From the Guidelines
To manage symptoms of redness and warmth, compounded midodrine 0.2% is the preferred treatment option. This is based on the most recent and highest quality study available, which reviewed medical management options for erythromelalgia and outlined the best approaches to management 1. When considering treatment, it's essential to try a topical medication for at least 4 weeks to assess its efficacy before switching to another option. Some other topical options that can be considered include:
- Phenylephrine (eg, Preparation H [GlaxoSmithKline])
- Oxymetazoline 0.05%
- Timolol maleate 0.5%
- Brimonidine tartrate 0.33% These treatments may help decrease redness, which can subsequently decrease pain, as noted in the study published in the Mayo Clinic Proceedings in 2023 1. It's crucial to identify the underlying cause of the symptoms, as they can indicate various conditions, and managing them appropriately can significantly impact morbidity, mortality, and quality of life. Given the potential for these symptoms to indicate serious underlying conditions, if they are severe, spreading, or accompanied by fever, or if they don't improve within 48-72 hours, it's essential to seek medical attention for further evaluation and treatment.
From the FDA Drug Label
NSAIDs are used to treat pain and redness, swelling, and heat (inflammation) from medical conditions The FDA drug label does not answer the question.
From the Research
Managing Redness and Warmth
To manage symptoms of redness and warmth, several approaches can be considered:
- Applying warm moist compresses: A study published in the European journal of oncology nursing 2 found that warm moist compresses had a positive effect on healing in patients with phlebitis, reducing redness, edema width, and pain intensity.
- Using cold water: A case report in Pediatrics 3 described a patient with erythromelalgia who obtained relief by immersing the affected extremity in cold water.
- Intravenous lidocaine and oral mexiletine therapy: The same case report in Pediatrics 3 found that this treatment was effective in reducing the frequency and severity of pain episodes in a patient with erythromelalgia.
- Heat and cold therapy: A study in Zeitschrift fur Rheumatologie 4 suggested that acute exsudative inflammations are better influenced by cold, while chronic torpid and proliferous inflammations are better influenced by heat.
- Locally applied heat or cold: A review in Seminars in arthritis and rheumatism 5 found that most studies reported beneficial effects of heat and cold on pain, joint stiffness, grip strength, and joint function in inflamed joints.
Alternative Interventions
Other interventions that may be effective in managing redness and warmth include:
- Warm water compresses: A study in Comprehensive child and adolescent nursing 6 found that warm water compresses were effective in reducing the degree of phlebitis, similar to 0.9% NaCl compresses.
- Nursing interventions: The study in European journal of oncology nursing 2 highlighted the importance of nursing practices in phlebitis care, including the application of warm moist compresses.