Antidolorifici antinfiammatori topici
Revisione paritaria di Dr Toni Hazell, MRCGPUltimo aggiornamento di Dr Hayley Willacy, FRCGP Ultimo aggiornamento 26 Mar 2023
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In questa serie:AntidolorificiAntidolorifici fortiCompresse antinfiammatorieTerapia caldo e freddo per il sollievo dal doloreMacchine TENS
Gli antidolorifici antinfiammatori topici sono usati per alleviare dolori muscolari, distorsioni e stiramenti. Possono anche aiutare ad alleviare l'artrite dolorosa. Gli antidolorifici antinfiammatori topici sono talvolta prescritti al posto dei medicinali antinfiammatori orali perché hanno meno effetti collaterali.
At a glance
Topical anti-inflammatory painkillers are gels, sprays, or foams for muscle pains, sprains, and arthritis.
They work by reducing pain and swelling in the area they are applied to.
They have fewer side-effects than anti-inflammatory medicines taken by mouth.
Apply them to the affected area and massage into the skin, washing your hands afterwards.
Do not apply to broken skin or sensitive areas like eyes or mouth.
A rash is the most common side-effect; stop use and seek advice if this occurs.
Some types can make your skin sensitive to light, so protect the treated area from the sun.

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What are anti-inflammatory painkillers?
Anti-inflammatory painkillers are a group of medicines that are used to ease muscle pains, sprains, strains and arthritis. They can be taken by mouth (tablets, capsules or liquids), injected, or applied to the skin.
When they are applied to the skin they are called topical anti-inflammatory painkillers. Sometimes they are called 'topical non-steroidal anti-inflammatory drugs' (NSAIDs), or just 'topical anti-inflammatories'.
Topical anti-inflammatories are available as gels, gel patches, sprays, or foams. They contain an anti-inflammatory medicine such as ibuprofene, diclofenac, felbinac, ketoprofen, or piroxicam and come in various brand names.
Other anti-inflammatory creams and ointments are available to ease muscle pains, strains and sprains - for example, capsaicin. However, this leaflet only discusses topical anti-inflammatory medicines.
How do topical anti-inflammatory painkillers work?
Torna ai contenutiWhen anti-inflammatories are taken by mouth they work by blocking (inhibiting) the effect of chemicals (enzymes) called cyclo-oxygenase (COX) enzymes. COX enzymes help to make other chemicals called prostaglandins.
Some prostaglandins are involved in the production of pain and inflammation at sites of injury or damage. A reduction in prostaglandin production reduces pain and inflammation.
Topical anti-inflammatories work in the same way but, instead of having an effect on all of the body, they only work on the area to which you have applied them. When they are applied they are taken into (absorbed into) your skin.
They then move deeper into areas of the body where there is inflammation (for example, your muscle). They relieve pain and reduce swelling affecting joints and muscles when rubbed into the skin over the affected area.
Using a topical preparation means that the total amount of anti-inflammatory in your body is very low. This means that you are much less likely to have a side-effect to this medicine.
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When are topical anti-inflammatory painkillers usually prescribed?
Torna ai contenutiTopical anti-inflammatories are usually prescribed if you have muscular pains, distorsioni e stiramenti. They can also be used to help ease pain caused by osteoarthritis in the knee or hand.
They are sometimes prescribed instead of oral anti-inflammatory medicines because they have fewer side-effects.
They may be prescribed with other measures such as, heat and ice to help reduce pain. See separate leaflet called Ice and Heat Therapy for Pain Relief.
How well do topical anti-inflammatory painkillers work?
Torna ai contenutiTopical anti-inflammatories work well to treat acute muscular pain and inflammation. Research trials provide good evidence that topical anti-inflammatories work better than dummy creams or gels. Studies suggest that topical anti-inflammatories can be as effective as tablets but have fewer side-effects.
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When using topical anti-inflammatory painkillers
Torna ai contenutiSome important considerations are:
How to apply.
How much to apply.
Sensitivity to light.
How to apply
Apply to the affected area and massage into the skin gently. Always wash your hands after you have finished rubbing the anti-inflammatory cream, gel or spray into the skin. This is to make sure that you avoid rubbing this medicine into sensitive areas of the body such as the eyes. Do not apply to skin that is broken, or near the eyes, nose, mouth, genital or bottom (anal) areas. Do not use plasters or bandages (dressings) on top of these medicines. Generally these medicines are applied to the skin 2-4 times a day. However, for specific advice for your medicine, see the leaflet that comes inside the packet.
How much to apply
This varies a lot, and depends upon which anti-inflammatory cream, gel, or spray you have. Read the instructions that are inside the packet of your medicine for more details.
Sensitivity to light
If you are using a topical anti-inflammatory there is a risk that your skin can become sensitive to light (photosensitivity). If you are using a preparation that contains ketoprofen you should cover the area of skin where ketoprofen has been applied (to protect it from sunlight). Also, you should not use a sunbed, or expose your skin to sunlight during treatment, and for two weeks after stopping.
Quali sono i possibili effetti collaterali?
Torna ai contenutiMost people who use topical anti-inflammatories do not have any side-effects. However, side-effects occur in a small number of users. The most common side-effect is a rash. If you develop a rash when using an anti-inflammatory, you should stop the treatment and ask your doctor or pharmacist for advice.
Some people have had an allergic reaction to these medicines - this is rare. An increase in sibilo has been reported in a very small number of people who have asma. However, these side-effects have happened when people have applied very large amounts to their skin.
For a full list of side-effects and possible interactions associated with your medicine, consult the leaflet that comes with your medication.
If you cannot tolerate these medications you may need other pain-relieving medication. See separate leaflet called Painkillers.
Can I buy topical anti-inflammatory painkillers?
Torna ai contenutiYes - you can buy some topical anti-inflammatories. For example, you can buy the smaller packs of ibuprofen gel, ketoprofen gel and diclofenac gel.
Qual è la durata abituale del trattamento?
Torna ai contenutiThis can vary depending on the reason for treating you, so speak with your doctor for advice. If you are using an anti-inflammatory for acute muscle pain, usually treatment lasts for as long as you have pain and inflammation. For example, a few days, or weeks. But if you are being treated for conditions like osteoarthritis, your doctor may advise you to use this medicine for the long term.
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Trattamenti e farmaci
Antidolorifici
There are three main types of painkiller: non-steroidal anti-inflammatory drugs (NSAIDS), paracetamol and opioids. Each works in a different way. Most people only need to take painkillers for a few days or weeks at most, but some people need to take them for a long time. Some painkillers are available over the counter from pharmacies; this includes some NSAIDs, paracetamol and some weak opioids (codeine or dihydrocodeine).
di Dr Philippa Vincent, MRCGP

