Warming ointments for bruises

In the complex treatment of bruises, as well as many other closed-type injuries, external agents in various forms are used - gels, ointments or creams.

A bruise causes pain and swelling, which develop due to impaired blood flow in small vessels; soft tissues do not receive nutrition, and their regeneration is hampered by local hypoxia and hyperpermeability of capillary walls. All these symptoms can be neutralized by ointment-based medications, including warming ointments for bruises. Hyperemic agents activate blood flow, normalize lymph circulation, help reduce the tone of damaged muscles, and significantly reduce pain symptoms.

Indications for the use of warming ointments for bruises

Almost all ointments for bruises are currently multi-component. They are used not only for the treatment of closed contusions of soft tissues, but also as an external therapeutic agent for many other diseases of the musculoskeletal system, including muscles.

Indications for the use of warming ointments for bruises are due to the following actions:

• Local anesthetic effect.
• Local anti-inflammatory action.
• Activation of lymph flow in the damaged area.
• Improving soft tissue trophism.
• Improving microcirculation.

Warming ointments for bruises are used only for closed contusion injuries, as well as for sprains, dislocations and other injuries diagnosed as moderate or mild injuries. The therapeutic effect of hyperemic agents is based on the action of the active components included in the ointment. Hyperemia (warming) helps improve blood microcirculation in damaged soft tissues, restoring normal blood flow and nutrition. Due to the fact that most ointments are multicomponent, they also have an anti-inflammatory effect, helping to reduce the symptoms of local inflammation.

Indications for use:

• Closed soft tissue contusions (without damage to the skin).
• Sprains, dislocations.
• Myalgia.
• Massage.
• Warming up muscles before (and after) training.
• Closed sports injuries.
• Local irritant therapy to activate peripheral circulation.

Pharmacodynamics

All irritating, warming ointments for bruises act as activators of the endings of the afferent nerves of the skin. In addition, the pharmacodynamics of hyperemic agents is due to the resorption property, when thermal exposure promotes blood flow, vasodilation and improvement of microcirculation in the bruise area.

The positive therapeutic effect is expressed in the improvement of trophism, which is achieved by influencing the skin-visceral reflexes, the center of which is located in the spinal cord. The afferent link in this case is the nerve endings of the skin, and the efferent (output) link is the sympathetic nerve fibers localized in certain areas of the medulla spinalis (spinal cord). In addition, the pharmacodynamics of the action of hyperemic agents is associated with the release of some active substances, such as histamine, which in turn provides a local trophic effect.

Also, one of the obvious signs of the work of warming ointments is considered to be local irritation, which distracts and thereby weakens the pain sensation at the site of injury or bruise. This action is explained by the interaction of trigger impulses (afferent) from the area of damage, mainly from the skin and injured subcutaneous tissue. It has been experimentally proven that the process of transmitting pain impulses to the spinal cord or brain comes through the visceral-afferent and somatic systems, and the local distracting effect of the ointment helps to interrupt this process. In addition, pain reduction is possible due to the activation of antinociceptive receptors of the central nervous system, which are responsible for the regulation and perception of pain. This property has long been used in the treatment of acupuncture, acupuncture.

Pharmacokinetics

External agents in the form of ointments are not capable of exerting a significant effect on the internal organs of the system, this is due to the form of the drug. The ointment does not penetrate into the systemic bloodstream, and those of its active substances that are still absorbed into the blood represent an insignificant amount, insufficient for a significant effect on the state of the body. It should be noted that, unlike pharmacodynamics, the pharmacokinetics of warming ointments for bruises has been little studied and there is no information on how and through which organs the active substance of the drug is excreted. Obviously, the mechanism of absorption, metabolism and excretion of ointment forms is not so interesting to microbiologists, pharmacists and doctors due to the fact that they do not pose a health hazard. The only exception may be combined ointments or gels containing methyl salicylates or bee and snake venom. Salicylates used externally are eliminated by the renal and extrarenal routes, but their concentration in the bloodstream is very low and is not capable of causing side effects. Ointments containing poisons can also have a deeper effect, in which the active component penetrates the blood through the skin and is excreted by the kidneys quite quickly.

