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What is capsaicin cream?

Other names: Capsicum frutescens, Capsicum annum, capsicum cream, cayenne pepper, chili pepper, hot pepper, paprika, pimiento, red pepper

Capsaicin (pronounced cap-SAY-sin) is the active ingredient in chili peppers. It's what gives chili peppers their kick.

Why do people use capsaicin cream?

Capsaicin cream is primarily used to relieve pain and itching. Conditions it is used for include:

• Back pain
  
• Bursitis
  
• Fibromyalgia
  
• Joint pain
  
• Muscle pain
  
• Nerve Pain
  
• Osteoarthritis
  
• Pain due to diabetic neuropathy
  
• Phantom pain after amputation
  
• Post-herpetic neuralgia
  
• Post-surgical neuropathic pain
  
• Pruritis (itching)
  
• Rheumatoid arthritis

When it is applied to the skin, capsaicin cream has been found to deplete substance P—a neurochemical that transmits pain—which desensitizes a person to pain.

Capsaicin cream produces a temporary reduction in pain, so it must be used regularly to provide prolonged pain relief.

What research has been done on capsaicin cream?

Thirteen out of 16 randomized controlled trials involving a total of 1535 people found capsaicin was more effective than placebo.

• Arthritis - Researchers with Case Western Reserve University examined the use of capsaicin cream in 70 patients with osteoarthritis and 31 with rheumatoid arthritis. After 4 weeks of applying a 0.025% capsaicin cream or placebo to painful knees, the capsaicin patients had significantly more pain relief. Rheumatoid arthritis patients had 57% pain reduction and osteoarthritis patients had 33% pain reduction-both were considered more effective than placebo.
  
  A European Journal of Pain study found that osteoarthritis pain was reduced after 6 weeks of using a 0.025% capsaicin cream.
  
  
• Back Pain - A German study compared a capsaicin plaster with a placebo for 3 weeks in 154 patients with chronic back pain. After 3 weeks, 60.8% of patients in the capsaicin group experienced at least a 30% reduction in pain, compared to 42.1% in the placebo group.
  
  
• Nerve Pain - A British Journal of Pharmacology study assessed the effectiveness of the topical pain-relieving medication doxepin, a 0.025% capsaicin cream, a combination, or a placebo in 200 patients with chronic nerve pain. After 4 weeks, all three treatments significantly reduced pain.
  
  A study by researchers with the Geisinger Clinical Oncology Program found that cancer patients with post-surgical nerve pain had substantially more pain relief after using capsaicin cream, with an average pain reduction of 53% versus 17% for the placebo.
  
  Researchers with the University of Toronto evaluated the effectiveness of 0.075% capsaicin cream or placebo in 143 patients with post-herpetic neuralgia. After 6 weeks, those using the capsaicin cream had a significant reduction in pain. In contrast, patients using the placebo cream remained unchanged. A 2 year follow-up found that the pain relief was maintained or further improved in 86%.
  
  At least 5 randomized controlled trials have found that 0.075% capsaicin cream is more effective than a placebo in relieving pain associated with diabetic neuropathy. An 8-week multicenter study of 235 patients with diabetic neuropathy involving the feet found that they were both equally effective in reducing pain. However, the capsaicin cream didn't have systemic side effects (such as drowsiness or cardiovascular side effects) prompting researchers to conclude that it may be a safer option.
  
  
• Pruritic Psoriasis - A study by the University of Michigan Medical School examined the safety and efficacy of 0.025% capsaicin cream versus placebo in patients with pruritic (itchy) psoriasis. After 6 weeks, capsaicin patients had significantly greater improvement in itching.

Common Doses

A recommended starting dose is 0.025% capsaicin cream applied four times a day. If this dose is ineffective, a 0.075% capsaicin cream can be used under the guidance of a health practitioner. Capsaicin cream is applied directly over areas of muscle or joint pain or itching.

Capsaicin cream can cause a stinging or burning sensation on the skin. Not everyone experiences it and the sensation doesn't appear to be necessary for it to work.

Some practitioners recommend using capsaicin cream for at least 4 continuous weeks to evaluate the effectiveness.

Safety

• Wear gloves when applying capsaicin cream.
  
• Do not apply it immediately after a hot bath or shower or use it with a heating pad.
  
• Avoid getting capsaicin cream in eyes and other mucus membranes or broken skin.
  
• The safety of capsaicin cream in pregnant or nursing women hasn't been established.

Side Effects

The main side effect of using capsaicin cream is that it can cause an uncomfortable burning sensation in the area.

Other side effects are coughing and skin redness. Higher doses can cause pain, inflammation, and skin blisters.

Drug Interactions

There have been no reported drug interactions with topical capsaicin cream.

Where to find capsaicin cream

Capsaicin cream can be found at drug stores, health food stores, and online. A tube or jar of capsaicin cream typically costs between $8 and $25.