Overview

Capsaicin 8% patches are used to treat nerve pain caused by peripheral neuropathy. They can be used alone or together with other medicines.

Capsaicin is found in chilli peppers. It’s what makes them taste hot.

You have nerves under your skin that sense pain. Capsaicin patches block the receptors on these nerves, making you feel less pain.

Capsaicin treatment involves applying a capsaicin patch to the area of your skin where you have pain.

Benefits of capsaicin treatment

Most people find this treatment effective and long-lasting. Some people have pain relief for weeks or months.

Capsaicin treatment does not work for everyone. If the treatment is not effective for you, we’ll discuss other treatment options in your follow-up appointment.

Giving your permission (consent)

We want to involve you in decisions about your care and treatment. If you decide to have the procedure or treatment, we’ll ask you to sign a consent form. This says that you understand what’s involved and agree to have the treatment.

Read more about our consent process.

Preparing for the procedure

Before the procedure

At least 1 week before the procedure, you must tell your doctor or nurse if you:

• have any allergies, especially to chilli peppers or capsaicin
• have high blood pressure
• have an infection, broken skin or rash near the area we need to treat
• have had a heart attack in the last year
• are using dimethylsulfoxyde (DMSO) ointment
• are pregnant or think you might be pregnant
• are breastfeeding

At least 3 days before the procedure, you should trim or shave any hair on the area we need to treat.

On the day

Before coming to hospital, you should:

• eat and drink as normal
• take your usual medication
• wear loose-fitting clothes over the area we need to treat
• put on comfortable shoes or flip-flops if we are treating your feet

Do not apply any creams or moisturisers to the area.

The procedure can take up to 2 hours. You can bring something to do during the procedure. For example, you might want to bring a book to read or music to listen to.

Checking your blood pressure

There is a risk that your blood pressure could increase during capsaicin treatment. We’ll monitor your blood pressure before the procedure to make sure it’s safe to proceed.

If your blood pressure is high, we might need to reschedule your treatment until it’s under control.

During the procedure

A nurse might mark the most painful areas on your skin with a pen. If the area is small, we’ll cut the capsaicin patch into smaller pieces.

Then we’ll place the capsaicin patch on your skin. We will not put the patch on any open wounds or broken skin.

We might use a bandage or surgical tape to keep the patch firmly on your skin.

We’ll leave the patch on for:

• 30 minutes if we’re treating the soles of your feet
• 60 minutes if we’re treating other parts of your body

After this, the nurse will carefully remove the capsaicin patch and apply a cleansing gel to the skin for about 1 minute. Then we’ll wipe it off and wash the area gently with soap and water.

This procedure can take up to 2 hours.

Side effects of capsaicin treatment

Capsaicin treatment can have temporary side effects for some people. These are usually not serious.

During the capsaicin treatment, your skin might:

• sting
• burn
• turn red (this may be harder to see on black or brown skin)

These side effects can continue for a few days after the treatment. They affect more than 1 in 10 people.

Other side effects include:

• itching and irritation
• bumps on your skin
• blisters
• swelling (inflammation)
• dry skin
• raised marks on your skin (wheals)
• a prickling sensation
• increased sensitivity of your skin
• bruising
• increased blood pressure

These side effects usually disappear within 7 days and do not typically need treatment.

After the procedure

Going home

You can go home shortly after the procedure and continue your normal daily activities. If you feel comfortable, you can drive home.

Most people will start to feel some pain relief the same day. However, it can take up to 14 days before you feel the maximum benefit.

Caring for the treated area

If the treated area is painful, stinging or burning, apply an ice pack (or a bag of frozen vegetables wrapped in a tea towel). If you need more relief, you can take your regular painkillers as needed.

The treated area may be sensitive to heat for a few days.

You should wash any clothes that have come into contact with the treated area separately from the rest of your laundry. Turn the clothes inside out before washing them.

If you're concerned about your side effects, contact us or ask a GP for advice.

Follow-up appointment

You’ll have a telephone follow-up appointment 6 to 8 weeks after the procedure.

During this appointment, we’ll discuss if you need more capsaicin treatment.

Getting more treatment

Capsaicin can be more effective when you have more than one treatment. Many patients benefit from a second treatment even if there is no obvious relief from the first.

You can have another capsaicin patch 90 days after your first one. If you’re still feeling the benefits of the first treatment, we might recommend you wait longer until your next one.