Topical and transdermal pain formulations are very popular among health care providers and patients, but unfortunately, not all doctors are familiar with how to best prescribe customized medications. Topical and transdermal preparations are often preferred to oral medications due to decreased side effects and the avoidance of initial breakdown of drug by the liver (first pass metabolism). Dosage forms include creams, ointments, and gels; medication sticks; solutions, and sprays.
 
   Compounded topical creams can play an outstanding role in meeting the needs of patients with diabetic neuropathy-associated pain. A recent study showed good to excellent results in relief of pain associated with diabetic neuropathy and relief of other chronic neuropathic pain with the use of compounded creams. Use of the creams resulted in a reduction in the need for oral analgesics and referrals made by physicians to pain specialists.