Capsaicin cream for neuropathic pain11/23/2023 ![]() ![]() At both 8 and 12 weeks about 10% more participants reported themselves much or very much improved with high‐concentration capsaicin than with 'active' placebo the point estimates of numbers needed to treat for an additional beneficial outcome (NNTs) were 8.8 (95% confidence interval (CI) 5.3 to 26) at 8 weeks and 7.0 (95% CI 4.6 to 15) at 12 weeks (2 studies, 571 participants moderate quality evidence). Efficacy outcomes were inconsistently reported, resulting in analyses for most outcomes being based on less than complete data.įor postherpetic neuralgia, we found four studies (1272 participants). Two studies used a placebo control and six used 0.04% topical capsaicin as an 'active' placebo to help maintain blinding. Studies were of generally good methodological quality we judged only one study at high risk of bias, due to small size. ![]() We included eight studies, involving 2488 participants, two more studies and 415 more participants than the previous version of this review. The benefits are expected to last for about 12 weeks, when another application might be made. It must be applied under highly controlled conditions, often following local anaesthetic, due to the initial intense burning sensation it causes. High‐concentration topical capsaicin is given as a single patch application to the affected part. Only the 8% patch formulation of capsaicin is available, with a capsaicin concentration about 100 times greater than conventional creams. The single application avoids noncompliance. High‐concentration (8%) capsaicin patches were developed to increase the amount of capsaicin delivered rapid delivery was thought to improve tolerability because cutaneous nociceptors are 'defunctionalised' quickly. Following application to the skin, capsaicin causes enhanced sensitivity, followed by a period with reduced sensitivity and, after repeated applications, persistent desensitisation. Topical creams with capsaicin are used to treat peripheral neuropathic pain. This review is an update of 'Topical capsaicin (high concentration) for chronic neuropathic pain in adults' last updated in Issue 2, 2013. ![]()
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