Qutenza® (High Concentration Capsaicin) for the Treatment of Post-Herpetic Neuralgia

 

Post-Herpetic Neuralgia

Post-herpetic neuralgia is a painful condition that persists after a shingles episode is over. The sharp and shooting pain associated with post-herpetic neuralgia occurs in the same area as that of the pain and rash of shingles and results from the damage to nerve fibres during the shingles infection.

Post-herpetic neuralgia is not generally considered life threatening, though the condition can lead to insomnia, weight loss, depression and even disability in some cases. Patients may also become hypersensitive to even a very light touch or pressure on the skin, such as when touched by hand, a piece of cloth or even a gentle breeze.

 

Qutenza®  (High Concentration Capsaicin)

Pain from damaged nerves may feel like a sharp, burning, tingling, shooting, or numb sensation. This pain can disrupt sleep, mood, work, and activities of daily living. Qutenza® (capsaicin) 8% patch is indicated for the management of neuropathic pain. Qutenza delivers a synthetic form of capsaicin, the substance in chili peppers that gives them their heat sensation, through application onto the skin of the effected area by a physician.

 

Qutenza® is indicated for the management of neuropathic pain associated with postherpetic neuralgia. You may experience relentless burning, sharp or stabbing pain in the area where you had a shingles rash. Post herpetic neuralgia is the result of infection with the herpes zoster virus, which lays dormant in the spine and can be reactivated, usually in later life, as a result of infection, immunosuppression or other causes. The herpes zoster virus causes irritation and dysfunction of nerves leading to this most painful of conditions. Post herpetic neuralgia is not only very painful but can be very disruptive to your daily activities. The local painful area can also be extremely sensitive to slight touch or temperature changes making wearing clothing, showering and other simple activities unbearable.

 

Procedure

Qutenza is applied directly to the skin at the painful site. It is non-narcotic and is unlikely to react negatively with other medication the patient may be taking. Qutenza can be used alone or in combination with other pain medications.

Qutenza patches will be applied to the painful area by a doctor or a nurse wearing special gloves. The patches should not be touched or tampered with during the procedure , as capsaicin at this strength can cause burning or stinging to the skin on the hands. The patches can initially cause reddening of the skin and a burning or stinging sensation in the area they are applied to. However, after a while, the capsaicin starts to desensitise the pain receptors so that pain in the area is reduced. To reduce any initial pain, the doctor or nurse will apply a local anaesthetic to the skin before applying the patch. They may also use other painkillers or cooling compresses.

The doctor or nurse will remove the patches after 30 minutes if they are being used to treat nerve pain on the feet or after 60 minutes if being treated for nerve pain on other parts of your body. Patients are free to return home after the procedure.

 

Qutenza patch therapy

 

Procedure Outcomes

It can then take Qutenza patches from 1 to 14 days to provide full pain relief. They will then provide up to 12 weeks of reduced pain following a single one-hour application. If the pain persists after this period, further patches can be administered, or less conservative treatment, such as PENS or Botox can be considered.