From the Guidelines
Topical creams that dilate blood vessels and improve blood flow to tissues include nitroglycerin, which can be applied as a 0.2-0.4% ointment 1-2 inches every 4-6 hours, as supported by 1. When considering topical creams for vasodilation, it's essential to understand the mechanisms and potential side effects. Nitroglycerin releases nitric oxide to relax smooth muscle in blood vessels, causing vasodilation 1. Other options, although not directly mentioned in the provided evidence, include minoxidil, nifedipine, and capsaicin, which work through different mechanisms such as opening potassium channels, blocking calcium channels, and depleting substance P, respectively. Some key points to consider when applying these medications:
- Use gloves to avoid absorbing the medication through your fingers
- Apply to intact skin only
- Watch for side effects like headaches, dizziness, or skin irritation
- If you have cardiovascular conditions or are taking medications for erectile dysfunction, consult your healthcare provider before using vasodilating creams to avoid dangerous drops in blood pressure. Additionally, the use of nitroglycerin paste to skin is mentioned in 1 as an option for treating vascular injury in pediatric supracondylar humerus fractures, further supporting its vasodilatory effects. However, it's crucial to prioritize the most recent and highest quality evidence, which in this case, is the 2010 American Heart Association guidelines for cardiopulmonary resuscitation and emergency cardiovascular care 1.
From the FDA Drug Label
The organic nitrates are vasodilators, active on both arteries and veins. NITRO-BID® for topical use contains lactose and 2% nitroglycerin in a base of lanolin, white petrolatum and purified water. Pentoxifylline administration has been shown to produce dose-related hemorrheologic effects, lowering blood viscosity, and improving erythrocyte flexibility.
Some topical creams that dilate blood vessels and improve blood flow to tissues are:
- Nitroglycerin (2%): a vasodilator that is active on both arteries and veins 2
- Pentoxifylline: improves blood flow by decreasing blood viscosity and improving erythrocyte flexibility, although it is not explicitly stated as a topical cream in the provided drug labels 3
From the Research
Topical Creams for Blood Flow Improvement
Some topical creams that can help dilate blood vessels and improve blood flow to tissues include:
- Menthol-based creams, as they have been shown to increase cutaneous blood flow 4
- Creams containing platelet-derived growth factors (PDGFs), which can stimulate migration and proliferation of cells, including those involved in blood vessel formation 5
Mechanism of Action
The mechanism of action of these creams involves:
- Activation of transient receptor potential melastatin 8 (TRPM8) receptors on sensory nerves and the vasculature, inducing a cooling sensation on the skin and increasing blood flow 4
- Stimulation of cell migration and proliferation by PDGFs, which can lead to improved blood flow and tissue repair 5
Key Findings
Key findings from studies on topical creams for blood flow improvement include:
- Topical menthol application increases skin blood flow compared to placebo 4
- PDGF-BB stimulates migration and proliferation of bone marrow mesenchymal stem cells into an injectable gelatin-hydroxyphenyl propionic acid matrix 5
- PDGFs have been shown to play a role in tumorigenesis and may be a therapeutic target for various diseases 6