Key Learning Points

• Topical analgesics work locally without producing significant systemic drug concentrations.

• Their mode of action involves reduction in peripheral sensitization, but central sensitization may also be affected.

• They have a better side-effect profile compared to similar agents given systemically due to less absorption.

• The most commonly prescribed agents are preparations of capsaicin, lidocaine alone or as a mixture with other agents, and nonsteroidal anti-inflammatory agents formulated as cream, paste, gel, patch, or spray

• Evidence from clinical trials suggests that there is a role for the use of certain topical analgesics in the management of neuropathic pain.

• New topical analgesics are currently being developed for both neuropathic as well as other painful conditions.

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