What are topicals for inflammation? A Guide to Types and Uses

October 6, 2025 •

4 min read

According to research published by the National Institutes of Health (NIH), topical anti-inflammatories achieve effective local therapeutic effects with significantly lower systemic absorption compared to oral medications. This makes topicals for inflammation an effective and often safer option for targeting pain and swelling directly at the source.

Quick Summary

Topical anti-inflammatories deliver medication directly to the affected area to reduce pain and swelling. Common types include NSAIDs, corticosteroids, and counterirritants, used for various conditions from arthritis to skin rashes.

Key Points

Localized Relief: Topical medications deliver pain-relieving and anti-inflammatory agents directly to the affected area, minimizing systemic side effects.
Variety of Types: Common topicals include Nonsteroidal Anti-Inflammatory Drugs (NSAIDs), corticosteroids, capsaicin, and counterirritants like menthol.
Targeted Use: Different types of topicals are suited for different conditions, such as NSAIDs for muscle and joint pain and corticosteroids for skin issues like eczema.
Fewer Systemic Side Effects: Compared to oral versions, topicals have a much lower risk of causing systemic problems like gastrointestinal bleeding or heart issues, making them safer for many individuals, especially the elderly.
Available Over-the-Counter and by Prescription: Depending on the potency, strength, and active ingredient, topical anti-inflammatories can be purchased over-the-counter or with a doctor's prescription.
Watch for Local Reactions: The most common side effects are mild skin reactions such as redness, itching, or irritation at the application site.

What Are Topical Anti-Inflammatories?

Topical anti-inflammatories are medicinal preparations, such as gels, creams, and patches, that are applied directly to the skin to treat pain and reduce localized swelling. Unlike oral medications that are absorbed into the bloodstream and circulate throughout the entire body, topical treatments deliver the active ingredients to the specific site of inflammation. This localized delivery minimizes the risk of systemic side effects, which can be a significant advantage, particularly for individuals with stomach sensitivities or other health concerns. They are a valuable option for managing a range of conditions, from minor sprains and strains to chronic conditions like osteoarthritis.

Major Types of Topicals for Inflammation

There are several major classes of topical medications used to combat inflammation, each with a distinct mechanism of action and primary uses.

Topical Nonsteroidal Anti-Inflammatory Drugs (NSAIDs) Topical NSAIDs are a popular choice for treating musculoskeletal pain and inflammation. They work by inhibiting cyclooxygenase (COX) enzymes, which are responsible for producing prostaglandins—chemicals that cause pain and inflammation in the body. By blocking this enzyme, topical NSAIDs reduce both pain and swelling at the site of application. Common examples include diclofenac (Voltaren), ibuprofen, and ketoprofen. These are available in various concentrations and formulations, with some being over-the-counter and others requiring a prescription.

Topical Corticosteroids These are potent anti-inflammatory medications used primarily to treat skin conditions. They suppress the immune response and inflammation associated with conditions like eczema, psoriasis, and dermatitis. Topical corticosteroids are categorized by their potency, from low-potency over-the-counter options like hydrocortisone to stronger prescription versions. They are available in forms such as creams, ointments, lotions, and gels. Because skin thickness and condition affect absorption, a healthcare provider should guide the appropriate strength and usage.

Capsaicin Creams Derived from chili peppers, capsaicin works by depleting substance P, a neurotransmitter that helps send pain signals to the brain. This can provide relief for mild to moderate muscle or joint pain, including pain from arthritis and nerve pain related to shingles. While it may cause a burning sensation upon initial application, this often diminishes with consistent use.

Counterirritants Products containing counterirritants, such as menthol and methyl salicylate, provide a heating or cooling sensation that distracts from the underlying pain. These are often found in over-the-counter creams, gels, and patches and are used for simple muscle aches, sprains, and backaches. While they do not directly treat the inflammation, the sensation they create can be an effective way to manage discomfort.

Uses and Considerations for Topical Treatments

Topical anti-inflammatories are best suited for localized pain and swelling in areas that are easily accessible, such as the hands, knees, elbows, and ankles. They are generally less effective for treating deep-seated pain in areas like the hips or spine.

