Capsaicin cream

Low, P.A., Opfer-Gehrking, T.L., Dyck, P.J., Litchy, W.J., O Brien, P.C. Double-blind, placebo-controlled study of the application of capsaicin cream in chronic distal painful polyneuropathy. Pain 1995, 62, 163-168,... 

This pungent product is responsible for the intense irritant effects of topical Capsicum preparations. Repeated application of capsaicin can deplete and prevent reaccumulation of substance P, an endogenous mediator of pain impulses from the periphery to the CNS. Since the early 1990s, capsaicin cream has been available in the U.S. as an approved drug for relief of postherpetic neuralgia and pain due to diabetic neuropathy and osteoarthritis. 

Over-stimulated pain receptors eventually release endorphins, which are natural pain-killing molecules. VRi receptors can lose their responsiveness after prolonged exposure to capsaicin which is why those who eat a lot of spicy food build up a tolerance to chilli. This is also why capsaicin is used in formulations designed to ease pain, repeated application of which desensitise the nerves. Regular application of a capsaicin cream to aching joints can relieve pain and increase flexibility. Chemotherapy for cancer patients often results in oral pain and sucking capsaicin-laced butterscotch has proved effective. 

Capsaicin (cap-say -i-sin). Also called capsicum, capsaicin is the main ingredient found in many hot peppers (Figure 6.2) and spices such as paprika and cayenne pepper. Capsaicin is also the active ingredient in self-defense products such as pepper spray. Capsaicin directly activates nociceptors located on nerve fibers, and thus it would seem to be counterproductive (if not crazy) to apply such a substance on a wound to relieve pain. However, it turns out that capsaicin creams, gels, and lotions are indeed effective pain relievers and counterirritants when applied topically to the skin. 

Rashid, M., Inoue, M., Bakoshi, S. and Ueda, H. (2003) Increased expression of vanilloid receptor 1 on myelinated primary afferent neurons contributes to the antihyperalgesic effect of capsaicin cream in diabetic neuropathic pain in mice. Journal of Pharmacology And Experimental Therapeutics DOI 10.1124/jpet.103.050948. 

Yoshimura, M.,Yonehara, N., Ito, T., Kawai,Y. and Tamura, T. (2000) Effects of topically applied capsaicin cream on neurogenic inflammation and thermal sensitivity in rats. Japanese Journal of Pharmacology 82(2), 116-121. 

Topical therapy may be of some benefit to the PHN patient. They are used after the skin lesions have healed but cannot be used on periocular tissue Topical lidocaine patches for analgesia is one such treatment. Capsaicin cream has also been used and may provide pain relief within 2 to 4 weeks of treatment. The cream is applied three to four times daily to the area of painful skin. Approximately 30% of treated patients experience burning, stinging, or redness of the skin on initial application, but with repeated use these reactions usually diminish or subside. 

Topical products can be used alone or in combination with oral analgesics or NSAIDs. Capsaicin, isolated from hot peppers, releases and ultimately depletes substance P from afferent nociceptive nerve fibers. Substance P has been implicated in the transmission of pain in arthritis, and capsaicin cream has been shown in four controlled studies to provide pain relief in OA when applied over affected joints. " ... 

Ellison, N., C.L. Loprinzi, J. Kugler, et al. 1997. Phase III placebo-controlled trial of capsaicin cream in the management of surgica 1 neuropathic pain in cancer patients. /. Clin. Oncol. 15(8) 2974. 

Capsaicin cream 0.075 % Pain relief at peripheral neuropathy e.g. post-herpetic neuralgia or shingles, reduction of itching and inflammation at psoriasis... 

The result is interesting because topical capsaicin cream (one of the standard treatments for this condition) relieves pain gradually over 2 weeks, while the essential oil acted within minutes. Geranium essential oil applied cutaneously in animal studies has suppressed cellular in amma-tion and neutrophil accumulation in in ammatory sites (Maruyama et al, 2006), but postherpetic neuralgia normally occurs after the in ammation has subsided. One of the main components of the... 

Capsaicin 0.075% cream three times a day for joint pain... 

