Capsaicin

  • Active component of hot chilli peppers
  • Cat. C

  • 0.025-0.075% cream, lotion, gel or stick (3-5x/day)
  • 8% patch (1hour/day)

  • – Activates TRPV1 receptor 🡪 release substance P from C neurons & depletion 🡪 ↓ transmission of itch, heat & pain
  • – Chronic use leads to neuronal degeneration at application sites

  • FDA
    • PHN (patch)
  • Off label
    • Uremic pruritus 
    • Notalgia paresthetica 
    • Brachioradial pruritus 
    • Prurigo nodularis 
    • Psoriatic pruritus

  • Allergy to any component of the formulation
  • Do not use on open/damaged skin

  • Initial sensation of burning +/- erythema (common > ½ of patients)

  • Therapeutic effect noted ~1 week after initiation 
  • Hand washing recommended after application of capsaicin, to prevent transfer to/irritation of non-affected skin, eyes, & mucosal surfaces