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Thread: mexiletine for painful burning

  1. #1
    Senior Member laser_cat's Avatar
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    Jan 2017
    Country: United States

    Default mexiletine for painful burning

    There is a condition called erythromelalgia (EM) which describes painful/burning extremities -- usually feet/hands, but sometimes face + ears -- that I think has similarities to the painful burning of rosacea (I think painful burning rosacea is currently named 'neurogenic rosacea').

    While there are some theories about the mechanisms, I think EM and rosacea both are unfortunate blanket terms, with many possible causes.

    Anyway, I came across a 2017 case report about a male with refractory burning/painful/swelling/red ears (EM of the ears only) -- affecting his sleep -- who responded to mexiletine (oral analog of lidocaine). My sense from EM forums + online communities is mexiletine is hit or miss, but when it hits, it can be pretty significant in terms of relief. It's one of the few drugs in the pain/burning-relief category that has minimal (nonsedating) side effects (maybe some heartburn), so I really think there's not a lot to lose by trying this.

    If this is of interest to anyone Since this case report involved the ears, thought it deserved a mention in the RF
    Last edited by laser_cat; 30th March 2018 at 08:45 PM.

  2. #2
    Senior Member Brady Barrows's Avatar
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    Jun 2005
    Centre, Alabama, USA


    thanks for the article. I have included this in the thread on Ketamine 0.5% and Amitriptyline 1% in a Lipoderm cream used for Erythomelalgia that Deansm initially reported here in RF December 2016.
    Brady Barrows
    Blog - Join the RRDi

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