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Ep 577 – Transdermal Transference: “I Have a Client Who . . .” Pathology Conversations with Ruth Werner

Woman enjoying in relaxing massaging at health spa treatment.

A massage therapist notices that more clients are reporting their use of topical hormone medications. Somehow, this never came up in massage school. Is the massage therapist at risk for being dosed? It’s possible, but it’s nuanced. Listen for more information!

 

Resources:

 

Commissioner, O. of the (2021) Investigation of skin-to-skin transfer risks of topically applied transdermal hormonal drugs, FDA. FDA. Available at: https://www.fda.gov/science-research/fda-stem-outreach-education-and-engagement/investigation-skin-skin-transfer-risks-topically-applied-transdermal-hormonal-drugs (Accessed: June 3, 2026).

 

Could Testosterone Gel Exposure Pose Risk to Close Contacts? (2025) Medscape. Available at: https://www.medscape.com/viewarticle/could-accidental-exposure-testosterone-gel-risk-your-close-2025a1000qpg (Accessed: June 3, 2026).

 

Estradiol Gel: Uses & Side Effects (no date) Cleveland Clinic. Available at: https://my.clevelandclinic.org/health/drugs/20075-estradiol-topical-gel (Accessed: June 4, 2026).

 

Hariri, L. and Rehman, A. (2026) “Estradiol,” StatPearls. Treasure Island (FL): StatPearls Publishing. Available at: http://www.ncbi.nlm.nih.gov/books/NBK549797/ (Accessed: June 4, 2026).

 

Khan, S. and Sharman, T. (2026) “Transdermal Medications,” StatPearls. Treasure Island (FL): StatPearls Publishing. Available at: http://www.ncbi.nlm.nih.gov/books/NBK556035/ (Accessed: June 3, 2026).

 

Medication Patches and Implications for Massage Therapy | ABMP (no date). Available at: https://www.abmp.com/Massage-and-Bodywork-Magazine/Issues/julyaugust-2024/medication-patches-and-implications-massage-therapy (Accessed: June 3, 2026).

 

Should I be worried about secondary transfer risk with testosterone gels? (no date). Available at: https://www.trted.org/articles/should-i-be-worried-about-secondary-transfer-of-my-testosterone-gel (Accessed: June 4, 2026).

 

Sjöström, K. et al. (2022) “A review of adverse events in animals and children after secondary exposure to transdermal hormone‐containing medicinal products,” Veterinary Record Open, 9(1), p. e48. Available at: https://doi.org/10.1002/vro2.48.

 

Types of Estrogen Hormone Therapy (no date). Available at: https://www.webmd.com/menopause/which-type-of-estrogen-hormone-therapy-is-right-for-you (Accessed: June 4, 2026).

 

Author Images
Image of Ruth Werner.
Ruth Werner Logo
Author Bio

 

Ruth Werner is a former massage therapist, a writer, and an NCBTMB-approved continuing education provider. She wrote A Massage Therapist’s Guide to Pathology, now in its seventh edition, which is used in massage schools worldwide. Werner is also a long-time Massage & Bodywork columnist, most notably of the Pathology Perspectives column. Werner is also ABMP’s partner on Pocket Pathology, a web-based app and quick reference program that puts key information for nearly 200 common pathologies at your fingertips. Werner’s books are available at www.booksofdiscovery.com. And more information about her is available at www.ruthwerner.com.   

 

               

Sponsors

 

Anatomy Trains is a global leader in online anatomy education and also provides in-classroom certification programs for structural integration in the US, Canada, Australia, Europe, Japan, and China, as well as fresh-tissue cadaver dissection labs and weekend courses. The work of Anatomy Trains originated with founder Tom Myers, who mapped the human body into 13 myofascial meridians in his original book, currently in its fourth edition and translated into 12 languages. The principles of Anatomy Trains are used by osteopaths, physical therapists, bodyworkers, massage therapists, personal trainers, yoga, Pilates, Gyrotonics, and other body-minded manual therapists and movement professionals. Anatomy Trains inspires these practitioners to work with holistic anatomy in treating system-wide patterns to provide improved client outcomes in terms of structure and function.    

Website: anatomytrains.com    

Email: info@anatomytrains.com          

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Precision Neuromuscular Therapy seminars (www.pnmt.org) have been teaching high-quality seminars for more than 20 years. Doug Nelson and the PNMT teaching staff help you to practice with the confidence and creativity that comes from deep understanding, rather than the adherence to one treatment approach or technique.

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Save your hands for the smaller structures and start getting your clients underfoot! At the Center for Barefoot Massage, we teach you how to enhance your pressure using gravity and physics and help your clients recover from persistent pain through nerd-level anatomical attention to detail—we just happen to use our feet to do it all!

From the slow, down-regulating glides of our FasciAshi Fundamentals strokes to the proprioceptive “pattern-interrupts” of our Barefoot Matwork techniques and the resisted movements from our Stretch Therapy class, we offer a complete suite of evidence-based tools for deep, myofascial Ashiatsu Barefoot Massage—we nicknamed our approach “FasciAshi.”

 

Worried about your body size in relation to your clients? Our innovation—the suspended Ashi-strap—allows a more diverse population of massage therapists to regulate and vector their weight and pressure distribution with clinical precision, making deep work effortless on a variety of client bodies.

At the Center for Barefoot Massage, we believe the future of massage is afoot! Find when and where our CE classes are happening next at centerforbarefootmassage.com.