mild or moderate pain by directly treating the affected body part.
How they work
They must be applied to the skin, at the level of which they are absorbed to get deep into the inflamed areas. Here they perform the same action carried out by NSAIDs taken orally: they inhibit the synthesis of molecules involved in inflammation (prostaglandins) by blocking an enzyme essential for their production (cyclooxygenase 2, COX 2).
NSAIDs taken topically act directly at the site of pain and inflammation, remaining there longer and accumulating in concentrations up to 500 times higher, but reaching the blood in quantities 20 times lower than oral formulations.
What are they?
They may contain active substances such as ibuprofen, diclofenac, ketoprofen and piroxicam. Several studies have shown that ibuprofen exerts the same benefits both when applied topically and orally. Other NSAIDs, such as indomethacin and benzidamine, are less effective.
In fact, not all NSAIDs have the same ability to cross the skin. Some, very hydrophobic, cross well the most superficial layers, but not so well the deep, more hydrophilic ones. For others, however, the exact opposite is true.
Some particular formulations allow, however, to increase the absorption of the active ingredient. This is the case of ibuprofen 10% lysine salt, in which the presence of salt masks the most hydrophilic portions of the molecule, facilitating penetration into the superficial layers of the epidermis.
In the deeper layers, however, the salt dissociates, favoring the solubility of ibuprofen and, therefore, its entry into the peripheral circulation. All this allows NSAIDs to reach deep into the muscle quickly and in high concentrations.
Directions
NSAIDs for topical applications are a safe and effective alternative to treat localized musculoskeletal pain. They can be used both in case of acute pain and after a sports trauma, but they are not indicated to treat deep visceral pain, such as colic.
Effects
Side effects of NSAIDs differ depending on the route of administration:
| Route of administration | Possible side effects |
|---|---|
| Oral | Bleeding and ulcers |
| Topical | Mild skin reactions |
With regard to topical NSAIDs in particular, except for possible mild skin reactions, they can be considered safe drugs. However, only one precaution must be respected: they must not be applied to any lacerations of the skin.
Joycelyn Elders is the author and creator of EmpowerEssence, a health and wellness blog. Elders is a respected public health advocate and pediatrician dedicated to promoting general health and well-being.
The blog covers a wide range of topics related to health and wellness, with articles organized into several categories.