Brief communication

Successful treatment of notalgia paresthetica with topical capsaicin: Vehicle-controlled, double-blind, crossover study☆

Pharmacologic treatments for patients with macular amyloidosis include amitriptyline (Yeo and Tey, 2013), onabotulinumtoxinA (Maari et al., 2014; Pérez-Pérez et al., 2014; Weinfeld, 2007), and gabapentin (Loosemore et al., 2007; Maciel et al., 2014). Topical treatments that have been used include tacrolimus (Ochi et al., 2016) and capsaicin (Andersen et al., 2016; Wallengren and Klinker, 1995). Other modalities including narrow band ultraviolet B (Pérez-Pérez et al., 2010), surgical decompression (Williams et al., 2010), osteopathic manipulation (Richardson et al., 2009), exercise (Fleischer et al., 2011), electrical muscle (Wang et al., 2009) and nerve stimulation (Philip et al., 2009; Savk et al., 2007), and acupuncture (Stellon, 2002).

Capsaicin acts locally by desensitizing peripheral nerve fibers by depletion of substance P. Topical capsaicin was found to be effective for notalgia paresthetica in a randomized trial. Preparations up to 0.1% can be used.110,111 A case series reported good results with a high-dose capsaicin 8% patch in patients with brachioradial pruritus.112