They don’t, honestly. Most topical treatments for things like headache or cramps aren’t really that effective. There are other transdermal medicines. Nicotine is a popular one. Other common prescription versions are lidocaine patches, scopolamine patches, and clonidine patches. They stay on for hours, and give steady dose of medicine, and often only need to be changed every few days.
There are some topical medicines that get absorbed and are effective, but many aren’t. Head-On is an example, and is actually a homeopathic medicine that is essentially just wax.
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