What to Know About Zostrix Cream

Topical Pain-Relieving Cream Containing Capsaicin

Zostrix is an over-the-counter pain-relieving cream that contains capsaicin—the active ingredient in chili peppers that make them spicy. When applied to your skin over a period of time, capsaicin works by temporarily interfering with the way your body interprets pain.

With regular use, capsaicin creams like Zostrix can be effective topical treatment options for people with certain types of muscle and joint pain. Some of these conditions include arthritis, muscle sprains and strains, back ache, and neuralgia (nerve pain).

Zostrix is applied to the skin surrounding the affected area typically three to four times per day, depending on your condition. Because capsaicin has a kick to it, you should expect to feel a warming, burning, or stinging sensation when first applying Zostrix. After continued use, that feeling usually decreases.

You’ll find Zostrix at your local pharmacy in cream, gel, and lotion forms, and you can also get it by prescription from your healthcare provider. It's a popular option for many people because Zostrix can often work in conjunction with the rest of your pain management plan.

Plus, you don't necessarily need a prescription for it, though it's recommended that you check with your practitioner before incorporating it into your treatment plan.

Applying Zostrix capsaicin cream to hand

curtoicurto / iStock / Getty Images

Capsaicin Relieves Pain

Capsaicin as a topical medication is well-known for its pain-relieving benefits. After the ingredient is extracted from the chili pepper, capsaicin can be incorporated into topical pain-relief creams and patches, which include Zostrix and other formulations.

Research suggests that when used consistently and correctly, capsaicin has the ability to help reduce chronic pain related to arthritis, musculoskeletal conditions, and diabetic neuropathy (a painful nerve condition found in people with diabetes).

When applied to the skin, it works by temporarily blocking the pain signals from your nerves to your brain, though you may not immediately feel pain free. That's because, after application, capsaicin appears to initially irritate the area before promoting pain relief.

Recent studies have found that capsaicin in cream or gel form effectively reduced pain in arthritis and diabetic neuropathy patients when used over a period of 12 weeks.

Other research has also indicated that using topical capsaicin could help improve symptoms of psoriasis and relieve nerve damage pain from conditions like shingles and HIV.

How To Use

There are many different types of capsaicin cream formulas that are available at your local pharmacy. Zostrix is one of the most common over-the-counter preparations. It's typically found in a 0.025% strength topical cream, and a 0.1% strength topical cream—which is considered the maximum strength.

Experts recommend applying Zostrix to the affected areas up to four times per day, and there are a number of application tips to follow:

  • Start with clean, dry skin.
  • Apply a thin layer of cream and rub in completely until absorbed.
  • Unless treating the hand area, wash your hands thoroughly with soap and water after applying.
  • Make sure not to touch your eyes, nose, or any sensitive areas after application.
  • Do not apply Zostrix to irritated or wounded skin.

Because stinging and irritation at the application site are common side effects for Zostrix, you may want to start by applying small amounts before building up a tolerance for larger doses. It's also a good idea to keep track of any adverse reactions.

Zostrix can be stored in a closed container or cabinet at room temperature. Keep it away from heat, moisture, and direct sunlight, and make sure it's not accessible to kids.

As with all medications, check expirations dates and get rid of outdated medicine. You can ask your healthcare provider, pharmacist, or other healthcare professional how best to properly dispose of any leftover Zostrix that you will no longer use.

Potential Side Effects

Keep in mind that there are side effects that come with using Zostrix, and any other topical cream or patch containing capsaicin. Some of the most common side effects that people experience affect the skin where Zostrix is applied. They include:

  • Stinging
  • Burning
  • Itching
  • Swelling
  • Soreness

Because of the way this medicine works, it's normal for these side effects to last for a few days to a few weeks and you may not see improvement or pain relief immediately. Many people experience noticeable pain reduction after roughly a few weeks of use, with best results typically happening after using it consistently for two to four weeks.

If the pain or side effects get worse or unbearable, check with your healthcare provider. You should also try not to inhale any residue from the medication, because that may cause throat irritation, coughing, sneezing, or watery eyes.

Also note that the areas you treat may be sensitive to heat (such as hot water, direct sunlight, and sweating) for a few days after application.

Serious side effects and allergic reactions can also occur with topical capsaicin. Stop using Zostrix and call your healthcare provider right away if you experience severe burning or blistering, intense pain, chills, difficulty breathing, or chest tightness.

Warnings and Precautions

When considering whether or not Zostrix may be right for you and your specific condition, it's a good idea to discuss with your healthcare provider first. You may be directed not to incorporate Zostrix into your routine if it interferes with other parts of your treatment plan.

Your practitioner should know about the other medications that you're currently using, whether you are also using another topical pain reliever (like one containing lidocaine or menthol, for example), and if you are allergic to chili peppers.

You should also check with your healthcare provider first before using Zostrix if you are pregnant or breastfeeding. Not much is known about how capsaicin may transfer to the baby in vitro, but experts do know that capsaicin use has the potential to negatively affect the baby while nursing.

It's not recommended to apply Zostrix on or near the breast area, as studies have shown that there could be harmful exposure if the baby comes into direct contact with areas of the skin that have been treated. 

Zostrix is not meant for children under the age of 18, so it's important to keep it out of reach of children. If accidentally swallowed, get immediate medical attention or contact Poison Control.

Here are a few other general precautions to take:

  • Do not apply Zostrix to broken, cracked, wounded, or irritated skin.
  • Avoid contact with your eyes and other areas of mucous membranes, otherwise it will burn.
  • Wash hands immediately after use.
  • Avoid bathing, swimming, or exercising for at least 30 minutes after application.
  • Don't bandage the affected area after applying.
  • Don't apply heat to the treated areas or sunbathe immediately before or after Zostrix use.
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