Capsaicin cream is intended for external use on the skin only. Do not swallow the medication. The treatment typically involves the application of a topical anesthetic until the area is numb. Then the capsaicin is applied by a therapist wearing rubber gloves and a face mask. The capsaicin remains on the skin until the patient starts to feel the heat at which point it is promptly removed. The result appears to be that the nerves are overwhelmed from the burning sensation and are unable to report pain for an extended period of time.
When you first begin to use capsaicin, a warm, stinging, or burning sensation (feeling) may occur. This sensation is related to the action of capsaicin on the skin and is to be expected. Capsaicin must be used regularly every day as directed if it is to work properly. Even then, it may not relieve your pain right away. The length of time it takes to work depends on the type of pain you have. In persons with arthritis, pain relief usually begins within 1 to 2 weeks. In most persons with neuralgia, relief usually begins within 2 to 4 weeks, although with head and neck neuralgias, relief may take as long as 4 to 6 weeks.