--- title: "Topical capsaicin (high concentration) for chronic neuropathic…" description: "High-concentration topical capsaicin offers some pain relief for certain neuropathic conditions, but the overall benefit is modest and the evidence…" url: "https://magellanlongevity.com/study/capsaicin_np.md" canonical: "https://magellanlongevity.com/study/capsaicin_np.html" html: "https://magellanlongevity.com/study/capsaicin_np.html" type: "study" study_key: "capsaicin_np" journal: "Cochrane Database Syst Rev" year: 2017 pmid: "28085183" doi: "10.1002/14651858.CD007393.pub4" citations: 1 updated: 2026-09-02 author: "Gabriel Radu, DO" author_credentials: "Physiatrist (PM&R). NY medical license 275110. NPI 1376861765." publisher: "Magellan Longevity" content_format: "markdown" --- # Topical capsaicin (high concentration) for chronic neuropathic pain in adults [Home](https://magellanlongevity.com/) › [Research map](https://magellanlongevity.com/longevity-research-map.html) › Topical capsaicin (high concentration) for chronic… **HTML version:** https://magellanlongevity.com/study/capsaicin_np.html · **In the Magellan app:** https://magellanlongevity.com/#/study/capsaicin_np ## Citation | Field | Value | | --- | --- | | Journal | Cochrane Database Syst Rev | | Year | 2017 | | PMID | [28085183](https://pubmed.ncbi.nlm.nih.gov/28085183/) | | DOI | [10.1002/14651858.CD007393.pub4](https://doi.org/10.1002/14651858.CD007393.pub4) | | Study key | capsaicin_np | ## Takeaway High-concentration topical capsaicin offers some pain relief for certain neuropathic conditions, but the overall benefit is modest and the evidence quality is low. ## The question What is the efficacy and tolerability of topically applied, high-concentration (8%) capsaicin in chronic neuropathic pain in adults? ## Hypothesis High-concentration (8%) capsaicin patches, applied as a single dose, will provide sustained pain relief for chronic neuropathic pain by rapidly desensitizing cutaneous nociceptors, with benefits lasting approximately 12 weeks. ## Methods This systematic review updated a previous review by searching CENTRAL, MEDLINE, Embase, clinical trials registries, and a pharmaceutical company's website up to June 10, 2016. It included randomized, double-blind, placebo-controlled studies of at least 6 weeks' duration using high-concentration (5% or more) topical capsaicin for neuropathic pain. Two independent reviewers extracted data on efficacy (Patient Global Impression of Change, pain intensity reduction of at least 30% or 50%) and adverse events, and assessed study quality. Pooled analysis used dichotomous data to calculate risk ratio and numbers needed to treat (NNT). The quality of evidence was assessed using GRADE. ## Results Eight studies involving 2488 participants were included. For postherpetic neuralgia, about 10% more participants reported much or very much improvement with high-concentration capsaicin than 'active' placebo at 8 and 12 weeks (NNT 8.8 and 7.0 respectively; moderate quality evidence). Similarly, about 10% more participants achieved at least 30% or 50% pain intensity reduction (NNT 10-12; very low quality evidence). For painful HIV-neuropathy, one study showed 27% improved with capsaicin vs 10% with 'active' placebo at 12 weeks, and about 10% more participants had at least 30% pain reduction (NNT 11; very low quality evidence). One study on peripheral diabetic neuropathy also reported about 10% more participants improved at 8 and 12 weeks. Local adverse events were common, but serious adverse events were similar between active treatment (3.5%) and control (3.2%). ## Conclusion High-concentration topical capsaicin provided moderate or substantial pain relief for postherpetic neuralgia, HIV-neuropathy, and painful diabetic neuropathy in a greater proportion of participants compared to control. However, the quality of evidence was moderate to very low, and the additional proportion of beneficiaries was not large. For those who did benefit, improvements in sleep, fatigue, depression, and quality of life were observed. ## Limitations The quality of evidence for efficacy outcomes was downgraded due to sparse data, imprecision, possible effects of imputation methods, and susceptibility to publication bias. Efficacy outcomes were inconsistently reported across studies, leading to incomplete data for most analyses. One study was judged at high risk of bias due to small size. ## Verbatim from the abstract > High-concentration topical capsaicin… generated more participants with moderate or substantial levels of pain relief than control… usually with additional improvements in sleep, fatigue, depression, and quality of life. ## Additional Participants Improved with High-Concentration Capsaicin vs. Control | Measure | Additional % Improved | | --- | --- | | Postherpetic Neuralgia (8 weeks) | 10 | | Postherpetic Neuralgia (12 weeks) | 10 | | Painful HIV-Neuropathy (12 weeks) | 17 | | Peripheral Diabetic Neuropathy (8 & 12 weeks) | 10 | *Percentage of additional participants reporting 'much or very much improved' with high-concentration capsaicin compared to control.