Assessing the efficacy of topical formulations in diabetic neuropathy: a narrative review

We conducted a review of topical medications available for alleviation of diabetic neuropathic pain (DNP) and compared their efficacy with oral medications for pain relief. We also explored the feasibility of compounding topical medications.

Searches on PubMed, Medline Ovid, and Embase databases were conducted and findings were presented as a narrative review.

8% Capsaicin patches and 5% Lidocaine patches had the most evidence. The literature also showed evidence for topical clonidine, gabapentin, and amitriptyline.

Topical formulations are a potential substitute to oral medications in patients suffering from DNP. Potential options include 8% Capsaicin patch, 5% Lidocaine patch, Clonidine gel, Topical gabapentin, and an amitriptyline and ketamine combination. A promising area of research that requires further study is the effect of a combination of topicals in alleviated DNP.