A double-blind evaluation of topical capsaicin in pruritic psoriasis

J Am Acad Dermatol. 1993 Sep;29(3):438-42. doi: 10.1016/0190-9622(93)70208-b.


Background: Substance P, an undecapeptide neurotransmitter, has been implicated in the pathophysiology of psoriasis and pruritus.

Objective: Safety and efficacy of topical capsaicin, a potent substance P depletor, were evaluated in patients with pruritic psoriasis.

Methods: Patients applied capsaicin 0.025% cream (n = 98) or vehicle (n = 99) four times a day for 6 weeks in this double-blind study. Efficacy was based on a physician's global evaluation and a combined psoriasis severity score including scaling, thickness, erythema, and pruritus.

Results: Capsaicin-treated patients demonstrated significantly greater improvement in global evaluation (p = 0.024 after 4 weeks and p = 0.030 after 6 weeks) and in pruritus relief (p = 0.002 and p = 0.060, respectively), as well as a significantly greater reduction in combined psoriasis severity scores (p = 0.030 and p = 0.036, respectively). The most frequently reported side effect in both treatment groups was a transient burning sensation at application sites.

Conclusion: Topically applied capsaicin effectively treats pruritic psoriasis, a finding that supports a role for substance P in this disorder.

Publication types

  • Clinical Trial
  • Multicenter Study
  • Randomized Controlled Trial
  • Research Support, Non-U.S. Gov't

MeSH terms

  • Administration, Topical
  • Adolescent
  • Adult
  • Aged
  • Capsaicin / administration & dosage*
  • Double-Blind Method
  • Female
  • Humans
  • Male
  • Middle Aged
  • Pruritus / drug therapy
  • Pruritus / metabolism
  • Psoriasis / drug therapy*
  • Psoriasis / metabolism
  • Substance P / metabolism


  • Substance P
  • Capsaicin