To be effective, capsaicin must be used regularly, and it may take up to 2 weeks to work. It is well tolerated, but some patients experience temporary burning or stinging at the site of application. Patients should be warned not to get the cream in their eyes or mouth and to wash their hands after application. 

Disease states in which currently available capsaicin solutions or creams are clearly beneficial, such as non-allergic (vasomotor) rhinitis (Stjarne et al., 1989 Lacroix et al., 1991 Marabini et al., 1991 Filiaci et al., 1994), urinary bladder hyperreflexia (Fowler et al., 1992 Geirsson et al., 1995) and notalgia parestetica (Leibsohn, 1992). 

Capsaicin (Capsin, Zostrix, Others) [OTC] [Topical Anesthetic/ Analgesic] Uses Pain d/t postherpetic neuralgia, chronic neuralgia, arthritis, diabetic neuropathy, postop pain, psoriasis, intractable pruritus Action Topical analgesic Dose Apply tid-qid Caution [C, ] Disp Creams, gel, lotions, roll-ons SE Local irritation, neurotox, cough Interactions May T cough W/ ACEIs EMS ... 

Capsaicin is the compound responsible for the characteristic spicy flavor of jalapeho and habahero peppers. Although it first produces a burning sensation on contact with the mouth or skin, repeated application desensitizes the area to pain. This property has made it the active ingredient in several topical creams for treatment of chronic pain. Capsaicin has also been used as an animal deterrent in pepper sprays, and as an additive to make birdseed squirrel-proof In Chapter 1, we discuss the structure, bonding, and properties of organic molecules like capsaicin. 

Capsaicin, the spicy component of hot peppers and active ingredient in topical creams for the treatment of chronic pain (Opener, Section 1.13)... 

Capsaicin is supplied pharmaceutically as a cream, gel. or lotion. The First application of the piepatation produces intense pain and irritation at the site of application, but usually no skin reaction occurs. Repeated applications cause desensitization, and eventually analgesic and anti-inflammatory effects occur., Stimulation of afferent nerve tracts causes a heat. sensation. 

The metabolism of capsaicin and dihydrocap-saicin has been studied in the context of food and their use in skin creams for the treatment of arthritic pain and inflammation. Capsaicin (Figure 17) is a much more complex molecule than other RCAs, and offers more functional groups and other sites for metabolism, cu-Hydroxycapsaicin (28) was detected in the urine... 

Capsaicin interacts with the canilloid receptor (VRl) on sensory afferents. VRl is a gated cation channel of the TRP family, modulated by a variety of noxious stimuli. Chronic exposure to capsaicin stimulates and desensitizes this channel. Capsaicin also causes local depletion of substance P, an endogenous neuropeptide involved in sensory perception and pain transmission. Capsaicin is available as a 0.025% cream (Zostrix, others) and 0.075% aeam (Zostrix HP, others) to be applied three to four times daily. Capsaicin is FDA approved for the treatment of postherpetic neuralgia and painful diabetic neuropathy, although its efficacy in relieving pain is debatable. 

Zostrix is one of several skin creams that contain capsaicin. Rubbing the cream on the less sensitive parts of the body (knee, elbow, neck) normally does not produce a burning sensation, and can provide relief from neuralgia or arthritis pain. One must avoid contacting eyes, nose, or mouth because capsaicin is the hot principle of the chili pepper and can cause painful burning of mucus membranes. Why would capsaicin work as an analgesic, when it directly stimulates pain receptors ... 

The client with osteoarthritis of the hands is prescribed capsaicin (Capsin) cream, a nonopioid topical analgesic. Which intervention should the nurse discuss with the client concerning this medication ... 

Various topical agents have been tested. Capsaicin is an alkaloid and a main ingredient in chilli peppers, and is available in a cream for topical use. This neurotoxin depletes substance P from the terminals of unmyelinated C-fibres. Substance P is considered the primary neurotransmitter of pain from the periphery to the CNS. Data suggest that Capsacain application produces degeneration followed by reinnervation of epidermal nerve fibres. This in combination with inconsistent results from clinical trials as regards its efficacy for treatment of painful diabetic neuropathy has resulted in limitation of its use [37],... 

An isolated report describes a woman taking an ACE inhibitor who developed a cough each time she used a topical cream containing capsaicin. 

---