Some conditions commonly treated with topicals include:

Acute injuries: Sprains, strains, and minor sports injuries.
Chronic pain: Pain associated with osteoarthritis in joints like the hands and knees.
Skin conditions: Rashes, eczema, and psoriasis (treated with corticosteroids).
Neuropathic pain: Nerve pain related to shingles or diabetes (treated with capsaicin or lidocaine).

Topical Anti-Inflammatories: NSAIDs vs. Corticosteroids


Feature	Topical NSAIDs	Topical Corticosteroids
Mechanism	Inhibits COX enzymes to block prostaglandin production, reducing pain and inflammation.	Suppresses immune response and reduces inflammation.
Primary Use	Musculoskeletal pain from injuries (sprains, strains), and conditions like osteoarthritis.	Inflammatory skin conditions like eczema, psoriasis, and various rashes.
Common Examples	Diclofenac (Voltaren), ibuprofen, ketoprofen.	Hydrocortisone, betamethasone, clobetasol.
Availability	Over-the-counter and prescription formulas available.	Over-the-counter (low potency) and prescription (high potency).
Typical Forms	Gels, creams, patches, solutions.	Creams, ointments, lotions, gels.
Key Consideration	Safer for those with systemic side effect risks from oral NSAIDs, but still requires caution.	Potency and duration of use are critical; misuse can lead to skin thinning.

Potential Side Effects and Safety Precautions

While topicals have a lower risk of systemic side effects compared to oral alternatives, local side effects can occur. The most common issues are mild skin reactions such as redness, itching, and dryness at the application site. Some individuals may experience an allergic reaction, which should be addressed immediately by a healthcare professional.

Important safety precautions for all topical medications include:

Do not apply to broken or infected skin. This can increase absorption and risk of infection.
Follow application instructions carefully. Avoid using more than the recommended dose or over larger areas than instructed.
Wash hands after application. This prevents accidental transfer to sensitive areas like the eyes, mouth, or genitals.
Avoid covering with bandages or heat. Unless specifically directed by a doctor, covering the area can increase absorption and risk.
Be aware of photosensitivity. Certain topicals, especially ketoprofen gels, can cause increased skin sensitivity to light.

Conclusion

Topicals for inflammation offer an effective and generally safer alternative to oral medications for many localized conditions, delivering concentrated relief directly to the source of pain or swelling. With a variety of options available—from NSAIDs for joint and muscle pain to corticosteroids for skin conditions—patients can find targeted relief with minimized systemic side effects. However, it is essential to follow directions carefully, be aware of potential side effects, and consult a healthcare provider for any persistent or severe conditions. This localized approach to treatment is a cornerstone of modern pain and inflammatory management, providing a crucial tool for both short-term injury and long-term chronic conditions.

Frequently Asked Questions

A topical cream is applied directly to the skin, delivering medication for localized relief with minimal systemic absorption, resulting in fewer body-wide side effects. An oral pill is absorbed into the bloodstream, circulating throughout the body to provide systemic relief, but with a higher risk of systemic side effects.

Yes, common side effects include mild skin reactions such as redness, itching, or irritation at the application site. While rare, more serious systemic side effects can occur, especially with large application areas or prolonged use.

Topical NSAIDs work by inhibiting cyclooxygenase (COX) enzymes in the body. This process reduces the production of prostaglandins, which are chemicals that promote pain and inflammation at the site of an injury or condition.

No, you should not apply topical anti-inflammatories to broken or irritated skin, as this can increase systemic absorption and raise the risk of side effects. Application should be limited to unbroken skin areas.

No. Topical corticosteroids are primarily used for inflammatory skin conditions like eczema and psoriasis, whereas topical NSAIDs are used mainly for musculoskeletal issues like arthritis, sprains, and strains.

The time to see results can vary depending on the product and condition. Some counterirritants offer immediate sensory relief, while NSAID gels may require consistent use over several days or weeks to achieve a therapeutic effect, especially for chronic conditions like osteoarthritis.

Long-term use of any medication, including topicals, should be discussed with a healthcare professional. While topical use has a lower risk of systemic issues, prolonged use of potent formulations can lead to local skin side effects.

OTC versions generally have lower concentrations of active ingredients and are intended for mild to moderate issues. Prescription versions contain higher concentrations and are typically used for more severe or chronic conditions under a doctor's supervision.