Painful diabetic peripheral neuropathy of the feet: integrating prescription-strength capsaicin into office procedures

Prescription-strength (8%) capsaicin topical system is a US FDA-approved treatment for painful diabetic peripheral neuropathy of the feet. A 30 min application of the capsaicin 8% topical system can provide sustained (up to 3 months) local pain relief by desensitizing and reducing TRPV1-expressing cutaneous fibers. Capsaicin is not absorbed systemically; despite associated application-site discomfort, capsaicin 8% topical system is well tolerated, with no known drug interactions or contraindications, and could offer clinical advantages over oral options. Capsaicin 8% topical system are not for patient self-administration and require incorporation into office procedures, with the added benefit of treatment compliance. This article reviews existing literature and provides comprehensive, practical information regarding the integration of capsaicin 8% topical systems into office procedures. Plain language summary: Capsaicin 8% topical system is used to treat diabetic nerve pain of the feet. This in-office 30 min application can provide lasting relief of pain (for up to 3 months) by targeting the nerves damaged by diabetes. Since capsaicin acts at the site of diabetic nerve pain without being absorbed into the bloodstream, it is unlikely to interfere with other treatments and has few undesirable effects. Discomfort at the application site is the most commonly reported adverse event. Capsaicin 8% topical system must be applied by a healthcare professional and up to four topical systems can be used per treatment. Incorporating the use of capsaicin 8% topical systems into office procedures can help provide relief for patients living with diabetic nerve pain of the feet and may improve treatment compliance. Tweetable abstract: This article reviews existing literature and provides comprehensive, practical information regarding the integration of capsaicin 8% topical systems into office procedures.