The Capsaicin Patch
Capsaicin is the substance in chili peppers that gives you a burning sensation when you eat hot, spicy foods. When applied to certain painful skin conditions, it produces an initial burning sensation, followed by pain relief. A high-concentration capsaicin patch was recently developed for the treatment of certain painful peripheral neuropathies. Mount Sinai neurologists led research on the high-concentration capsaicin patch and have trained physicians around the world in using the new treatment. Marketed as Qutenza®, the patch is now available to treat post-herpetic neuralgia (persistent pain after shingles rash) and other types of painful neuropathies.
To determine whether the capsaicin patch is right for you, your doctor will conduct an initial evaluation at his or her office. If your doctor believes you are a candidate for the capsaicin patch, he or she will schedule you for a follow-up visit at the Mount Sinai clinical neurophysiology unit. You do not need any special preparation for this visit.
What is involved?
At the clinic, your doctor identifies the area of skin where you experience the most pain. An anesthetic cream (lidocaine) is applied to this area and left on for one hour, after which it is washed off. Your doctor then carefully applies the capsaicin patch and leaves it on for 30 to 60 minutes. You may require more than one patch.
After application, you might feel a burning sensation, like a sunburn. If the discomfort becomes too intense, you will receive oral pain medications. Many patients, however, do not feel increased discomfort during or after the procedure.
After the capsaicin patch is removed, your skin will be washed. Your skin may be slightly red, but this is not dangerous. You may then go home.
Over the next one to two days, you may experience discomfort from the procedure. You may use oral pain medication during this time if you need it. Within days of applying the capsaicin patch, most patients experience significant pain relief in the area where the patch was applied. Pain relief lasts for about three months. Treatment may be repeated as necessary.
Talk to your physician about whether the capsaicin patch may help you. For referral appointments, please call Mount Sinai neurologist David M. Simpson, MD, at 212-241-8748. Application of the capsaicin patch is performed in the clinical neurophysiology area, located in the Annenberg Building, second floor (area 218).
David M. Simpson, MD