Capsaicin

Sounds like 'kap-SAY-i-sin'

Easy-to-read medicine information about capsaicin – what is it, how is it used and possible side effects.

Type of medicine Also called
  • Topical analgesic (a cream that is applied to the skin for pain relief) 
  • Zostrix®
  • Zostrix HP®

What is capsaicin?

Capsaicin is used to relieve certain types of pain. This may be pain caused by osteoarthritis, nerve pain caused by shingles or diabetes (diabetic peripheral neuropathy). It works by decreasing a natural substance in your body called substance P, that helps pass pain signals to the brain. In New Zealand, capsaicin is available as a cream that is applied to the painful area. There are 2 strengths of capsaicin cream, which have different uses. 

  • 0.025% (called Zostrix) is used to relieve pain in osteoarthritis.
  • 0.075% (called Zostrix HP) is used to relieve nerve pain caused by shingles or diabetes (diabetic peripheral neuropathy).  

How to use capsaicin cream

  • Capsaicin cream is applied to the painful area on the skin.  
  • The usual dose of capsaicin cream is a pea-sized amount to the affected area 3 to 4 times daily (not more than every 4 hours).
  • Pain relief usually begins within the first week of treatment and increases with regular application over the next few weeks. Review after 4 to 8 weeks.
  • Use this medication regularly to get the most benefit from it. To help you remember, use it at the same times each day.

Tips on how to apply capsaicin

  • Use a small amount of cream for each application and gently rub into the affected area.
  • Wash any left over cream from your hands after applying. If using the cream for pain on your hands, do not wash your hands for at least 30 minutes after applying the cream.  
  • Do not apply the cream to broken or irritated skin; only use it after lesions have healed if using it for nerve pain caused by shingles.
  • Avoid contact with eyes and mucous membranes (nose, mouth, genital area).
  • Do not apply tight bandages or heat (heating pads, hot water bottles, and heat lamps) to the area where the cream has been used.
  • Do not apply the cream immediately before or after activities such as bathing or showering, swimming, sunbathing or heavy exercise.
  • Avoid hot showers or baths immediately after application.

Possible side effects

Like all medicines, capsaicin can cause side effects, although not everyone gets them. 

Side effects What should I do?
  • The most common side effect is a sensation of stinging or burning after application of capsaicin
  • This sensation is related to the action of capsaicin on the skin and is to be expected
  • It usually eases after the first few days of application and should disappear with continued use
  • See tips above on how to apply capsaicin
  • Blistering or swelling at the application site
  • Increased or unusual pain at the application site
  • Tell your doctor
  • Signs of an allergic reaction such as skin rash, itches, swelling of the face, lips, mouth and tongue or problems breathing
  • Tell your doctor immediately or ring HealthLine 0800 611 116

Learn more

The following links have more information on capsaicin. 

Capsaicin Dermnet NZ
Zostrix Cream Medsafe Consumer Information Sheet, NZ
Zostrix HP Cream Medsafe Consumer Information Sheet, NZ

References

  1. Capsaicin New Zealand Formulary
Credits: Sandra Ponen, pharmacist. Reviewed By: Angela Lambie, Pharmacist, Auckland Last reviewed: 15 Jan 2019