III. Mechanism

  1. Capsaicin is derived from chili peppers (genus Capsicum) such as jalapeno peppers
  2. Capsaicin is a Transient Receptor Potential Vanilloid 1 (TRPV1) Agonist
    1. TRPV1 activates cation channels on pain nerve fibers (nociceptive fibers)
    2. Nociceptive nerves depolarize, transmitting pain signal to the spinal cord
  3. Capsaicin depletes Substance P from pain fibers, desensitizing nerves and preventing pain transmission
    1. Requires frequent and repeat applications for effect
    2. Inconsistent use is not effective

IV. Dose: Capsaicin Cream (OTC)

  1. Neuropathic pain
    1. Apply Capsaicin cream as a thin film (0.025% to 0.075%) to affected area 3-4 times daily
  2. Cannabinoid Hyperemesis Syndrome (off label)
    1. Apply Capsaicin cream as a thin film (0.075%) to 15 x 25 cm periumbilical area every 4 hours until symptoms resolve

V. Dose: Capsaicin Patch (high dose - 8%)

  1. Applied in office
  2. Pre-treat area by applying 4% Lidocaine cream for 60 minutes
  3. Check area for Anesthesia following application
  4. Apply Capsaicin 8% cream with gloves and leave on for 60 minutes
  5. Wash off after 1 hour

VI. Adverse effects

  1. Local Irritation
    1. Erythema (63%)
    2. Burning Sensation (42%)
      1. Most significant on initial application
    3. Less commonly, Pruritus, edema and local swelling
  2. Increased pain for up to first week of application

VII. Precautions

  1. Wash hands thoroughly after Capsaicin application

VIII. Resources

Images: Related links to external sites (from Bing)

Related Studies

Cost: Medications

capsaicin (on 12/21/2022 at Medicaid.Gov Survey of pharmacy drug pricing)
CAPSAICIN 0.025% CREAM Generic OTC $0.08 per gram
CAPSAICIN 0.075% CREAM Generic OTC $0.08 per gram
CAPSAICIN 0.1% CREAM Generic OTC $0.18 per gram