Capsaicin and the treatment of Vulvar Vestibulitis Syndrome: a valuable alternative?

Objective : To assess the efficacy of topical capsaicin in the treatment of vulvar vestibulitis syndrome. Study Design : Thirty-three consecutive women referred for Vulvar Vestibulitis Syndrome were treated with topical capsaicin 0.05 %. The capsaicin cream was applied twice a day for 30 days, then once a day for 30 days and, finally, two times a week for 4 months. Results : In 19 patients (59%) improvement of symptoms was recorded, but no complete remission was observed. Symptoms recurred in all patients after the use of capsaicin cream was discontinued. A return to a twice-weekly topical application of the cream resulted in the improvement of symptoms. Severe burning was reported as the only side effect by all the patients. Conclusion: Response to treatment was only partial, possibly due to the concentration of the compound being too low, or to the need for more frequent than daily applications. The therapeutic role of capsaicin should hence be confined to a last-choice medical approach.