Capsaicin cream

​​Capsaicin cream is a topical pain relief medication made from capsaicin, which is the active ingredient in hot peppers.

Capsaicin cream is commonly used to relieve pain caused by conditions such as arthritis, neuropathy, and muscle pain.

How does capsaicin cream work?

Capsaicin cream works by depleting substance P, a chemical involved in transmitting pain signals to the brain. 

When applied to the skin, the capsaicin in the cream binds to the sensory nerve endings, causing the release of substance P. Over time, the repeated exposure to capsaicin leads to a reduction in the amount of substance P, which interferes with the transmission of pain signals. As a result, the skin becomes less sensitive to pain and the sensation of pain is reduced.

It’s important to note that capsaicin cream may cause a warm or burning sensation when first applied, but this sensation typically decreases over time with continued use. 

Side effects of capsaicin cream

Capsaicin cream is a very safe medication with minimal side effects.  The most common among them are:

  • Skin irritation: Capsaicin cream can cause skin irritation, redness, and itching. This is usually mild and goes away with time.
  • Burning sensation: The cream can cause a warm or burning sensation when first applied, but this typically decreases over time.
  • Allergic reactions: Rarely, people may experience an allergic reaction to capsaicin cream, which can cause symptoms such as hives, difficulty breathing, and swelling of the face, lips, tongue, or throat.

It’s important to follow the instructions of a healthcare provider when using capsaicin cream. If you experience any severe or persistent side effects, stop using the cream and talk to your healthcare provider.

How long does it take to work?

The length of time it takes for capsaicin cream to start working varies from person to person. Some people may experience relief from pain after a few days of use, while others may not see the full effects of the cream until several weeks of use.

In general, the effects of capsaicin cream may improve with continued use, as the skin becomes less sensitive to pain and the nerve endings become depleted of substance P.

If you’re using capsaicin cream for pain relief and don’t notice improvement after several weeks, talk to your healthcare provider. They may recommend adjusting the frequency or amount of cream used, or switching to a different treatment option.

How long do the effects last?

In general, the effects of capsaicin cream can last several hours to a few days.

Some people may find that they need to reapply the cream several times per day to maintain pain relief, while others may need to apply it less frequently.

What are the benefits of capsaicin cream over other medications?

Capsaicin cream offers several benefits over other pain medications, including:

  1. Topical application: Capsaicin cream is applied directly to the skin, which allows for targeted pain relief without affecting the entire body.
  2. Fewer side effects: Compared to oral pain medications, capsaicin cream is less likely to cause systemic side effects, such as drowsiness, nausea, or dizziness.
  3. Non-addictive: Capsaicin cream does not contain addictive substances and does not pose a risk of dependence or abuse.
  4. Fewer drug interactions: Because capsaicin cream is not absorbed into the bloodstream, it is less likely to interact with other medications.

It’s important to keep in mind that capsaicin cream may not be appropriate for everyone, and it’s always best to talk to a healthcare provider before starting any new treatment. They can help determine if capsaicin cream is right for you and recommend the most effective and safe treatment plan.

About the Author

Dave Harrison, MD

Dr. Harrison is a board certified Emergency Physician with a part time appointment at San Francisco General Medical Center and is an Assistant Clinical Professor-Volunteer at the UCSF School of Medicine. Dr. Harrison attended medical school at Tufts University and completed his Emergency Medicine residency at the University of Southern California. Dr. Harrison manages the editorial process for