Formulations of topical diclofenac, ibuprofen, ketoprofen, piroxicam, and indomethacin demonstrated significantly higher rates of clinical success (more participants with at least 50% pain relief) than matching topical placebo (moderate or high quality data ). Benzydamine did not. Three drug and formulation combinations had NNTs for clinical success below 4. For diclofenac, the Emulgel® formulation had the lowest NNT of (95% CI to ) in two studies using at least 50% pain intensity reduction as the outcome . Diclofenac plasters other than Flector® also had a low NNT of ( to ) based on good or excellent responses in some studies. Ketoprofen gel had an NNT of ( to ), from five studies in the 1980s, some with less well defined outcomes. Ibuprofen gel had an NNT of ( to ) from two studies with outcomes of marked improvement or complete remission. All other drug and formulation combinations had NNT values above 4, indicating lesser efficacy .
Retinoids are widely used in medicine and play a very important role in treating disease not just limited to the skin. Although first line for many different skin conditions, therapy should be tailored to individual patients based on the side effect profile. Due to individual variability, some people may experience better overall results with the use of different retinoid therapies. It is important not to forget that overuse of this medication can lead to the development of chronic skin dryness, irritation, and discoloration. If any of these side effects are noticed, contact your physician immediately.