Highlights
- •EMLA caused significant reductions in capsaicin-induced pain compared with placebo.
- •EMLA enhanced capsaicin-induced superficial blood perfusion.
- •Capsaicin reduced the neurogenic flare induced by histamine compared with EMLA.
- •Topical analgesic pretreatment does not interfere with capsaicin desensitization.
Abstract
Perspective
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- Topical capsaicin for pain management: Therapeutic potential and mechanisms of action of the new high-concentration capsaicin 8% patch.Br J Anaesth. 2011; 107: 490-502
- Antipruritic effect of pretreatment with topical capsaicin 8% on histamine- and cowhage-evoked itch in healthy volunteers: A randomized, vehicle-controlled, proof-of-concept trial.Br J Dermatol. 2017; 177: 107-116
- Cellular and molecular mechanisms of pain.Cell. 2009; 139: 267-284
- Arendt-Nielsen L: Vascular response of human skin after analgesia with EMLA cream.Br J Anaesth. 1989; 63: 655-660
- Depth and duration of skin analgesia to needle insertion after topical application of EMLA cream.Br J Anaesth. 1990; 64: 173-177
- Vascular and sensory responses of human skin to mild injury after topical treatment with capsaicin.Br J Pharmac. 1981; 73: 755-758
- The capsaicin receptor: A heat-activated ion channel in the pain pathway.Nature. 1997; 389: 816
- Neurocutaneuous disease: Cutaneuous neuroanatomy and mechanisms of itch and pain.J Am Acad Dermatol. 2016; 74: 197-212
- Pharmacologic management of neuropathic pain: Evidence-based recommendations.Pain. 2007; 132: 237-251
European Medicin Agency (EMA): Qutenza, INN-capsaicin summary of product characteristics. 2009.
- Multicenter assessment of quantitative sensory testing (QST) for the detection of neuropathic-like pain responses using the topical capsaicin model.Can J Pain Taylor & Francis. 2018; 2: 266-279
- Structure-activity relationships for some substance P-related peptides that cause wheal and flare reactions in human skin.J Physiol. 1983; 335: 449-465
- Topical EMLA pre-treatment fails to decrease the pain induced by 1% topical capsaicin.Pain. 1999; 80: 637-642
- Architecture of the cutaneous autonomic nervous system.Front Neurol Front. 2019; 10: 970
- Systematic review of topical capsaicin in the treatment of pruritus.Int J Dermatol. 2010; 49: 858-865
- Capsaicin-sensitive C-and A-fibre nociceptors control long-term potentiation-like pain amplification in humans.Brain Oxford. 2015; 138: 2505-2520
- The effects of local and intravenous anesthetics on recombinant rat VR1 vanilloid receptors.Anesth Analg. 2003; 96: 1656-1660
- Tolerability of the capsaicin 8% patch following pretreatment with lidocaine or tramadol in patients with peripheral neuropathic pain: A multicentre, randomized, assessor-blinded study.Eur J Pain. 2014; 18: 1240-1247
- Molecular mechanisms of nociception.Nature. 2001; 413: 203-210
- A randomized, controlled, open-label study of the long-term effects of NGX-4010, a high-concentration capsaicin patch, on epidermal nerve fiber density and sensory function in healthy volunteers.J Pain Elsevier. 2010; 11: 579-587
- Mechanisms of inflammatory pain.Br J Anaesth Elsevier. 2001; 87: 3-11
- Comparison of cooling and EMLA to reduce the burning pain during capsaicin 8% patch application: A randomized, double-blind, placebo-controlled study.Pain Elsevier. 2013; 154: 2729-2736
- Differential effects of bupivacaine and tetracaine on capsaicin-induced currents in dorsal root ganglion neurons.Neurosci Lett. 2005; 380: 21-25
- Effects of lidocaine patch on intradermal capsaicin-induced pain: A double-blind, controlled trial.J Pain. 2011; 12: 323-330
- Sensory neurons and circuits mediating itch.Nat Rev Neurosci. 2014; 15: 19-31
- The vanilloid receptor TRPV1 is activated and sensitized by local anesthetics in rodent sensory neurons.J Clin Invest. 2008; 118: 763-776
- Mechanisms of sensory transduction in the skin.Nature. 2007; 445: 858
- Roles of capsaicin-insensitive nociceptors in cutaneous pain and secondary hyperalgesia.Brain. 2001; 124: 1754-1764
- Capsaicin dermal patch: in non-diabetic peripheral neuropathic pain.Drugs. 2010; 70: 1831-1842
- Efficacy of Qutenza® (capsaicin) 8% patch for neuropathic pain: a meta-analysis of the Qutenza.Clinical Trials Database Pain. 2013; 154: 1632-1639
