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

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

Research output: Contribution to journalArticlepeer-review

52 Scopus citations

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
DOIs
StatePublished - 1999
Externally publishedYes

Keywords

  • Heat hyperalgesia
  • Thermal testing
  • Thermal thresholds

ASJC Scopus subject areas

  • Dermatology

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