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Evidence summaries

Topical Capsaicin (Low Concentration) for Chronic Neuropathic Pain in Adults

Topical low concentration capsaicin cream may not have a clinically significant effect over placebo in reducing chronic neuropathic pain, and it appears to cause frequent adverse events. Level of evidence: "C"

The quality of evidence is downgraded by study limitations (lack of/unclear allocation concealment and imprecise results).

Summary

In a Cochrane review [Abstract] 1 six studies (with 389 participants) compared topically applied low dose (< 1.0%) capsaicin cream with placebo cream, applied regularly several times daily over several weeks, in chronic neuropathic pain in adults. All included studies were published before 1996. Only two studies reported data for the preferred primary outcome of at least 50% pain relief, and there were too few data for pooled analysis.

Local skin reactions were more common with capsaicin, usually tolerable, and attenuated with time; the NNH for repeated low-dose application was 2.5 (95% CI 2.1 to 3.1).

OutcomeNumber of participants (trials)Control:PlaceboIntervention:CapcaicinEffect size (95 % CI)
Pain relief > 50%124(2)8/61(13%)18/63(29%)NA
Adverse event: burning, stinging, erythema557(5)66/275(24%)179/282(64%)RR 2.64(2.10 to 3.31)

Clinical comments

It is unlikely that topical (rubbed on the skin), low-concentration (< 1%) capsaicin provides any useful pain relief in neuropathic pain conditions.

Note

Date of latest search: 30.06.2012

    References

    • Derry S, Moore RA. Topical capsaicin (low concentration) for chronic neuropathic pain in adults. Cochrane Database Syst Rev 2012;(9):CD010111. [PubMed]

Primary/Secondary Keywords