Voltaren gel, a topical nonsteroidal anti-inflammatory drug (NSAID) containing diclofenac, offers localized pain relief for osteoarthritis. While generally well-tolerated when used as directed, improper application can lead to adverse reactions and reduced efficacy. Understanding the prohibited application sites is crucial for maximizing benefits and minimizing risks associated with this medication.
Restricted Application Areas
Applying Voltaren gel to certain areas of the body can increase the risk of side effects or simply be ineffective. It is vital to adhere to the manufacturer's guidelines regarding application sites.
Broken or Damaged Skin
Never apply Voltaren gel to any area with compromised skin integrity. This includes cuts, open wounds, infections, rashes, severe peeling, or burns. The reasons for this restriction are two-fold:
- Increased absorption: Applying the gel to broken skin can cause a greater amount of the medication to enter the bloodstream, elevating the risk of systemic NSAID side effects such as gastrointestinal bleeding or cardiovascular events.
- Delayed healing and irritation: The gel's ingredients can further irritate the damaged tissue, potentially delaying the healing process or causing a severe skin reaction.
Eyes and Mucous Membranes
Voltaren gel is intended for external use on the skin only. Contact with sensitive areas like the eyes, nose, and mouth must be strictly avoided. If accidental contact occurs, the area should be rinsed thoroughly with water or saline immediately. If irritation persists, consult a physician. Inadvertent application to mucous membranes can cause significant irritation and increase the risk of systemic absorption.
Large Joints and Off-Label Use
Voltaren gel is only approved for specific, topically treatable joints afflicted by osteoarthritis pain, including the hands, wrists, elbows, knees, ankles, and feet. The gel's safety and effectiveness have not been evaluated for larger joints like the hips or shoulders, or for the spine (including the back). Using the gel on these unapproved areas is an off-label use and may not provide relief while still posing systemic risks. It is not approved for general muscle aches or sprains unrelated to arthritis.
Important Precautions for Safe Voltaren Application
Beyond avoiding specific body parts, several application methods must be avoided to prevent complications.
Avoiding Heat and Occlusive Dressings
After applying Voltaren gel, do not cover the treated area with bandages, heating pads, or hot tubs. The addition of external heat or occlusive (airtight) dressings significantly increases the amount of medication absorbed through the skin. This heightened absorption can raise the risk of serious NSAID side effects without enhancing local pain relief. Wait at least 10 minutes before putting on clothing or gloves over the treated area.
Minimizing Sun Exposure
The active ingredient in Voltaren gel can increase your skin's sensitivity to natural and artificial sunlight. This condition, known as photosensitivity, can lead to severe sunburns, rashes, blistering, and swelling. During treatment, it is important to minimize or avoid exposure to sunlight and tanning beds on the treated area. If sun exposure is unavoidable, cover the treated skin with clothing or use sunscreen.
The Risk of Concomitant Topical Products
Avoid applying other topical products—including sunscreens, cosmetics, lotions, or other medicated creams—to the same skin area treated with Voltaren gel. The interaction between these products can alter absorption and increase the risk of skin reactions. Ensure the skin is clean and dry before each application.
Side-Effect Comparison: Topical vs. Oral NSAIDs
While topical application minimizes systemic absorption compared to oral NSAIDs, risks still exist. The following table compares some common side effects.
| Feature | Voltaren Gel (Topical) | Oral NSAIDs (e.g., ibuprofen, naproxen) |
|---|---|---|
| Application Site | Localized to hands, wrists, elbows, knees, ankles, feet. | Systemic absorption via the digestive system. |
| Primary Indication | Osteoarthritis pain in specific joints. | Widespread pain, inflammation, fever, various arthritis types. |
| Systemic Absorption | Minimal, reducing systemic risk. | High, leading to greater risk of systemic side effects. |
| GI Side Effect Risk | Lower incidence of GI bleeding and ulceration. | Higher risk of serious gastrointestinal adverse events, including bleeding and ulceration. |
| Cardiovascular Risk | Small but present risk of heart attack and stroke, especially with high doses or prolonged use. | Increased risk of serious cardiovascular events, which can be fatal. |
Conclusion: Practice Safe Application
Voltaren gel is an effective tool for localized pain management from osteoarthritis when used correctly. Knowing where you should not put Voltaren gel is critical to preventing complications such as increased systemic side effects, localized irritation, and poor treatment outcomes. Always follow the manufacturer's directions, apply only to approved joints, and avoid broken skin, heat, and sun exposure on treated areas. As with any medication, discussing your specific health conditions and medication usage with a healthcare provider is the safest approach.
Authoritative Link
For more detailed prescribing information and warnings regarding Voltaren gel, refer to the official documentation provided by the FDA. FDA Prescribing Information for Voltaren Gel