Names of warming ointments for bruises

We present a list of the most popular and effective warming external remedies for soft tissue bruises:

• Apizatron is a product containing bee venom that relieves inflammation at the site of the injury and has a warming and distracting local effect.
• Viprosal is an ointment with gyurza venom. It helps well with soft tissue bruises, activating microcirculation and improving tissue trophism.
• Virapin is a remedy with bee venom that helps with sprains, myalgia, and bruises.
• Thermal balm Rescuer Forte, containing fir essential oil, sea buckthorn oil, capsaicin, vitamins, beeswax. The product helps relieve pain, activate blood supply to damaged tissues, accelerates the resorption of hematomas.
• Gymnastogal is a complex ointment that includes benzene ether of nicotinic acid, hydroxyl, methyltrans and other components. The product is used to treat bruises, sprains, and myositis.
• Vipratox is an ointment containing a complex of various snake venoms and methyl salicylate. It is used as a warming agent for radiculitis, bruises, and joint pain.
• Kapsikam is a pain-relieving and warming ointment containing benzyl nicotinate, turpentine, and camphor. It relieves inflammation and pain well, and warms up the site of injury in case of bruises and closed injuries.
• Efkamon is a product with camphor, methyl salicylate, clove essential oil, and pepper tincture. A very strong warming ointment, indicated for the treatment of myalgia, neuralgia, bruises, myositis, and arthritis.
• Finalgon, which contains nonivamide and nicoboxil, which, due to their local irritant effect, relieve pain and inflammation at the site of the injury.
• Espole is a warming ointment indicated for muscle strains, ligament strains, and in the treatment of bruises.
• Myoton is a preparation containing essential oils and plant substances. The ointment relieves inflammation, eliminates pain in myalgia, myositis, and bruises.

How to use warming ointments for bruises?

The method of applying a warming ointment for bruises is somewhat different from the use of painkillers or cooling agents. The main rule is that the bruise should not be warmed during the first 24 hours. Locally irritating ointments or gels are applied only after two or three days. In addition, the method of application requires caution, since many irritants contain essential oils, pepper extract or poisons, which, when they come into contact with mucous membranes (eyes, nose), can cause not just discomfort, but real allergic symptoms.

How to use warming ointments for bruises:

• The site of the injury should be prepared - rub it with light massage movements. This helps to activate blood circulation and creates the possibility for better absorption of the drug.
• If the goal is to achieve the fastest possible effect, then it is best solved by a product in the form of a gel, not an ointment. The gel overcomes the skin barrier faster and acts on the nerve receptors.
• The amount of ointment applied depends on the extent of the injury. But in general, it is considered that the injury site should be less than 15 centimeters in diameter.
• The ointment is applied to the bruised area no more than 30 times a day.
• It is necessary to pay attention to the condition of the skin. Any scratch or irritation is a categorical contraindication for the use of irritants.
• If the skin is hypersensitive, the injured area should first be lubricated with any neutral cream or vegetable oil.
• The course of treatment, as a rule, does not exceed 7 days. Longer treatment with warming ointments for bruises is unacceptable.

The ointment applied to the bruise begins to act within 2-3 minutes, the effect of the drug lasts up to 1 hour. The intensity of the warming effect is not related to the thickness of the ointment layer, so do not overdo it to avoid burning the skin.

General recommendations on the rules for using external warming agents are indicated on the factory packaging.

Use during pregnancy

Warming ointments for bruises during pregnancy are contraindicated in the same way as other thermal procedures. This can activate the blood flow not only to the site of the bruise, but also disrupt the hemodynamic process in the tissues in principle. It is believed that the use of the following ointments during pregnancy is strictly contraindicated:

• All ointments containing bee venom – Apizartron, Apitoxin, Virapin.
• All ointments with snake venom - Viprosal, Vipraxin.
• Ointments with essential oils.
• Ointments containing NSAIDs (non-steroidal anti-inflammatory drugs).
• Ointments containing salicylates.

In addition to the fact that irritating, hyperemic agents can provoke an allergic reaction, there is a risk of active substances entering the bloodstream and overcoming the placental barrier. Women should be especially careful in the third trimester of gestation, when the arterial duct is very sensitive to any impact, including local.

The use of warming ointments for bruises during pregnancy or lactation is permitted only with the permission of a doctor.

Contraindications to the use of warming ointments for bruises

Since warming ointments for bruises currently contain many active components, and also due to their irritating effect, there are diseases and conditions in which such products cannot be used.

