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All about: Capsaicin Topical

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Some commonly used brand names are:

In the U.S.—

  • Zostrix
  • Zostrix-HP

In Canada—

  • Zostrix
  • Zostrix-HP


  • Analgesic, specific pain syndromes (topical)
  • antineuralgic, specific pain syndromes (topical)
  • antipruritic (topical)


Capsaicin (cap-SAY-sin) is used to help relieve a certain type of pain known as neuralgia (new-RAL-ja) . Capsaicin is also used to temporarily help relieve the pain from osteoarthritis (OS-te-o-ar-THRI-tis) or rheumatoid arthritis (ROO-ma-toid ar-THRI-tis) . This medicine will not cure any of these conditions.

Neuralgia is a pain from the nerves near the surface of your skin. This pain may occur after an infection with herpes zoster (shingles). It may also occur if you have diabetic neuropathy (di-a-BET-ick new-ROP-a-thee) . Diabetic neuropathy is a condition that occurs in some persons with diabetes. The condition causes tingling and pain in the feet and toes. Capsaicin will help relieve the pain of diabetic neuropathy, but it will not cure diabetic neuropathy or diabetes.

Capsaicin may also be used for neuralgias or itching of the skin caused by other conditions as determined by your doctor.

Capsaicin is available without a prescription; however, your doctor may have special instructions on the proper use of this medicine.

  • Topical
  • Cream (U.S. and Canada)

Before Using This Medicine

If you are using this medicine without a prescription, carefully read and follow any precautions on the label. For capsaicin, the following should be considered:

Allergies—Tell your health care professional if you have ever had any unusual or allergic reaction to capsaicin or to the fruit of Capsicum plants (for example, hot peppers). Also tell your health care professional if you are allergic to any other substances, such as foods, preservatives, or dyes.

Pregnancy—Capsaicin has not been reported to cause birth defects or other problems in humans.

Breast-feeding—It is not known whether capsaicin passes into breast milk. Although most medicines pass into breast milk in small amounts, many of them may be used safely while breast-feeding. Mothers who are using this medicine and who wish to breast-feed should discuss this with their doctor.

Children—Use is not recommended for infants and children up to 2 years of age, except as directed by your doctor. In children 2 years of age and older, this medicine is not expected to cause different side effects or problems than it does in adults.

Older adults—Many medicines have not been studied specifically in older people. Therefore, it may not be known whether they work exactly the same way they do in younger adults. Although there is no specific information comparing use of capsaicin in the elderly with use in other age groups, this medicine is not expected to cause different side effects or problems in older people than it does in younger adults.

Other medical problems—The presence of other medical problems may affect the use of capsaicin. Make sure you tell your health care professional if you have any other medical problems, especially:

  • Broken or irritated skin on area to be treated with capsaicin

Proper Use of This Medicine

If you are using capsaicin for the treatment of neuralgia caused by herpes zoster, do not apply the medicine until the zoster sores have healed.

It is not necessary to wash the areas to be treated before you apply capsaicin, but doing so will not cause harm.

Apply a small amount of cream and use your fingers to rub it well into the affected area so that little or no cream is left on the surface of the skin afterwards.

Wash your hands with soap and water after applying capsaicin to avoid getting the medicine in your eyes or on other sensitive areas of the body. However, if you are using capsaicin for arthritis in your hands, do not wash your hands for at least 30 minutes after applying the cream.

If a bandage is being used on the treated area, it should not be applied tightly.

When you first begin to use capsaicin, a warm, stinging, or burning sensation (feeling) may occur. This sensation is related to the action of capsaicin on the skin and is to be expected. Although this sensation usually disappears after the first several days of treatment, it may last 2 to 4 weeks or longer. Heat, humidity, clothing, bathing in warm water, or sweating may increase the sensation. However, the sensation usually occurs less often and is less severe the longer you use the medicine. Reducing the number of doses of capsaicin that you use each day will not lessen the sensation and may lengthen the period of time that you get the sensation. Also, reducing the number of doses you use may reduce the amount of pain relief that you get.

Capsaicin must be used regularly every day as directed if it is to work properly. Even then, it may not relieve your pain right away. The length of time it takes to work depends on the type of pain you have. In persons with arthritis, pain relief usually begins within 1 to 2 weeks. In most persons with neuralgia, relief usually begins within 2 to 4 weeks, although with head and neck neuralgias, relief may take as long as 4 to 6 weeks.

Once capsaicin has begun to relieve pain, you must continue to use it regularly 3 or 4 times a day to keep the pain from returning. If you stop using capsaicin and your pain returns, you can begin using it again.

Dosing—The dose of capsaicin may be different for different patients. Follow your doctor's orders or the directions on the label . The following information includes only the average dose of capsaicin. If your dose is different, do not change it unless your doctor tells you to do so.

  • For topical dosage form (cream):
    • For neuralgias or itching of the skin:
      • Adults and children 2 years of age or older—Apply regularly 3 or 4 times a day and rub well.
      • Children up to 2 years of age—Use and dose must be determined by your doctor.

Missed dose—If you miss a dose of this medicine, use it as soon as possible. However, if it is almost time for your next dose, skip the missed dose and go back to your regular dosing schedule. Do not double doses.

Storage—To store this medicine:

  • Keep out of the reach of children.
  • Store away from heat and direct light.
  • Keep the medicine from freezing. Do not refrigerate.
  • Do not keep outdated medicine or medicine no longer needed. Be sure that any discarded medicine is out of the reach of children.

Precautions While Using This Medicine

If capsaicin gets into your eyes or on other sensitive areas of the body, it will cause a burning sensation. If capsaicin gets into your eyes, flush your eyes with water. If capsaicin gets on other sensitive areas of your body, wash the areas with warm (not hot) soapy water.

If your condition gets worse, or does not improve after 1 month, stop using this medicine and check with your doctor.

Side Effects of This Medicine

Along with its needed effects, a medicine may cause some unwanted effects. Although not all of these side effects may occur, if they do occur they may need medical attention. Some side effects may occur that usually do not need medical attention. These side effects may go away during treatment as your body adjusts to the medicine. However, check with your doctor if any of the following side effects continue or are bothersome:

More common

Warm, stinging, or burning feeling at the place of treatment

Other side effects not listed above may also occur in some patients. If you notice any other effects, check with your doctor.

Revised: 05/01/1998

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