Is there an antidote for pepper spray exposure?

Treatment for Pepper Spray Exposure

The most effective immediate treatment for pepper spray exposure to the eyes is irrigation with copious amounts of tap water for at least 15 minutes. 1

Immediate Management

• Begin decontamination by irrigation immediately after pepper spray exposure to minimize eye damage and tissue irritation 1
• Use large volumes of tap water for irrigation, continuing for at least 15 minutes to effectively flush the irritant from the eyes 1
• When performing irrigation, take care to avoid contaminating the unaffected eye, other individuals, or surrounding areas 1
• Some patients may require assistance keeping their eyelids open during irrigation to ensure thorough cleansing 1

Alternative Irrigation Solutions

• If immediately available, eye irrigation with normal saline, Ringer's lactate solution, or a commercial eye wash solution is reasonable and may be more comfortable for the patient 1
• Commercial eye irrigation solutions may result in less severe eye injury compared to other irrigation fluids 1
• Balanced salt solutions may be more comfortable than plain water for irrigation 1

Important Considerations

• Wearing protective goggles during potential exposure significantly reduces the severity of ocular symptoms, as demonstrated by significantly lower Schirmer test results in unprotected versus protected individuals 2
• There is no specific antidote for capsaicin, the active ingredient in pepper spray 3
• Baby shampoo, contrary to popular belief, provides no better relief from pepper spray-induced discomfort than irrigation with water alone 4
• Approximately 6.8% of pepper spray exposures result in more severe symptoms that warrant medical evaluation, with ocular symptoms being the most common (53.8%) 5

Potential Complications

• Pepper spray can cause temporary blindness, severe burning sensation, and in some cases, more serious corneal and conjunctival damage 6
• Some individuals may develop reduced tear production following exposure, which can lead to dry eye symptoms 2
• Severe exposures can result in complete epithelial defects, limbal ischemia, and in rare cases, deep stromal scarring 6
• People with respiratory conditions such as asthma may be more susceptible to respiratory effects, though evidence is limited 3

When to Seek Medical Attention

• Persistent ocular symptoms after thorough irrigation should prompt medical evaluation 5
• Respiratory distress, especially in individuals with pre-existing respiratory conditions 3
• Signs of severe corneal injury including persistent pain, decreased vision, or inability to open the eye 6
• Contact regional poison centers for expert advice on management of severe cases 1

Common Pitfalls to Avoid

• Delaying irrigation - immediate decontamination is critical to minimize tissue damage 1
• Cross-contaminating the unaffected eye or other individuals during treatment 1
• Assuming that specialized solutions like baby shampoo are more effective than water alone 4
• Failing to recognize the potential for more serious ocular injury requiring medical evaluation 5, 6