What You Should Know About the Topical Cream Capsaicin

A Sensible Option to Treating Certain Minor Muscle, Joint, and Nerve Pains

Capsaicin is the active ingredient in chili peppers.
Capsaicin is the active ingredient in chili peppers. Danita Delimont/Getty Images

Capsaicin, an ingredient in many topical (on the skin) preparations, is used to relieve muscle, joint, and nerve pain. The pain-easing property of capsaicin is sort of a paradox, considering capsaicin is actually the active component of chili peppers (why it produces a burning sensation when it first touches your skin).

Regardless, capsaicin works by desensitizing pain fibers and blocking pain messages from being relayed to the brain.

If you are considering using topical capsaicin to ease your pain, here are 10 things you should know:

 #1: Capsaicin Is Available Over the Counter and by Prescription

It's convenient that you do not need a prescription for capsaicin from your doctor, as capsaicin is available over-the-counter.

Even so, be sure to follow the directions given by your doctor or the directions on the label (there are different dosages or strengths of capsaicin available).

Capsaicin is available as a cream, gel, liquid, lotion, and patch. It's marketed under many brand names like Zostrix, DiabetAid Pain and Tingling Relief, and Capsagel.

Also, there is a prescription-strength capsaicin 8 percent patch called Qutenza which was developed to allow for rapid delivery of the pain reliever. This way desensitization of nerve fibers occurs more quickly (as opposed to over-the-counter capsaicin products which require multiple applications).

Qutenza is prescribed mostly to treat painful nerve conditions like postherpetic neuralgia and diabetic neuropathy. It's important to note that Qutenza can only be applied by a doctor as a local anesthetic is usually needed first due to the intense burning the patch causes.

#2: Capsaicin Is Easy to Use

When applying capsaicin, be sure to rub the capsaicin cream or gel into the painful area until no more cream is visible on the skin.

Then, wash your hands thoroughly after applying it so the capsaicin does not penetrate through the skin of your hands. Of course, if the capsaicin was applied for​ hand pain, wash your hands after 30 minutes.

#3: Don't Use Extra Doses of Capsaicin

It's important to stick to the directions, and not use extra amounts of capsaicin. In other words, more is not better. If you should inadvertently miss a dose, use it as soon as you remember unless it's close to the time of the next dose.

#4: Capsaicin Has No Known Drug Interactions

Though there are no recognized drug interactions with capsaicin, please use capsaicin under the guidance and advice of your doctor and continue taking your current medications.

#5: Capsaicin May Cause a Burning Sensation

You may experience a warm, burning sensation when you begin using capsaicin, but this sensation should go away within a few days. The sensation should lessen the longer you use capsaicin. Interestingly, reducing the number of daily doses of capsaicin will not reduce the sensation, but it may reduce the pain relief achieved.

#6: Arthritis Pain Relief Is Not Immediate

Even with regular use of capsaicin, arthritis pain relief will take some time. Pain relief from arthritis typically is evident one to two weeks after starting capsaicin.

To prevent pain from returning, capsaicin must be continued. However, if the pain is not better after using capsaicin for three or four weeks, talk to your doctor. It may not be worth it for you to continue.

#7: Capsaicin Must be Handled With Care

Be aware of what can happen if you get capsaicin in your eyes because of the burning sensation it causes. If capsaicin gets in your eyes, immediately flush them with water.

In addition, avoid using capsaicin on other sensitive areas like the mouth, inside the nose, or genital areas. If there is contact, wash the areas with warm soapy water.

Finally, it's important to keep capsaicin out of reach of children.

#8: Some People Should Not Use Capsaicin

One of the reasons why it's important to talk to your doctor before using capsaicin is that not everyone should use it. When speaking with your doctor, be sure to tell him or her about:

  • Broken skin
  • Skin irritation
  • Previous allergic reactions to capsaicin, hot peppers, other drugs, dyes, foods, and preservatives
  • Breastfeeding
  • Pregnancy or current attempts to become pregnant

#9: Used to Ease Pain in Many Health Conditions

In addition to certain types of nerve pain, capsaicin is used to temporarily alleviate minor aches and pains of muscles and joints associated with:

  • Backache
  • Strains and sprains 
  • Arthritis 
  • Bruises
  • Cramps
  • Muscle stiffness or soreness

#10: Research Supports the Use of Capsaicin for Some Specific Conditions

Research suggests that the properties of capsaicin make it an option for relieving pain associated with osteoarthritis (if one or only a few joints are involved) and for rheumatoid arthritis

In terms of neuropathy (nerve pain), research shows that the prescription capsaicin 8 percent patch Qutenza may be effective for some people in reducing pain. For people who do achieve pain relief, they also tend to have improvements in sleep, fatigue, depression, and quality of life. 

A Word From Verywell

Topical capsaicin is generally a well-tolerated option for easing mild forms of muscle, nerve, or joint pain. Even so, it does not work for everyone. If your doctor recommends it, be open-minded, but try not to get discouraged if you end up moving forward with another pain-easing therapy. 

Sources:

Derry S, Rice AS, Cole P, Tan T, Moore RA. Topical capsaicin (high concentration) for chronic neuropathic pain in adults. Cochrane Database Syst Rev. 2017 Jan 13;1:CD007393.

Lexicomp. (2013). Capsaicin: Drug Information.

McAlindon TE et al. OARSI guidelines for the non-surgical management of knee osteoarthritis. Osteoarthritis Cartilage. 2014 Mar;22(3):363-88.

O'Neill J, Brock C, Olesen AE, Andresen T, Nilsson M, Dickenson AH. Unravelling the mystery of capsaicin: A tool to understand and treat pain. Pharmacol Rev. 2012 Oct;64(4):939-71.

Richards BL, Whittle SL, Buchbinder R. Neuromodulators for pain management in rheumatoid arthritis. Cochrane Database Syst Rev. 2012 Jan 18;1:CD008921.

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