Effect of EMLA pre-treatment on capsaicin-induced burning and hyperalgesia

Gil Yosipovitch, Howard I. Maibach, Michael C. Rowbotham

Research output: Contribution to journalArticle

51 Citations (Scopus)

Abstract

Capsaicin, which has been studied extensively as a treatment for itch and several chronic pain disorders, induces burning during the first week of therapy, causing a substantial percentage of patients to discontinue treatment prematurely. We examined whether pre-treatment with the topical anesthetic EMLA reduces the burning sensation induced by capsaicin and alters capsaicin effects on thermal sensation and pain thresholds. Healthy adult volunteers participated in the single-blind, 6-day study. After baseline measurement of warmth, cold pain and heat pain thresholds with a computerized thermal sensory analyzer, subjects applied EMLA thrice daily on one forearm and vehicle placebo on the other forearm, 60 min before applying capsaicin 0.075% on both forearms. Subjects rated burning sensations 3 times a day throughout the study. After 1 and 5 days of thrice daily application of EMLA or vehicle followed by capsaicin, thermal sensory testing was repeated. Subjects rated burning sensations to be significantly less on the EMLA pre- treated forearm compared with the placebo pre-treated forearm during all 5 days of treatment (p<0.01). Capsaicin with and without EMLA produced significant heat pain hyperalgesia and cold pain hypoalgesia after 1 day of treatment. After 5 days of treatment, heat pain hyperalgesia persisted on both forearms; however, it was significantly less on the EMLA-treated forearm vs the vehicle-treated site (p<0.03). Cold pain hypoalgesia persisted in both forearms. The warmth sensation threshold was significantly higher on the EMLA-pre-treated forearm after 1 and 5 days of treatment. In conclusion, pre- treatment with EMLA significantly reduced the burning sensation from capsaicin and attenuated heat hyperalgesia during treatment.

Original languageEnglish (US)
Pages (from-to)118-121
Number of pages4
JournalActa Dermato-Venereologica
Volume79
Issue number2
StatePublished - Apr 28 1999
Externally publishedYes

Fingerprint

Capsaicin
Hyperalgesia
Forearm
Hot Temperature
Pain
Therapeutics
Pain Threshold
Placebos
EMLA
Somatoform Disorders
Hypesthesia
Local Anesthetics
Chronic Pain
Healthy Volunteers

Keywords

  • Heat hyperalgesia
  • Thermal testing
  • Thermal thresholds

ASJC Scopus subject areas

  • Dermatology

Cite this

Effect of EMLA pre-treatment on capsaicin-induced burning and hyperalgesia. / Yosipovitch, Gil; Maibach, Howard I.; Rowbotham, Michael C.

In: Acta Dermato-Venereologica, Vol. 79, No. 2, 28.04.1999, p. 118-121.

Research output: Contribution to journalArticle

Yosipovitch, Gil ; Maibach, Howard I. ; Rowbotham, Michael C. / Effect of EMLA pre-treatment on capsaicin-induced burning and hyperalgesia. In: Acta Dermato-Venereologica. 1999 ; Vol. 79, No. 2. pp. 118-121.
@article{8e5e67a14d2a4eadba4cb71844f9071b,
title = "Effect of EMLA pre-treatment on capsaicin-induced burning and hyperalgesia",
abstract = "Capsaicin, which has been studied extensively as a treatment for itch and several chronic pain disorders, induces burning during the first week of therapy, causing a substantial percentage of patients to discontinue treatment prematurely. We examined whether pre-treatment with the topical anesthetic EMLA reduces the burning sensation induced by capsaicin and alters capsaicin effects on thermal sensation and pain thresholds. Healthy adult volunteers participated in the single-blind, 6-day study. After baseline measurement of warmth, cold pain and heat pain thresholds with a computerized thermal sensory analyzer, subjects applied EMLA thrice daily on one forearm and vehicle placebo on the other forearm, 60 min before applying capsaicin 0.075{\%} on both forearms. Subjects rated burning sensations 3 times a day throughout the study. After 1 and 5 days of thrice daily application of EMLA or vehicle followed by capsaicin, thermal sensory testing was repeated. Subjects rated burning sensations to be significantly less on the EMLA pre- treated forearm compared with the placebo pre-treated forearm during all 5 days of treatment (p<0.01). Capsaicin with and without EMLA produced significant heat pain hyperalgesia and cold pain hypoalgesia after 1 day of treatment. After 5 days of treatment, heat pain hyperalgesia persisted on both forearms; however, it was significantly less on the EMLA-treated forearm vs the vehicle-treated site (p<0.03). Cold pain hypoalgesia persisted in both forearms. The warmth sensation threshold was significantly higher on the EMLA-pre-treated forearm after 1 and 5 days of treatment. In conclusion, pre- treatment with EMLA significantly reduced the burning sensation from capsaicin and attenuated heat hyperalgesia during treatment.",
keywords = "Heat hyperalgesia, Thermal testing, Thermal thresholds",
author = "Gil Yosipovitch and Maibach, {Howard I.} and Rowbotham, {Michael C.}",
year = "1999",
month = "4",
day = "28",
language = "English (US)",
volume = "79",
pages = "118--121",
journal = "Acta Dermato-Venereologica",
issn = "0001-5555",
publisher = "Society for the Publication of Acta Dermato-Venereologica",
number = "2",

