Abstract
Capsaicin (8-methyl-N-vanillyl-6-nonenamide) is an active component of chilli peppers. It binds to TRPV1 (transient receptor potential channel) receptors which is a heat-activated calcium channel. It causes depletion of substance P and decrease the density of epidermal nerve fibres. The effect takes 3–4 weeks to manifest. It is available in 0.025 %, 0.075 % cream and 8 % patch. 0.075 % cream applied 3–4 times/day has shown efficacy in painful diabetic neuropathy and postherpetic neuralgia (NNT for 50 % pain relief is 6.7). It is associated with burning sensation which can be reduced by co-administration of glyceryl trinitrate or EMLA (eutectic mixture of local anaesthetics).
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Further Reading
McCleane GJ. Topical Doxepin hydrochloride reduces neuropathic pain: a randomised double blind, placebo controlled study. Pain Clinic. 1999;12:47–50.
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Gupta, R. (2014). Topical Agents. In: Pain Management. Springer, Berlin, Heidelberg. https://doi.org/10.1007/978-3-642-55061-4_22
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DOI: https://doi.org/10.1007/978-3-642-55061-4_22
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