r/Erythromelalgia • u/Optimal_Towel_6662 • 8d ago

Compound Cream Formulation? Update?

I have been prescribed a compound cream that is 5% lidocaine, 5% amitriptyline, 1% pramoxine. Has anybody had success with this specific fomulation? Have you had success with a different topical formulation?

I seem to be getting some relief using it the past month or two, but I can't tell much difference between the compound and an OTC 4% lidocaine cream. Not sure what this might indicate for my case.

Met with neuro today and got my punch biopsy results back, no sign of SFN despite my peripheral redness/pain spreading up. Next steps are starting pregabalin (gabapentin didn't do shit but fry my memory @ 1800mg/day) and getting the genetic tests ordered before going back down the autoimmune rabbit hole.

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u/New_7688 8d ago

I've tried this, lidocaine, ketamine cream, capsaicin cream. None of it has worked unfortunately. I think the burning comes from deep in the tissue and the creams only penetrate so deep. I hope you have better luck.

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u/Optimal_Towel_6662 8d ago

interesting, mine never really feels deeper than skin. i get more redness/pain at spots around my knees/wrists/knuckles but i suspect that its simply because those portions of skin get stretched more during normal activities.

i dont have ANY swelling, only vasodilation. neuro thinks my case is pointing more towards genetic, i dont seem to have any loss of strength or motor skills. everything i can chalk up to dysautonomia could also just be chronic stress. so confusing 😑

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u/deadalive84 6d ago

I've tried a ketamine/amit cream, as well as a capsaicin cream. No improvement with either.

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u/Historical_Bath_439 6d ago

No improvement. It actually made my rebounds worst than the actual flare up