Topical capsaicin for pain management

Capsaicin causes sensory nerve blockade through substance P depletion. Topical application initially results in sensitisation and burning pain, but repeat administration can lead to reduced sensitivity or desensitisation.

The role of capsaicin for musculoskeletal conditions is discussed in the Rheumatology guidelines.

Low-concentration capsaicin creams (most commonly 0.075%) are no more effective than placebo in treating neuropathic pain, but may relieve pain by inducing heat in the application area.

High-concentration capsaicin patches (8%) have some efficacy in localised neuropathic pain. They are not registered for use in Australia, but are available via the Special Access Scheme.