Treatment of Bear Mace (Oleoresin Capsicum) Exposure to the Face
Immediately irrigate the affected areas with copious amounts of water or saline for at least 15 minutes, focusing on the eyes and face, as this is the primary treatment for oleoresin capsicum exposure and minimizes tissue damage. 1, 2
Immediate Decontamination
- Remove the patient from the contaminated area and begin thorough irrigation immediately with large volumes of water or sterile saline 1, 2
- Irrigate eyes continuously for at least 15 minutes with copious amounts of water, as capsaicin causes intense conjunctival irritation and corneal epithelial damage 2, 3
- Avoid rubbing or touching the affected areas, as this can spread the oleoresin capsicum and worsen symptoms 2
- Remove all contaminated clothing carefully to prevent further exposure and cross-contamination 1
- Decontamination should be performed carefully to avoid contaminating surrounding skin and clothing 2
Symptom Management
Ocular Effects
- Expect blepharospasm, conjunctivitis, periorbital edema, and transient corneal epithelial damage that typically heals within 24 hours 2, 3
- Visual acuity usually remains unchanged, though temporary blurring may occur 3
- Corneal sensitivity changes may persist for up to 7 days, with mechanical and chemical sensitivity alterations 3
- No specific antidote exists for capsaicin exposure; treatment is supportive 2
Dermatological Effects
- Burning sensation, erythema, and hyperalgesia are expected and result from neurogenic inflammation caused by capsaicinoids 2
- Cool compresses may provide symptomatic relief for facial burning 2
Respiratory Effects
- Monitor for respiratory symptoms including burning sensation in nose, sore throat, chest tightness, or dyspnea 2, 4
- Provide supplemental oxygen if respiratory distress develops 4
- Most respiratory symptoms resolve spontaneously with supportive care 2
Clinical Monitoring
- Symptoms typically resolve within 30-45 minutes with proper decontamination, though some effects may persist longer 2, 3
- Focal epithelial cell damage heals within 1 day in most cases 3
- Observe for systemic toxicity, though life-threatening effects are rare in the majority of exposed individuals 2
Important Caveats
- There is no role for milk, antacids, or neutralizing agents in treating oleoresin capsicum exposure 2
- Avoid using iodine or antibiotic-containing solutions for initial irrigation 5
- The molecular mechanisms involve complex cascades that can lead to cellular damage through oxidative stress, but single exposures appear harmless to corneal tissues 4, 3
- Vulnerable populations may experience more severe effects, requiring closer monitoring 4