Capsaicin 8% Patch Application

What is the 8% Capsaicin patch?

The 8% capsaicin patch is a patch for use on your skin. The 8% capsaicin patch contains a synthetic form of capsaicin which is the compound that gives chilli peppers their heat sensation. The capsaicin acts on pain-sensing nerves in the skin, making them less sensitive to pain. The effects of the 8% capsaicin patch are expected to last for many weeks (on average 3 months or more).

Why is the procedure done?

Peripheral neuropathic (nerve) pain (PNP) is a particular type of pain caused by damage to the peripheral somatosensory system (nerves that pick-up sensation of touch, temperature, pinprick and pain), the network of nerves that transmits information between the brain and every other part of the body. When these nerves become damaged, they sometimes send inappropriate messages to the brain. The resulting pain is often described as burning, stabbing, shooting, aching or like “an electric shock”. PNP can be caused by certain diseases such as shingles or diabetes, surgical or medical procedures (e.g. hernia repair or chemotherapy) or an injury.

What are the beneficial effects?

The 8% capsaicin patch is designed to provide prolonged pain relief for people who have nerve pain due to damaged nerves in the skin. Most people will start to feel some pain relief on the first day the patch is applied. However, it may take up to 14 days before you feel the maximum benefit. Some patients will experience approximately 30-50% reduction in their pain after the treatment. Some patients may experience prolonged pain relief for 3 months or more, others get relief for shorter periods of time. Some may not get any benefit from the procedure at all.

How is the procedure done?

We will ask you to come to the outpatient department where a specialist nurse will map the areas; a blunt pin and a cotton tip is used to identify which area is hypersensitive and the skin is marked with a special pen. DO NOT remove any hair immediately before your appointment as the skin needs to be free from any cuts or abrasions before applying the patch. If you have a lot of hair in the painful area, you may shave the area to be patched 3 days before the procedure. Otherwise, any hair in the treatment area will be clipped using surgical hair clippers.

Please take your normal pain medications on the morning of the procedure. Please do not apply any moisturizer to the area the day before treatment or on the day of treatment. The nurse will cut the 8% capsaicin patch into smaller pieces to fit the treatment area. They will then place the capsaicin patch on your skin. A bandage and/or tape may be placed on the patch to keep it firmly on your skin. The capsaicin patch will initially be left on for 30 minutes if you are being treated for nerve pain on the soles of your feet. This might be extended to 60 minutes on the next treatment if required. This would be classed as “off -label” and not covered by the marketing license or the Qutenza product, which will be clearly stated on your consent form. You will be treated for 60 minutes if your nerve pain is on another part of your body.

After this time a nurse will carefully remove the patch. They will then apply a cleansing gel to the skin, which will be left on for two minutes before being wiped off. The treated area will then be washed gently with soap and water and if required, the area will then be cooled. You will be allowed to go home shortly after the procedure.

What are the side effects?

It is usual for the skin to sting, feel burning hot or become red during and after the capsaicin patch treatment. This may last up to 3 days following the treatment. Your blood pressure may go up because of the reaction to the capsaicin patch, however, this settles quickly once the patch is removed. Side effects experienced during the treatment are difficult to treat with pain killers, however, once the patch has been removed, side effects can be improved by cooling the area. Please be aware that the treatment side effects will be unlikely to have resolved completely before you are discharged home. Cool packs will be given to assist you on your journey home, if required.

Other side effects include itching, bumps, blisters, swelling, dryness, prickling sensation, inflammation of the skin, increased sensitivity of the skin and very rarely skin blistering. These side effects are normal and may last anywhere between a few hours, or up to several days after the treatment. Side effects such as burning can be managed well by continuing to cool the area once you get home. If any of these side effects become serious or if you experience any other side effects please contact your specialist nurse for advice on 0151 556 3686.

Can I have further 8% capsaicin patch therapy?

Approximately half of patients will find the 8% capsaicin patch is effective. Some people have long lasting relief or pain reduction for weeks or even months before the pain returns. We will contact you after 3 weeks to establish if your pain has reduced. We will also ask if the painful area has reduced in size. You may be required to attend a follow up appointment to establish if there has been any improvement. If an improvement has been noted, we will offer you a further patch application in 3 months. Some patients may require 2-3 separate applications, at 3 month intervals, before improvement is noticed. Once an overall successful outcome has been established, we will offer you further patch applications in 3 monthly intervals.

Advice and precautions

• You may eat and drink as normal, before and after the procedure.
• You can go home shortly after the capsaicin treatment, and we advise you to have somebody available to take you home.
• You can resume your normal daily activities as soon as you feel able.
• Avoid hot baths and showers for 48 hours, you can still bath and shower but keep the water tepid and use a separate towel to dry the area.
• If the treated area is painful, stinging or burning apply cold compresses to the affected area.

It is very important to tell your doctor or the secretary of the pain clinic, at least a week before the capsaicin treatment if
• You are allergic to any medications
• You have an infection or skin irritation at the treatment site
• You think you might be pregnant
• You have had a recent heart attack or have unstable hypertension (high blood pressure).

Contacts

For appointments or to rearrange an appointment please contact the pain secretary on 0151 556 3394
For advice following your treatment please contact the nurse specialists on 0151 556 3686