}

TY - JOUR

T1 - Effect of EMLA pre-treatment on capsaicin-induced burning and hyperalgesia

AU - Yosipovitch, Gil

AU - Maibach, Howard I.

AU - Rowbotham, Michael C.

PY - 1999/4/28

Y1 - 1999/4/28

N2 - Capsaicin, which has been studied extensively as a treatment for itch and several chronic pain disorders, induces burning during the first week of therapy, causing a substantial percentage of patients to discontinue treatment prematurely. We examined whether pre-treatment with the topical anesthetic EMLA reduces the burning sensation induced by capsaicin and alters capsaicin effects on thermal sensation and pain thresholds. Healthy adult volunteers participated in the single-blind, 6-day study. After baseline measurement of warmth, cold pain and heat pain thresholds with a computerized thermal sensory analyzer, subjects applied EMLA thrice daily on one forearm and vehicle placebo on the other forearm, 60 min before applying capsaicin 0.075% on both forearms. Subjects rated burning sensations 3 times a day throughout the study. After 1 and 5 days of thrice daily application of EMLA or vehicle followed by capsaicin, thermal sensory testing was repeated. Subjects rated burning sensations to be significantly less on the EMLA pre- treated forearm compared with the placebo pre-treated forearm during all 5 days of treatment (p<0.01). Capsaicin with and without EMLA produced significant heat pain hyperalgesia and cold pain hypoalgesia after 1 day of treatment. After 5 days of treatment, heat pain hyperalgesia persisted on both forearms; however, it was significantly less on the EMLA-treated forearm vs the vehicle-treated site (p<0.03). Cold pain hypoalgesia persisted in both forearms. The warmth sensation threshold was significantly higher on the EMLA-pre-treated forearm after 1 and 5 days of treatment. In conclusion, pre- treatment with EMLA significantly reduced the burning sensation from capsaicin and attenuated heat hyperalgesia during treatment.

AB - Capsaicin, which has been studied extensively as a treatment for itch and several chronic pain disorders, induces burning during the first week of therapy, causing a substantial percentage of patients to discontinue treatment prematurely. We examined whether pre-treatment with the topical anesthetic EMLA reduces the burning sensation induced by capsaicin and alters capsaicin effects on thermal sensation and pain thresholds. Healthy adult volunteers participated in the single-blind, 6-day study. After baseline measurement of warmth, cold pain and heat pain thresholds with a computerized thermal sensory analyzer, subjects applied EMLA thrice daily on one forearm and vehicle placebo on the other forearm, 60 min before applying capsaicin 0.075% on both forearms. Subjects rated burning sensations 3 times a day throughout the study. After 1 and 5 days of thrice daily application of EMLA or vehicle followed by capsaicin, thermal sensory testing was repeated. Subjects rated burning sensations to be significantly less on the EMLA pre- treated forearm compared with the placebo pre-treated forearm during all 5 days of treatment (p<0.01). Capsaicin with and without EMLA produced significant heat pain hyperalgesia and cold pain hypoalgesia after 1 day of treatment. After 5 days of treatment, heat pain hyperalgesia persisted on both forearms; however, it was significantly less on the EMLA-treated forearm vs the vehicle-treated site (p<0.03). Cold pain hypoalgesia persisted in both forearms. The warmth sensation threshold was significantly higher on the EMLA-pre-treated forearm after 1 and 5 days of treatment. In conclusion, pre- treatment with EMLA significantly reduced the burning sensation from capsaicin and attenuated heat hyperalgesia during treatment.

KW - Heat hyperalgesia

KW - Thermal testing

KW - Thermal thresholds

UR - http://www.scopus.com/inward/record.url?scp=0032968111&partnerID=8YFLogxK

UR - http://www.scopus.com/inward/citedby.url?scp=0032968111&partnerID=8YFLogxK

M3 - Article

C2 - 10228629

AN - SCOPUS:0032968111

VL - 79

SP - 118

EP - 121

JO - Acta Dermato-Venereologica

JF - Acta Dermato-Venereologica

SN - 0001-5555

IS - 2

ER -