Contraindications for use:

• Pregnancy, lactation period.
• It is advisable not to use warming ointments in the treatment of children under 12 years of age.
• History of allergies. Be especially careful with ointments that contain essential oils and poisons.
• Damage to the skin – scratches, cuts, wounds, ulcers, dermatitis, eczema.
• Hypersensitivity of the skin.
• Diseases of the musculoskeletal system in the acute stage (arthritis, arthrosis).
• Use with caution in case of neuropathologies.
• Chronic hepatitis.
• Infectious diseases.
• Tuberculosis.
• Use with caution in diabetes.
• Deep soft tissue damage, bone fracture.
• Extensive hematomas.

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Side effects

Since warming ointments may contain quite active components - essential oils, poisons (bee, snake), which have a pronounced irritating effect, side effects when applied are inevitable. This is especially true for injuries accompanied by damage to the skin - wounds, scratches, ulcers, dermatitis.

Side effects that may accompany the application of warming ointments for bruises:

• Local skin burn.
• Allergic reaction, up to and including Quincke's edema.
• Local skin irritation and swelling.
• Ulceration of the skin at the site of the injury.
• Vesicular rash.
• The appearance of pustules and pustules.
• Dermatitis.
• Itching.
• Rarely – shortness of breath and cough as a sign of the onset of an allergic reaction.

If any alarming signs appear, you should immediately stop using the ointment; side effects should be neutralized within 24 hours. If symptoms increase or last more than one day, you should consult a doctor and receive adequate treatment.

Overdose

Overdosing on hyperemic ointments is unlikely. It is possible only with a strong desire to quickly relieve swelling, eliminate a hematoma or numb a bruised area. Overdosing may be due to an excessively thick layer of ointment or its frequent application. Other cases of violation of the regimen for using warming agents have not been noted in medical practice.

The intensity of symptoms in case of overdose depends on how often the gel or ointment is applied, its quantity and the area size. The method of eliminating unwanted side effects is simple - stop using the drug and carefully treat the skin. The ointment is removed with a napkin or cloth, the bruise is lubricated with baby cream or Panthenol is used. If signs of an allergic reaction or dermatitis appear, you should consult a doctor and get professional medical help.

Interactions with other drugs

There is no specific data on the interaction of warming ointments for bruises with other drugs. However, it is obvious that any combination drugs should not be combined with any means to avoid complications and possible allergic reactions.

The general principle of using warming ointments is that they are applied only after the primary symptoms of the bruise have been eliminated in the first day. Hyperemic drugs are used on the 2nd or 3rd-1st day as monotherapy. Warming gels or ointments should not be combined with other ointment-based medications, an exception may be a neutral drug that is pre-applied to the skin as a protector. Also, two or three warming ointments should not be mixed, their composition is already complex, and such experiments may not only have no effect, but also provoke a burn or allergy.

Interaction with other drugs administered orally or by injection is unlikely, since a bruise is not considered a serious injury requiring complex therapy.

How to store warming ointments for bruises?

Many ointments with warming properties contain essential oils. Therefore, the first rule, which, incidentally, also applies to all other ointment forms, is to store the medicine in a closed form. Standard storage conditions are indicated on the factory packaging, and they should be followed so that the ointment does not lose its medicinal properties.

Storage rules:

• The ointment is stored closed, preferably in its packaging.
• The ointment should be placed in a cool place, protected from sunlight.
• The stability of the ointment consistency depends on the temperature conditions specified in the instructions. Gels should be stored in the refrigerator and kept at room temperature for 20-30 minutes before application. Thicker fat-based ointments can be stored at room temperature, not exceeding 15-18 degrees.
• Warming emulsions are stored in the cold.
• Any ointments, especially warming ones, should be stored in a place inaccessible to children. It should be taken into account that hyperemic agents contain strong irritating components, if they enter the gastrointestinal tract, they can cause intoxication.

The method and conditions for storing the ointment depend on its physical and chemical properties; all recommendations are usually described in the instructions or on the factory packaging.

Best before date

The shelf life of the ointment-based medicine does not exceed 2 years. Longer storage destroys the active ingredients of the ointment, it becomes ineffective and can even cause unwanted complications.

The expiration date of the warming ointment for bruises is usually indicated on the manufacturer's packaging. If the medicine is not used within this period and the expiration date is reached, the ointment should be disposed of.

Warming ointments for bruises can be used independently, most of them are over-the-counter drugs. However, to avoid side effects, you need to carefully read the instructions or consult with your doctor.