Gout is a kind of arthritis that causes severe and sudden pain, swelling, and redness around joints. It most frequently occurs at the joint near the base of the big toe and causes extreme sensitivity to touch or weight along with decreased range of motion. The pain and inflammation of gout is caused by a buildup of urate crystals around the joint that results from high blood levels of uric acid. A high level of uric acid may be related to particular diets, obesity, certain medical conditions, genetics, and other factors. Gout can be cured if uric acid levels are managed and brought back to normal levels. A topical gout cream with multiple ingredients can effectively reduce pain while the cause of the uric acid buildup is treated.
Gout Cream Ingredients
One of the main benefits of using a compounded topical gout cream instead of an oral medication is the decreased risk of systemic side effects. NSAIDs, colchicines, and steroids taken orally can often cause gastrointestinal problems. A topical medication is applied directly to the area of pain, which increases effects locally while reducing absorption into other parts of the body. Ingredients that may be included in a compounded gout cream include:
NSAIDs: Non-steroidal anti-inflammatory drugs (NSAIDS) are found in many over-the-counter medications like Advil. A compounding pharmacy can make NSAIDs in the form of topical creams that are applied directly to the affected joint. These drugs will reduce pain, swelling, and inflammation from an acute gout attack. NSAIDs used for treating gout include indomethacin, naproxen, ibuprofen, and ketoprofen.
Colchicine: Colchicine is an alkaloid that is extracted from the plant Colchicum autumnale. While colchicine is one of the fastest-acting drugs available for treating gout, it is often avoided as a first-line treatment because of its adverse effects when administered orally. When taken by mouth, colchicine can cause severe nausea and vomiting. Applying colchicine topically may reduce adverse effects.
Corticosteroids: Steroids may be used to reduce inflammation around the joint. In some cases they are injected directly into the joint. Usually steroids are only used to treat gout if NSAIDs and colchicines are unsuccessful.
Lidocaine: This topical anesthetic is found in many pain creams we compound. It can numb pain receptors but will not decrease inflammation.
Capsaicin: Topically applied capsaicin can reduce the sensation of pain in the area of application by overloading pain receptors. It works by stimulating pain receptors so that it burns initially but then pain is reduced.
Important Notes on Gout Cream
- Most gout creams that contain NSAIDs can be applied three to four times a day as needed. One important note is that if a patient is taking any NSAIDs orally, using a cream that also contains an NSAID may lead to adverse effects since small amounts will still enter the bloodstream.
- Studies have shown that topically applied NSAIDs are as effective as orally administered NSAIDs. When administered topically, there may be some redness and itching around the application site but otherwise side effects are rare. The gastrointestinal side effects that can result from taking NSAIDs orally are much more severe.
- Creams for managing joint pain are most effective when applied to areas where they can easily penetrate to the joint – areas like the hands, feet, ankles, knees, and elbows. A cream may also be advantageous for individuals who are taking multiple medications.
- Topical pain creams are most effective for treating smaller areas like particular joints. They may not be the best choice for treating larger areas or for treating pain throughout the body.
- Treatment for an acute gout attack should begin as soon as possible after symptoms start. Certain drugs like colchicines are less effective if treatment is started a few days after an attack.
Example Gout Cream Formulations
Ketoprofen 10%, Lidocaine 5%, Indomethacin 2%, Triamcinolone 0.1 % Cream
Colchicine 0.2% Cream