Correlation between local vascular and sensory changes following tissue inflammation induced by repetitive application of topical capsaicin.

The aim of the present study was to investigate local vascular and sensory changes and their correlation in order to obtain a better understanding of the mechanisms of allodynia, hyperalgesia and vascular changes following tissue inflammation induced by repetitive application of capsaicin cream. This type of application was utilized as a controlled model of inflammation which was altered in intensity due to its repetitive applicability. Ten healthy volunteers participated in two experiments separated by at least five days. Each experiment consisted of a baseline session followed by five additional sessions. Before these sessions either 1.5 g capsaicin (1%) or placebo cream was applied to the volar site of the forearm for 15 min. The areas of stroking allodynia and pin-prick hyperalgesia were mapped and the intensity of spontaneous pain (VAS) was assessed after each application of the cream. In addition, the visible flare, temperature (IR-Thermography), and blood- flow (Laser-Doppler) were measured. The first application of capsaicin was perceived as painful; it induced both secondary hyperalgesia and allodynia. Compared to placebo, the first application of capsaicin cream also resulted in an increased blood-flow, elevated temperature and visible flare. The highest values of these sensory and vascular parameters were reached after the third application. A direct correlation between visible flare, secondary mechanical hyperalgesia and allodynia following repetitive application of capsaicin indicates that both common central and peripheral mechanisms were involved in these changes. Copyright 1998 Elsevier Science B.V.