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Capsaicin

Sounds like 'kap-SAY-i-sin'

Key points about capsaicin

Capsaicin is a cream that is used for pain relief for osteoarthritis and nerve pain.
It's also been used to relieve itching in palliative care.
Capsaicin is also called Zostrix and Zo-Rub (Zo-Rub Osteo and Zo-Rub HP).
Find out how to apply it safely and possible side effects.

Man rubbing pain relief cream into shoulder

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Product recall

There is a product recall of 0.075% Rugby Capsaicin Topical Cream due to potential problems with the product appearance. The affected batch number is 24-01307 with an expiry date of 01/2026. Check at home to see if you have received the affected product which you should return to your pharmacy. The 0.025% Capsaicin Topical Cream is unaffected.

Capsaicin is a cream that is used to relieve pain caused by osteoarthritis, or nerve pain caused by shingles or diabetes (diabetic peripheral neuropathy). It's absorbed through the skin into the painful area and works by decreasing a natural substance in your body called substance P, that helps pass pain signals to the brain.

There are 2 strengths of capsaicin cream, which have different uses:

0.025% (Rugby®, Zo-Rub Osteo® or Zostrix®) is used to relieve pain in osteoarthritis.
0.075% (Rugby®, Zo-Rub HP® or Zostrix HP®) is used to relieve nerve pain caused by shingles or diabetes (diabetic peripheral neuropathy).

Both strengths of capsaicin cream have also been used to relieve itching in palliative care.

August 2024: The funded brand of capsaicin is changing

From August 2024, a new brand of capsaicin cream, Zo-Rub Osteo and Zo-Rub HP will be funded. These have the same active ingredient and work in the same way as Zostrix and Zostrix HP. Find out more about Zostrix and Zostrix HP supply issue(external link).

Capsaicin cream is applied to the painful area on the skin.
The usual dose of capsaicin cream is a pea-sized amount to the affected area 3 to 4 times daily, with a gap of at least 4 hours between each application.
Pain relief usually begins within the first week of regular treatment and increases with regular use over the next few weeks. It can take up to 6 weeks to achieve its full effect.

Tips on how to apply capsaicin

Use a small amount of cream for each application and gently rub into the affected area.
Wash any leftover cream from your hands after applying. If using the cream for pain on your hands, wash your hands after 30 minutes of applying the cream.
Don't apply the cream to broken or irritated skin. If you're using it for nerve pain caused by shingles, only use it after lesions have healed.
Avoid contact with eyes and other sensitive areas such as the nose, mouth and genital area. Wash it off straight away if it gets in contact with these areas.
Don't apply tight bandages or heat (heating pads, hot water bottles, and heat lamps) to the area where the cream has been used.
Don't apply the cream immediately before or soon after activities such as bathing or showering, swimming, sunbathing or heavy exercise.
Avoid hot showers or baths immediately after applying it.

Like all medicines, capsaicin can cause side effects, although not everyone gets them.

Side effects	What should I do?
The most common side effect is stinging or burning feeling after application of capsaicin.	See tips above on how to apply capsaicin. This stinging or burning feeling is to be expected It usually eases after the first few days of regular use and should disappear over time.
Blistering or swelling at the application site Increased or unusual pain at the application site	Tell your doctor.
Signs of an allergic reaction such as skin rash, itches, swelling of the face, lips, mouth and tongue or problems breathing	Tell your doctor immediately or ring Healthline 0800 611 116.

Diabetic neuropathy (nerve damage)
Osteoarthritis | Pona ngoikore
Shingles | Mate huaketo hei
Nerve pain

The following links have more information on capsaicin.

Capsaicin(external link) Dermnet NZ
Zostrix Cream(external link) Medsafe Consumer Information Sheet, NZ