Topical Pain Relievers

What Over-the-Counter Analgesics Are

Over-the-counter (OTC) analgesics are a class of medicines that relieve pain. Depending on the dosage form, some may also reduce fever. There are two different categories of analgesics: internal and external. Internal analgesics are pain relievers and fever reducers. These medicines are intended for internal use and are either taken by mouth in the form of pills and liquids, or inserted into the rectum in suppository form. External analgesics are topical pain relievers and are not intended to reduce fever. These medicines are for external use only and are applied directly to the outer body surface in lotions, sprays, and other forms. Before selecting an OTC analgesic medicine, you should first consider the type of symptoms you are experiencing and then determine the best course of treatment.

What Topical Pain Relievers Are for

Topical pain relievers, or external analgesics, are a group of different medicines that are used “externally,” which means on the skin. Some are intended to relieve minor body aches and pains such as backache, muscle ache, and arthritis. Some products soothe sunburn and minor burns, while others are used for itching and skin irritations due to eczemas, contact allergies, and insect bites.

How Topical Pain Relievers Work

Topical pain relievers, like all OTC medicines, contain certain active ingredients that make them work in the human body. The product’s active ingredients, including how much of a substance is in each dose, are listed first on the Drug Facts label.

Depending on the active ingredients, topical pain relievers are intended to treat a number of different conditions, including inflammation, minor aches and pains of joints and muscles, sunburn and other minor burns, and itching and irritation. Many products are available to consumers over the counter in spray, lotion, cream, gel, ointment, patch, and medicated wipe form.

Below is a list of the active ingredients in topical pain relievers and how they work:

  • Benzocaine - Numbing action reducing itching, burning, and pain on skin
  • Camphor – Cooling action reducing itching, burning, and pain on skin, as well as joint and muscle aches
  • Capsaicin - Warming action reducing joint and muscle aches
  • Diphenhydramine - Reduces itching and redness on skin
  • Hydrocortisone - Reduces itching and redness on skin
  • Lidocaine – Numbing action reducing itching, burning, and pain on skin
  • Menthol - Cooling action reducing itching, burning, and pain on skin, as well as joint and muscle aches
  • Methyl salicylate – Relieves joint and muscle aches
  • Pramoxine – Numbing action reducing itching, burning, and pain on skin
  • Trolamine salicylate – Relieves joint and muscle aches
  • All of the tips for safe use of OTC topical pain relievers also apply to children. But like most OTC medicines, there are some additional considerations when it comes to treating kids.
    • OTC topical pain relievers may contain more than one active ingredient, and the ingredients may come in different concentrations. Some of these concentrations should not be used on children.
    • Read the Drug Facts label carefully to make sure the topical pain reliever can be used on the child you wish to treat.
  • Additional tips by ages—Be sure to read the entire list for medicines that may or may not be labeled for your child:
    • Talk to a healthcare provider before using an OTC topical pain reliever containing benzocaine, camphor, diphenhydramine, hydrocortisone, lidocaine, menthol, or pramoxine in a child age 2 and under.
    • Talk to a healthcare provider before using an OTC topical pain reliever containing methyl salicylate or trolamine salicylate in a child age 12 and under.
    • Do not use an OTC topical pain reliever containing methyl salicylate on a child under the age of 12 if the child has arthritis-like conditions.
    • If a child under age 12 is experiencing external anal itching, talk to a healthcare provider before using a topical pain medicine containing hydrocortisone on the affected area.
    • Talk to a healthcare provider before using an OTC topical pain reliever containing capsaicin on a child age 18 and under.