Topical capsaicin cream showed promising nausea relief for cannabinoid hyperemesis syndrome in a pilot RCT
In a pilot randomized trial of 30 patients, topical capsaicin cream applied to the abdomen significantly reduced nausea at 60 minutes compared to placebo in suspected cannabinoid hyperemesis syndrome, with 29% achieving complete resolution.
Quick Facts
What This Study Found
At 60 minutes, mean nausea severity was 3.2 cm (capsaicin) vs. 6.4 cm (placebo) on a 0-10 scale (difference = -3.2 cm, 95% CI: -0.9 to -5.4). Nausea reduction: 46% (capsaicin) vs. 25% (placebo). Complete nausea resolution: 29.4% (capsaicin) vs. 0% (placebo, RR = 3.4). At 30 minutes, the difference was not yet statistically significant.
Key Numbers
30 patients (17 capsaicin, 13 placebo). At 60 min: 3.2 vs. 6.4 cm nausea (difference -3.2). 46% vs. 25% nausea reduction. Complete resolution: 29.4% vs. 0%. 1 patient discontinued for skin irritation.
How They Did This
Double-blind, randomized, placebo-controlled pilot trial of 30 adults presenting with suspected CHS exacerbation. 0.1% capsaicin or placebo cream applied to anterior abdomen. Nausea assessed by visual analog scale at 30 and 60 minutes.
Why This Research Matters
CHS has no established treatment. Topical capsaicin is inexpensive, readily available, and this is the first RCT testing it for CHS, moving beyond case reports to controlled evidence.
The Bigger Picture
CHS is an increasingly common ED presentation with limited treatment options. Topical capsaicin activates TRPV1 receptors, the same pathway involved in the hot shower relief that CHS patients characteristically seek.
What This Study Doesn't Tell Us
Small pilot trial; not powered for definitive conclusions; suspected CHS diagnosis (no gold standard exists); 30-minute endpoint was not significant; one patient could not tolerate the cream.
Questions This Raises
- ?Would a larger trial confirm these findings?
- ?Is higher-concentration capsaicin more effective?
- ?What is the optimal application timing and duration?
Trust & Context
- Key Stat:
- Complete nausea resolution: 29% capsaicin vs. 0% placebo; significant at 60 minutes
- Evidence Grade:
- Small pilot RCT providing initial controlled evidence; not powered for definitive conclusions.
- Study Age:
- Published in 2020.
- Original Title:
- A Pilot Trial of Topical Capsaicin Cream for Treatment of Cannabinoid Hyperemesis Syndrome.
- Published In:
- Academic emergency medicine : official journal of the Society for Academic Emergency Medicine, 27(11), 1166-1172 (2020)
- Authors:
- Dean, Diana J, Sabagha, Noor, Rose, Kaitlin, Weiss, Alexander, France, John, Asmar, Timothy, Rammal, Jo-Ann, Beyer, Margaret, Bussa, Rebecca, Ross, Jacob, Chaudhry, Kaleem, Smoot, Thomas, Wilson, Kathleen, Miller, Joseph
- Database ID:
- RTHC-02503
Evidence Hierarchy
Participants are randomly assigned to treatment or placebo groups to test cause and effect.
What do these levels mean? →Frequently Asked Questions
How does capsaicin cream help with CHS?
Capsaicin activates TRPV1 receptors, the same receptor pathway that responds to heat. This may explain why CHS patients characteristically find relief from hot showers. Applying capsaicin cream to the abdomen may provide similar relief without needing a shower.
Is this now a standard treatment for CHS?
Not yet. This pilot trial is promising, but with only 30 patients, a larger confirmatory trial is needed. However, given the safety profile of topical capsaicin and the lack of other CHS treatments, some emergency departments have already adopted it.
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Cite This Study
https://rethinkthc.com/research/RTHC-02503APA
Dean, Diana J; Sabagha, Noor; Rose, Kaitlin; Weiss, Alexander; France, John; Asmar, Timothy; Rammal, Jo-Ann; Beyer, Margaret; Bussa, Rebecca; Ross, Jacob; Chaudhry, Kaleem; Smoot, Thomas; Wilson, Kathleen; Miller, Joseph. (2020). A Pilot Trial of Topical Capsaicin Cream for Treatment of Cannabinoid Hyperemesis Syndrome.. Academic emergency medicine : official journal of the Society for Academic Emergency Medicine, 27(11), 1166-1172. https://doi.org/10.1111/acem.14062
MLA
Dean, Diana J, et al. "A Pilot Trial of Topical Capsaicin Cream for Treatment of Cannabinoid Hyperemesis Syndrome.." Academic emergency medicine : official journal of the Society for Academic Emergency Medicine, 2020. https://doi.org/10.1111/acem.14062
RethinkTHC
RethinkTHC Research Database. "A Pilot Trial of Topical Capsaicin Cream for Treatment of Ca..." RTHC-02503. Retrieved from https://rethinkthc.com/research/dean-2020-a-pilot-trial-of
Access the Original Study
Study data sourced from PubMed, a service of the U.S. National Library of Medicine, National Institutes of Health.
This study breakdown was produced by the RethinkTHC research team. We analyze and report published research findings without making health recommendations. All interpretations are based solely on the published abstract and study data.