From the FDA Drug Label
Use temporarily relieves minor pain Directions Adults and children over 12 years: ◆ Apply to affected area not more than 3 to 4 times daily The best topical treatments for pain from skin excoriation are:
- Lidocaine (TOP): can be used to relieve minor pain from skin excoriation 1, 1
- Capsaicin (TOP): although the label does not explicitly mention skin excoriation, it can be applied to affected areas to relieve pain 2 Key considerations:
- Always follow the directions and apply the topical as instructed
- For children under 18 years (capsaicin) or under 12 years (lidocaine), consult a doctor before use 2, 1
From the Research
The most effective topical treatment for pain from skin excoriation is lidocaine 4% cream, which can be applied sparingly to the affected area up to 3-4 times daily for localized pain relief. This is based on the evidence from 3, which reviews the various topical analgesics, their mechanisms of action, and their efficacy, and finds that topical lidocaine has been widely studied and found to reduce pain in patients with postherpetic neuralgia.
For wound care, gently cleaning the area with mild soap and water, then applying an antibiotic ointment like bacitracin or Neosporin before covering with a non-stick bandage can be beneficial. Hydrocolloid dressings can also be especially helpful as they create a moist healing environment while providing a protective cushion that reduces pain.
Some key points to consider when treating skin excoriation include:
- Avoiding scratching or further trauma to the area, as this will worsen pain and delay healing
- Using topical treatments that protect exposed nerve endings or reduce inflammation
- Considering prescription options, such as stronger topical anesthetics or topical or oral antibiotics, for moderate to severe excoriations
- Managing the underlying condition, such as excoriation disorder, with a comprehensive treatment plan that may include psychotherapy, behavioral interventions, and pharmacologic treatments, as discussed in 4, 5, 6, and 7.
It's also important to note that while alternative therapies such as yoga, aerobic exercise, acupuncture, biofeedback, hypnosis, and inositol and N-acetylcysteine may show promise in the treatment of excoriation disorder, as discussed in 5, the evidence for their use in treating pain from skin excoriation is limited. Similarly, the use of low-dose naltrexone, as discussed in 7, may be beneficial in managing excoriation disorder, but its effectiveness in treating pain from skin excoriation is not well established.