Why have I been prescribed this?
- A Capsaicin 8% patch can be used to help reduce peripheral nerve pain – this is pain arising from damage to nerves in the peripheral nervous system. The peripheral nervous system consists of nerves which relay messages between the brain and spinal cord and other areas of the body
- Nerve pain is often described as burning, shooting, stabbing, pins and needles, crawling, electric shock like pain
- Damage to the nerves may be due to diabetes (peripheral diabetic neuropathy), surgery (e.g. after having a limb amputated) or an infection (e.g. shingles)
How does it work?
- Capsaicin is a substance found in chilli peppers, it makes them hot
- The capsaicin patch is applied to the skin. Initially the capsaicin activates certain structures in the skin (called nociceptors) which causes nerves to send pain messages to the brain. This can cause an itching, prickling, burning sensation. The high strength of capsaicin in the patch quickly alters the nerves and desensitises them, making them less sensitive to pain. This reduces the number of pain signals sent to the brain, reducing pain
- Capsaicin is also available in creams – the capsaicin concentration in the patch is 100 times greater than in the creams. The high concentration of capsaicin in the patch means the patch only needs to be applied for a short period of time
- The patch is applied in controlled conditions in the pain clinic and removed before you go home. Following treatment pain may be reduced for up to 12 weeks. If you find the treatment beneficial it can be repeated at 3 monthly intervals
How it is applied?
- The capsaicin patch will be applied in the pain clinic by a healthcare professional (HCP)
- Your skin in the painful area should be dry and unbroken. The HCP will mark the treatment area on your skin. If necessary, they will clip your hair in and around the treatment area to ensure that the patch sticks to your skin. The area will be washed with mild soap and water and dried thoroughly
- An anaesthetic cream may be applied to the treatment area for 1 hour before the patch is applied and then washed off. However, this is not usually necessary. You should take your usual pain killers prior to treatment and bring them with you in case required
- The capsaicin patch will be cut to the right size by the HCP and applied to your skin. It will be covered with cling film or a bandage to stop it moving. You must not touch the treatment area during the treatment as this may burn or irritate your eyes, nose, face, scalp or other sensitive areas
- It is common for you to feel a burning sensation and for the skin to become red during the treatment. You may be given a cold compress to help reduce the pain
- The patch will be applied for 30 to 60 minutes, depending on the area of the body being treated. The patch will then be removed and the area cleansed and washed
- You will be able to go home shortly after the procedure
- The areas treated with the capsaicin patch may be sensitive to heat, so you may wish to avoid hot showers or baths, direct sunlight and vigorous exercise for a few days following treatment. It is best to avoid washing the affected area for 48 hours after the patch application to improve the effectiveness of the treatment
What monitoring is needed?
Your blood pressure will be monitored during your treatment because pain during the treatment may cause your blood pressure to increase
How long will it take to work?
- You may notice a reduction in your pain on the day the patch is applied but it can take up to 2 weeks for maximum effect
- Generally pain is reduced for up to 3 months after the treatment, although some people experience pain relief for longer. Some people do not experience any benefit from treatment
What are the possible side effects?
- The most common side effects are application site redness, abnormal sensation, pain and itching and small bumps where the patch is applied
- Experiencing pain whilst the patch is applied is common, due to the prescription strength capsaicin. You should tell the healthcare professional how you feel during the treatment. Your blood pressure may temporarily increase because of this
- Pain usually begins to decrease once the patch is removed but you may feel a burning sensation for a few hours – you can take your regular painkillers as needed
- Other uncommon side effects include a cough, blisters, swelling, dryness and bruising. They generally improve within 1 week. If they are severe contact your GP or pain clinic team for advice
- Eye irritation, muscle spasms, nausea, altered heart function, palpitations, fast heart rate, altered taste and throat irritation can also occur, but are uncommon. Speak to your GP or pain clinic team for advice if they occur or you have any concerns
Can I drive after the treatment?
- The capsaicin patch is unlikely to have an effect on your ability to drive, but some patients may require temporary use of pain-reducing medicines during or after their treatment. Some of these medicines (for example opioids) may influence your ability to drive. It is advised that you do not drive on the day of treatment
What should I tell my doctor, pharmacist or pain team?
- If you have high or unstable blood pressure or if you have recently had any heart problems or a stroke. If so, you may have an increased risk of heart problems or stroke during treatment, since treatment-related pain may cause an increase in your blood pressure. Your blood pressure will be monitored during the treatment and shortly after the patch has been removed, by the healthcare professional in the pain clinic
- If you are pregnant or breast feeding
- If you are allergic to any medications
- If you have an infection at the treatment site
Further information: www.qutenza.com/pdfs/Qutenza_Patient_Guide.pdf
South Tees Hospitals NHS Foundation Trust would like your feedback. If you wish to share your experience about your care and treatment or on behalf of a patient, please contact The Patient Experience Department who will advise you on how best to do this.
This service is based at The James Cook University Hospital but also covers the Friarage Hospital in Northallerton, our community hospitals and community health services.