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Capsaicin

Capsaicin is the active ingredient in Chile peppers, and activates the transit receptor potential vanilloid channel of small peripheral sensory nerves.
Capsaicin effective by  repeated application is thought  to occur through desensitization and the temporary reduction in the number of pain fibers in the skin.
 
Capsaicin 8% patch is the second nine treatment for peripheral neuropathic pain such as post herpetic neuralgia and painful polyneuropathy, but has no effectiveness in other pain conditions.
10.6 patients need to be treated with Capsaicin for one patient to benefit.
Capsaicin Local side effects include skin reactions and discomfort on initial application.
 
Capsaicin 8% patches are applied by avhealthcare professional and the treatment can be repeated every three months.
 
There is no good evidence that weaker, over the counter preparations of menthol, Capsaicin  or methyl salicylate have an effect on pain.

Topical treatment associated with a skin rash in almost 80% of patients treated.

Topical treatment acts by depleting substance P from C-fiber afferents.

Topical treatment interferes with interaction of VR1 receptors on C-fibers.

Topical treatment generally requires several week treatment to achieve a therapeutic response.

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