- Interactions of local anesthetics with voltage-gated Na + channels.J Membr Biol. 2004; 2011: 1-8
- Topical capsaicin in humans: parallel loss of epidermal nerve fibers and pain sensation.Pain. 1999; 81: 135-145
- Unravelling the mystery of capsaicin: A tool to understand and treat pain.Pharmacol Rev ASPET;. 2012; 64: 939-971
- Arendt-Nielsen L: Somatosensory and vasomotor manifestations of individual and combined stimulation of TRPM8 and TRPA1 using topical L-menthol and trans-cinnamaldehyde in healthy volunteers.Eur J Pain. 2014; 18: 1333-1342
- Topical capsaicin. The fire of a ‘hot'medicine is reignited.Expert Opin Pharmacother. 2010; 11: 1359-1371
- A heat-sensitive TRP channel expressed in keratinocytes.Science (80-) Am Assoce Advance Sci. 2002; 296: 2046-2049
- The quaternary lidocaine derivative, QX-314, exerts biphasic effects on transient receptor potential vanilloid subtype 1 channels in vitro.Anesthesiology. 2011; 114: 1425-1434
- Activity-dependent silencing reveals functionally distinct itch-generating sensory neurons.Nat Neurosci. 2013; 16: 910
- Quantitative sensory testing in the German Research Network on Neuropathic Pain (DFNS): Standardized protocol and reference values.Pain. 2006; 123: 231-243
- Calcitonin gene-related peptide: Physiology and pathophysiology.Physiol Rev Am Physiol Soc. 2014; 94: 1099-1142
- Thermoreceptors and thermosensitive afferents.Neurosci Biobehav Rev. 2010; 34: 177-184
- Chemical response pattern of different classes of C-nociceptors to pruritogens and algogens.J Neurophysiol Am Physiol Soc Bethesda, MD. 2003; 89: 2441-2448
- Early and late effects of prolonged topical capsaicin on cutaneous sensibility and neurogenic vasodilatation in humans.Pain. 1991; 47: 285-294
- Group N-4010 CS: Controlled trial of high-concentration capsaicin patch for treatment of painful HIV neuropathy.Neurol AAN Enterprises. 2008; 70: 2305-2313
- TRPV3 is a temperature-sensitive vanilloid receptor-like protein.Nature. 2002; 418: 186-190
- The cloned capsaicin receptor integrates multiple pain-producing stimuli.Neuron. 1998; 21: 531-543
- Capsaicin prevents histamine-induced itching.Int J Clin Pharmacol Res. 1986; 6: 163
- A “cute” desensitization of TRPV1.Curr Pharm Biotechnol Bentham Sci Publ. 2011; 12: 122-129
- Evidence for two different heat transduction mechanisms in nociceptive primary afferents innervating monkey skin.J Physiol. 1995; 483: 747-758
- Unbiased classification of sensory neuron types by large-scale single-cell RNA sequencing.Nat Neurosci Nat Publ Grp. 2015; 18: 145-153
- The time course of brief and prolonged topical 8% capsaicin-induced desensitization in healthy volunteers evaluated by quantitative sensory testing and vasomotor imaging.Exp Brain Res. 2018; 236: 2231-2244
- Depth of cutaneous analgesia after application of a eutectic mixture of the local anesthetics lidocaine and prilocaine (EMLA cream).J Am Acad Dermatol Elsevier. 2000; 42: 584-588
- A multicenter, randomized, double-blind, controlled dose finding study of NGX-4010, a high-concentration capsaicin patch, for the treatment of postherpetic neuralgia.J Pain. 2010; 11: 972-982
- Tolerability of NGX-4010, a capsaicin 8% dermal patch, following pretreatment with lidocaine 2.5%/prilocaine 2.5% cream in patients with post-herpetic neuralgia.BMC Anesthesiol BioMed Central. 2011; 11: 25
- Differential effects on sensory functions and measures of epidermal nerve fiber density after application of a lidocaine patch (5%) on healthy human skin.Eur J Pain. 2011; 15: 907-912
- Percutaneous penetration kinetics of lidocaine and prilocaine in two local anesthetic formulations assessed by in vivo microdialysis in pigs.Biol Pharm Bull. 2007; 30: 830-834
- Three functionally distinct classes of C-fibre nociceptors in primates.Nat Commun. 2014; 5: 4122
- TRPV3 is a calcium-permeable temperature-sensitive cation channel.Nature. 2002; 418: 181
- Effect of EMLA pre-treatment on capsaicin-induced burning and hyperalgesia.Acta Derm Venereol. 1999; 79: 118-121
Article info
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Footnotes
Disclosures: Center for Neuroplasticity and Pain (CNAP) is supported by the Danish National Research Foundation (DNRF121). The authors have no conflict of interest to report.
Statement of exclusivity: The data included in the present paper have not been published elsewhere.