High dose topical capsaicin in the treatment of meralgia paresthetica: a case report

Meralgia paresthetica (MP) can be challenging to manage, especially in patients with comorbidities that complicate treatment options. Previous studies reported successful pain management of MP by applying topical capsaicin 0.025% cream. However, use of capsaicin 8% patches for MP has been lacking. We presented the case of a 72-year-old female with a body mass index of 35 and large volume ascites, who was experiencing severe left lateral thigh pain and numbness due to MP. The patient had cirrhosis with thrombocytopenia and recurrent spontaneous bacterial peritonitis, requiring frequent hospitalization. She had previously tried lidocaine 5% patch, capsaicin 0.1% patch, gabapentin, and oxycodone, with minimal relief. Interventional procedures were deferred due to concerns for increased bleeding and infection risks. As an alternative, the patient was treated with capsaicin 8% patches in the clinic. Following treatment, the patient reported 100% relief without side effects. Each application of capsaicin 8% patch offered her three to five months of pain relief. To our knowledge, this is the first reported case of using capsaicin 8% patches for MP. This off-label use of capsaicin 8% patch showed promise for pain management for MP. However, prospective studies are needed to determine the long-term efficacy, safety, and optimal dosing.High-Dose Capsaicin Patch Relieved Thigh Nerve Pain in a Complex Patient - Plain Language Summary.