8% topical capsaicin for peripheral neuropathy

A 2024 review of PN treatment options suggests that 8% topical capsaicin can favorably modify the course of (diabetic) PN, rather than merely reduce PN pain, significant though that is in its own right. Whether it can be similarly useful in other forms of PN is not addressed. Here’s an excerpt from the paper:
Of note, recent evidence suggests that treatment with capsaicin 8% topical systems may have an impact beyond pain relief, including the promotion of healthy nerve regeneration (see Unmet needs in the treatment of painful DPN: Disease prevention section for details).68–71 Systemic exposure to capsaicin following application of the topical system is very transient and low, since the high-concentration capsaicin does not penetrate deep into the dermal layers of the skin.58,72 As a result, the capsaicin 8% topical system is well tolerated, with a general lack of systemic ADRs, no potential DDIs or contraindications to its use, and no requirements for dose titration or adjustments in any patients (Table 2).40This makes the capsaicin 8% topical system particularly favorable for use in complex patient populations, such as those taking multiple medications, those with co-morbid conditions, including hepatic or renal impairment, and those in whom treatment with oral medications that increase the risk of falls and fractures is considered unsuitable.
https://www.ncbi.nlm.nih.gov/pmc/articles/PMC10949339/