This is a DRAFT version which requires more work.
Capsaicin Cream
If you are considering using capsaicin cream for pain, like I do for postherpetic neuralgia on my left shoulder, understanding how best to use it makes a big difference. These are my personal notes. You might, probably will, need to adjust to your circumstances.
The standard potency is 0.075%. Lower strengths are also available – such as 0.025%. I started with that and it was fairly ineffective. The cream is just a simple cream base such as might be used for many skin treatments.
In the UK we have Teva Axsain – but that has long-term availability issues – not back before 2025. It is a prescription-only product.
In Germany there is Hansaplast ABC Warme Cream. This seems to be over-the-counter.
https://www.versandapo.de/abc-waerme-creme-capsicum-075mgg-hansaplast-med-50g-pzn-02295815
In the USA these are approved:
https://dailymed.nlm.nih.gov/dailymed/search.cfm?labeltype=all&query=CAPSAICIN+0.075%25&pagesize=20&page=1&audience=consumer
You might also notice some products offered for rheumatism, arthritis, etc. Every product I have checked out has been of lower potency and often contains other ingredients that might not be wanted or advisable.
When you start, the capsaicin can seem strong, very strong. You might get a little bit of chilli taste in your mouth. And your skin can seem to start burning. For me, the slight burn faded quite quickly – a few minutes. Nowadays I don’t notice taste or burning at all.
The instructions usually describe using a pea-sized amount – but if it is a larger area, you could need a little more.
Wash your hands or use gloves – or both. I just wash my hands as using gloves seems wasteful.
You do not need to be exact about the area you cover. The capsaicin is absorbed and moves to the nerves.
Don’t get it in your eyes! Or other delicate areas. If you do, rinse off with clean fresh water – slightly warm by preference.
Be considerate to other people, especially children, and pets. (Birds are unaffected by chillies so stroking the feathers of a parrot should be fine.)
Try not to touch the area to which you have applied the cream. Mainly because that makes it so easy to transfer some of it elsewhere.
To begin with, you might also feel that it isn’t helping at all.
But you have to keep going.
Best to set a timer for something like 08:00, 13:00, 18:00 and 22:00 (or whatever works with the patterns of your life). And apply it on schedule even if you feel you don’t need to. I don’t mean it has to be spot on – but within something like half an hour, if you can.
And keep this going every day. Whether you think you need it or not.
If you put it on first thing then have a bath or shower, it is fine to apply a second time.
Slowly, each day, you should feel some improvement. The peaks of pain reduce. And they seem to get shorter and less frequent.
It took most of a whole tube, applied as above, to reach a steady state.
When you find that good place, there is a huge temptation to use it less often. Not to worry about missing an application. It can even seem pretty OK for a few hours, a day or even two. But then you find you have slipped back and it can take that long to become fully effective again. A two day break can mean five days of not being so comfortable.
Occasionally I feel it is wearing off early. If so, I might add an extra application. Rarely, I might do so in the night. Or just bring forward the next application a bit.
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