title: Topical antacid therapy for capsaicin-induced dermal pain: a poison center telephone-directed study.
abstract: OBJECTIVE
  The study aimed to assess the effects of topical antacids for treatment of capsaicin-induced dermal pain after exposure to capsaicin containing hot peppers, personal protection sprays, or topical creams.
  
  
  METHODS
  Participants of the study were California Poison Control System (CPCS) hotline callers 12 years or older with dermal pain from exposure to capsaicin-containing products or plants. Participants were instructed to apply a topical antacid and assessed for perceived pain (using a 0-10 scale) pre- and posttreatment. A positive response was defined as a sustained reduction of pain 33% or more within 30 minutes or achieving a pain score of 0 to 1.
  
  
  RESULTS
  Of 93 eligible patients, 64 applied antacids and had outcome data available. Patients contacted the CPCS a median of 1 hour postexposure with a median initial pain score of 7.5/10. Thirty-six (56%) were exposed to unrefined (natural) peppers and 28 (44%) to refined capsaicin (eg, capsaicin-containing cream). Before calling the CPCS, 57 (89%) attempted at least one treatment. Forty-five (70%) reported positive response to antacid treatment as a 33% reduction in pain in 30 minutes (n = 17), a reduction in pain to a score of 0 to 1 (n = 3), or both (n = 25). A 33% reduction in pain within 30 minutes was associated with exposure to refined capsaicin (odds ratio, 3.37; 95% confidence interval, 0.98-11.66). Concomitant refined capsaicin exposure and early treatment (<1 hour of symptoms) was associated with even greater odds of response (odds ratio, 5.4; 95% confidence interval, 1.4-21.2).
  
  
  CONCLUSIONS
  Topical application of antacids for capsaicin-induced pain is effective, particularly in early treatment of exposure to refined capsaicin.
authors.affiliation: Department of Clinical Pharmacy, School of Pharmacy, University of California, San Francisco, CA 94143-1369, USA. susank@calpoison.org
authors.forename: Susan Y
authors.initials: SY
authors.lastname: Kim-Katz
authors.forename: Ilene B
authors.initials: IB
authors.lastname: Anderson
authors.forename: Thomas E
authors.initials: TE
authors.lastname: Kearney
authors.forename: Conan
authors.initials: C
authors.lastname: MacDougall
authors.forename: Karen S
authors.initials: KS
authors.lastname: Hudmon
authors.forename: Paul D
authors.initials: PD
authors.lastname: Blanc
mesh_terms: D000287:Administration, Topical; D000328:Adult; D000863:Antacids / Q000008:administration & dosage / Q000627:therapeutic use*; D002211:Capsaicin / Q000506:poisoning*; D005260:Female; D015277:Hotlines; D006801:Humans; D008297:Male; D010146:Pain / Q000188:drug therapy*; D010147:Pain Measurement; D011039:Poison Control Centers; D013997:Time Factors
chemical_list: D000863:Antacids; D002211:Capsaicin