As a young hospital pharmacist I often dispensed nitroglycerin tablets to relieve angina

(chest pain)  caused by coronary artery disease. Later,as a physician internist I prescribed it both

while working in the emergency room and on the hospital floors.

                        Now,as a physician dermatologist, I am amazed at the many uses of this valuable

medication even when  used topically(ie,not taken internally but applied to various parts of the outside

of the body.)

                      Nitroglycerin can be applied as an ointment to the skin where it again -as in the heart-

dilates or widens small blood vessels which have been vasoconstricted by various factors including

cold temperatures,emotions,hormones and even certain medications.In addition, autoimmune

diseases  such as systemic lupus erythematosus and systemic sclerosis can also cause this


                    This vasosparm or constriction of the blood supply to body parts such as the fingers

and toes is called Raynaud's phenomenon. And,if your fingers or toes have ever been exposed to

freezing cold temperatures even for a short time,you know how discomforting it is and how fast

you have tried to rewarm them.

                    Pernio,also called chilblains,is an inflammatory response to cold on the hands and

feet and is characterized by itching,red patches and swelling and blistering.

                   Also,topical nitroglycerin ointment has been used in dermatology to  treat small

tender nodules usually found on the outer rim of the ears (ie,the helix of the ear) which are

exquisitely sensive to pressure-especially when the patient lays on them in bed at night.

This condition is called chondrodermatitis nodularis helicis (literally inflamation of the ear


                   In addition,topical nitroglycerin ointment is also used to relieve the severe

pain caused by long term tears in the lining of the anal cavity,called anal fissures, by

reducing the pressure on them.

                  Two of the most common side effects of topical nitroglycerin include headaches 

and dizziness,although this is even less likely with the 1 % formulation than with the

2 % product.

                  In summary, topical nitroglycerin may be a safe,inexpensive and effective

therapy wherever increased cutaneous blood flow is needed.