Can capsaicin 8% patch be applied to both upper and lower extremities?

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Last updated: December 17, 2025View editorial policy

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Capsaicin 8% Patch Application Sites

Yes, the capsaicin 8% patch can be applied to both upper and lower extremities for localized peripheral neuropathic pain. The patch is designed for application to any affected area of intact skin where peripheral neuropathic pain is localized, regardless of whether it involves the arms, legs, hands, or feet 1, 2.

Approved Application Sites

  • The capsaicin 8% patch is specifically indicated for application to the most painful areas of intact skin on any peripheral location, including both upper and lower extremities 1.

  • For chemotherapy-induced peripheral neuropathy (CIPN), the patch is commonly applied to both feet and hands, demonstrating its utility across different extremity locations 2.

  • Clinical studies have demonstrated efficacy in various peripheral neuropathic conditions affecting different body regions, including postherpetic neuralgia (which can occur on trunk or extremities), HIV-associated neuropathy (commonly affecting feet), and diabetic peripheral neuropathy (typically affecting lower extremities) 1, 3.

Application Protocol for All Extremity Sites

  • Apply topical lidocaine 4% to the treatment area for 60 minutes before capsaicin patch application to reduce application-related discomfort, regardless of the extremity being treated 1, 3.

  • The patch should remain in place for 30-60 minutes under medical supervision: 60 minutes for postherpetic neuralgia and 30 minutes for other neuropathic conditions 1.

  • Healthcare staff must wear gloves during the entire application process to avoid unintentional contact with the capsaicin 1.

Important Considerations for Extremity Application

  • The patch should only be applied to intact skin—avoid broken, irritated, or damaged skin areas 1.

  • Patients should be warned to avoid contact with eyes, mucous membranes, and genitalia after handling treated areas, as capsaicin is a potent local irritant 1.

  • A single application provides pain relief lasting up to 12 weeks, and treatment can be repeated every 90 days if pain persists or returns 1, 3.

Expected Outcomes Across Different Extremity Locations

  • Response rates are comparable across different peripheral neuropathic conditions: approximately 38% for postherpetic neuralgia, 48% for HIV-associated neuropathy, and 38% for mononeuropathies 4.

  • For CIPN affecting hands and feet, the capsaicin 8% patch is now often a preferred treatment option for localized neuropathic pain 2.

References

Guideline

Capsaicin Cream Dosing for Neuropathic Pain

Praxis Medical Insights: Practical Summaries of Clinical Guidelines, 2025

Guideline

Efficacy of Capsaicin Cream for Neuropathic Pain

Praxis Medical Insights: Practical Summaries of Clinical Guidelines, 2025

Professional Medical Disclaimer

This information is intended for healthcare professionals. Any medical decision-making should rely on clinical judgment and independently verified information. The content provided herein does not replace professional discretion and should be considered supplementary to established clinical guidelines. Healthcare providers should verify all information against primary literature and current practice standards before application in patient care. Dr.Oracle assumes no liability for clinical decisions based on this content.

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