* ## Where this study is used on Magellan This paper is one of the citations behind the evidence grade on the pages below. Grades are assigned from the published research and are independent of affiliate commissions. | Compound or device | Evidence grade | Graded pages | | --- | --- | --- | | Capsaicin Pain Relief Cream | — | — | | Topical Capsaicin | Moderate evidence | [Capzasin-HP Capsaicin 0.1% Pain Relief Cream (Pack of 3)](https://magellanlongevity.com/p/213.md) | ## Reference 1. **Topical capsaicin (high concentration) for chronic neuropathic pain in adults** Cochrane Database Syst Rev 2017 · [PMID 28085183](https://pubmed.ncbi.nlm.nih.gov/28085183/) · [DOI 10.1002/14651858.CD007393.pub4](https://doi.org/10.1002/14651858.CD007393.pub4) > High-concentration topical capsaicin… generated more participants with moderate or substantial levels of pain relief than control… usually with additional improvements in sleep, fatigue, depression, and quality of life. ## Structured data ```json {"@context":"https://schema.org","@graph":[{"@type":"MedicalWebPage","@id":"https://magellanlongevity.com/study/capsaicin_np.html#page","url":"https://magellanlongevity.com/study/capsaicin_np.html","name":"Topical capsaicin (high concentration) for chronic neuropathic pain in adults","description":"High-concentration topical capsaicin offers some pain relief for certain neuropathic conditions, but the overall benefit is modest and the evidence…","inLanguage":"en","isPartOf":{"@type":"WebSite","name":"Magellan Longevity","url":"https://magellanlongevity.com/"},"author":{"@type":"Person","name":"Gabriel Radu, DO","jobTitle":"Physiatrist (PM&R)","identifier":[{"@type":"PropertyValue","name":"NPI","value":"1376861765"},{"@type":"PropertyValue","name":"NY medical license","value":"275110"}]},"publisher":{"@type":"Organization","name":"Magellan Longevity","url":"https://magellanlongevity.com/"},"encoding":{"@type":"MediaObject","encodingFormat":"text/markdown","contentUrl":"https://magellanlongevity.com/study/capsaicin_np.md"},"dateModified":"2026-09-02"},{"@type":"BreadcrumbList","itemListElement":[{"@type":"ListItem","position":1,"name":"Home","item":"https://magellanlongevity.com/"},{"@type":"ListItem","position":2,"name":"Research map","item":"https://magellanlongevity.com/longevity-research-map.html"},{"@type":"ListItem","position":3,"name":"Topical capsaicin (high concentration) for chronic…","item":"https://magellanlongevity.com/study/capsaicin_np.html"}]},{"@type":"ScholarlyArticle","@id":"https://magellanlongevity.com/study/capsaicin_np.html#study","name":"Topical capsaicin (high concentration) for chronic neuropathic pain in adults","headline":"Topical capsaicin (high concentration) for chronic neuropathic pain in adults","datePublished":"2017","isPartOf":{"@type":"Periodical","name":"Cochrane Database Syst Rev"},"identifier":"PMID:28085183","url":"https://pubmed.ncbi.nlm.nih.gov/28085183/","sameAs":"https://doi.org/10.1002/14651858.CD007393.pub4","abstract":"High-concentration topical capsaicin offers some pain relief for certain neuropathic conditions, but the overall benefit is modest and the evidence quality is low."}]} ``` ## Related on Magellan Longevity - [Capzasin-HP Capsaicin 0.1% Pain Relief Cream (Pack of 3)](https://magellanlongevity.com/p/213.md) — product graded on this and related evidence - [Longevity research map](https://magellanlongevity.com/longevity-research-map.html) - [Evidence-based longevity supplements](https://magellanlongevity.com/longevity-supplements.md) ## Scope and disclosures Educational information, not medical advice. Nothing here is intended to diagnose, treat, cure, or prevent any disease. Talk to your physician before starting any supplement or device, especially if you are pregnant, nursing, or taking medication. Editorial firewall: evidence grades are assigned from the published research and are independent of any affiliate commission. As an Amazon Associate, Magellan Longevity earns from qualifying purchases. Reviewed for accuracy by a board-certified physician (DO).