Trattamenti e farmaci
Compresse antinfiammatorie
Anti-inflammatory tablets are used to treat arthritis, sprains, painful periods and other painful conditions. Most people have no trouble taking these tablets. However, some people develop side-effects which can sometimes be serious. In particular - if you have any cardiovascular (heart, stroke or blood vessel) condition or certain gut conditions, or are elderly, these medicines are prescribed with caution and only where there are no alternatives and at the lowest doses and durations necessary.
di Dr Toni Hazell, MRCGP

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Domande frequenti
Can I use dressings or plasters over the area where I've applied topical anti-inflammatory painkillers?
No, you should not use plasters or bandages (dressings) on top of these medicines. Apply the medicine directly to the skin and follow the instructions given with the product.
Are there other types of creams that reduce muscle pain, and how do they differ from topical anti-inflammatories?
Yes, other anti-inflammatory creams and ointments are available to ease muscle pains, strains, and sprains, such as capsaicin. However, this article specifically discusses topical anti-inflammatory medicines, which contain ingredients like ibuprofen, diclofenac, or ketoprofen and work by blocking pain and inflammation-causing chemicals locally in the body.
How do I know the correct amount of topical anti-inflammatory to use?
The amount you should apply varies depending on the specific cream, gel, or spray you are using. Always read the instructions provided inside the packet of your medicine for detailed guidance on how much to apply.
What should I do if I accidentally get the anti-inflammatory gel in my eyes?
Although the article doesn't specify what to do if you get it in your eyes, it does state that you should always wash your hands after applying the medicine to avoid rubbing it into sensitive areas of the body such as the eyes, nose, or mouth. This implies that contact with these areas should be avoided.
Can I use topical anti-inflammatory painkillers if I have asthma?
An increase in wheezing has been reported in a very small number of people with asthma when using these medicines. This has usually happened when very large amounts were applied to the skin. If you have asthma, it would be important to consider this potential side effect.
How do topical anti-inflammatories compare to anti-inflammatory tablets in terms of effectiveness and side effects?
Topical anti-inflammatories can be as effective as anti-inflammatory tablets for treating pain and inflammation but have fewer side-effects because the total amount of anti-inflammatory absorbed into your body is very low. They work only on the applied area, unlike tablets which have a system-wide effect.
Ulteriori letture e riferimenti
- Formulario Nazionale Britannico (BNF); Servizi di Evidenza NICE (accesso solo nel Regno Unito)
- Osteoartrite nei maggiori di 16 anni: diagnosi e gestione; Linee guida NICE (ottobre 2022)
- NSAIDs - prescribing issues; NICE CKS, aprile 2020 (accesso solo Regno Unito)
- Analgesia - dolore da lieve a moderato; NICE CKS, novembre 2021 (accesso solo Regno Unito)
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About the author

Jenny Whitehall
BSc (Hons), Diploma in Pharmacy Practice
About the reviewerView full bio

Dr Toni Hazell, MRCGP
MBBS, BSc, MRCGP, DFSRH, Dip GU med, DRCOG, DCH (London, UK, 2000)
Dr. Toni Hazell qualified from St. Mary’s Hospital Medical School and did her VTS at Northwick Park Hospital.
Storia dell'articolo
Le informazioni su questa pagina sono scritte e revisionate da clinici qualificati.
Prossima revisione prevista: 24 Mar 2028
26 Mar 2023 | Ultima versione
21 Feb 2012 | Pubblicato originariamente
Autore:
Jenny Whitehall

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