Abstract
BACKGROUND: Neuropathic pain, characterized by nerve damage, can significantly impact quality of life. Traditional treatments often fall short, prompting the exploration of topical therapies such as capsaicin. This systematic review aims to evaluate the efficacy, safety, and tolerability of topical capsaicin in treating neuropathic pain.
METHODS: A systematic review of clinical studies assessing the topical use of capsaicin for neuropathic pain of different etiologies, including painful diabetic peripheral neuropathy (DPN) and postherpetic neuralgia (PHN), was conducted. Data were extracted regarding pain relief and adverse effects. A systematic review of literature identified through database searches, including PubMed and ScienceDirect, was conducted using the search term "topical capsaicin."
RESULTS: A total of 22 studies were included (placebo-controlled: n = 13; active-controlled: n = 4; uncontrolled: n = 4; comparison of two capsaicin formulations: n = 1). Topical capsaicin demonstrated significant efficacy in reducing pain intensity and improving quality of life across various neuropathic pain conditions. Localized adverse effects were reported but were generally tolerable and occurred more often in the first week of treatment. Comparisons between 0.025% and 0.075% formulations indicated that the higher concentration is generally more effective. The development of a new roll-on formulation of capsaicin retains efficacy while reducing adverse effects.
CONCLUSION: Topical capsaicin 0.075% is a promising and effective option for neuropathic pain management, providing meaningful pain relief and improved quality of life with a manageable and favorable safety profile. Further research is needed to evaluate long-term efficacy and explore combination treatment approaches.