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Qutenza - the 8% capsaicin patch, done properly.

A licensed, clinic-applied high-strength capsaicin cutaneous patch - what it is, how it works and where it fits in modern UK neuropathic pain guidance. Delivered by a pain physician on a dedicated Qutenza list.

See indicative pricing
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Indicative pricing

What private Qutenza costs in the UK.

Indicative ranges across our partner pain units. Cost scales with patch count.

In short

£1,600–£2,300, in-clinic time 2–3 hours.

TreatmentIndicative range
Qutenza - single treatment (1 patch, small area) £1,100–£1,650
Qutenza - single treatment (2 patches) £1,600–£2,300
Qutenza - single treatment (3–4 patches, larger area) £2,200–£3,200
Qutenza - repeat cycle at 90 days £1,100–£3,000
Consultation only (assessment for Qutenza) £250–£450
Skin biopsy for small-fibre neuropathy (if needed) £600–£1,100

Cost is dominated by the patch itself and clinic nurse time.

The problem

A defined medicine, applied to the wrong indication, is still the wrong medicine.

Qutenza gets misused two ways in UK private practice - applied for pain that is not truly cutaneous neuropathic, or applied by clinics without the proper protocol. We fix both.

  • Match the medicine to the mechanism

    Qutenza works on TRPV1-bearing skin nociceptors. Deep somatic pain and central pain do not respond - even if a clinic offers it.

  • Apply to intact skin, on protocol

    60 minutes on the feet, 30 minutes elsewhere, with the correct cleansing gel. Off-protocol application undermines both safety and effect.

  • Plan the repeat before the first treatment

    A single cycle rarely settles chronic neuropathic pain. Success comes with planned 90-day repeats and a broader medication plan.

When it helps

When Qutenza is the right step.

The licensed and off-label indications where Qutenza has the strongest evidence - plus the one red flag that means Qutenza is not for that skin.

  • Post-herpetic neuralgia (PHN)

    The original licensed indication - persistent pain in a healed shingles distribution, particularly thoracic.

  • Painful diabetic peripheral neuropathy

    Licensed since 2020 in the EU/UK for painful diabetic peripheral neuropathy of the feet in adults.

  • HIV-associated distal sensory polyneuropathy

    A recognised indication in specialist HIV pain services - burning feet from ART-related neurotoxicity.

  • Post-surgical neuropathic pain

    Off-label but well-established use in chronic post-thoracotomy, post-mastectomy and post-hernia repair neuropathic pain.

  • Chemotherapy-induced peripheral neuropathy

    A growing evidence base for CIPN of the feet - often alongside neuropathic drugs and physiotherapy.

  • Localised neuropathic pain with allodynia

    Best suited to focal, cutaneous neuropathic pain with mechanical allodynia (light touch causes pain).

  • Failed oral neuropathic drug ladder

    When gabapentinoids, TCAs and SNRIs have failed or caused unacceptable side effects - Qutenza offers a systemic-side-effect-free option.

  • Red flag: application on damaged skin

    Qutenza must never be applied to broken, ulcerated or actively inflamed skin, or on the face. Systemic capsaicin absorption is a real risk.

Product detail

Exactly what Qutenza is, and how it is used.

Formulation, mechanism, application technique, UK licensing and where Qutenza sits in the guidance.

  • What Qutenza actually is

    A cutaneous patch containing 179 mg of 8% capsaicin - around 100 times stronger than any over-the-counter capsaicin cream. A single-use, dermatologist-strength medicine.

  • Mechanism - TRPV1 defunctionalisation

    High-dose capsaicin overstimulates the TRPV1 receptor on nociceptive C-fibres, causing reversible retraction of epidermal nerve endings. Skin nerve density recovers over weeks; analgesia lasts 8 to 12 weeks.

  • Formulation and packaging

    A 14 cm × 20 cm patch (280 cm²), a cleansing gel and application gloves. Applied intact to dry skin, then removed cleanly by the trained clinician.

  • Application time by site

    Feet - 60 minutes contact time. All other sites (trunk, shoulders, thighs) - 30 minutes contact time. Cutting to fit is permitted.

  • Pre-treatment options

    Topical lidocaine 4% or eutectic anaesthetic cream for 60 minutes, oral analgesia, or (in some units) no pre-treatment with careful application. Local cooling helps during and after.

  • UK licensing status

    Licensed in the UK for peripheral neuropathic pain in non-diabetic adults (PHN and other) since 2010, and specifically for painful diabetic peripheral neuropathy of the feet since 2020.

  • Where it sits in the guidance

    NICE CG173 lists topical capsaicin as a treatment for localised neuropathic pain in adults intolerant of oral therapy. UK pain societies place Qutenza third-line for PHN and second-line for painful DPN in the right patient.

  • What it is not

    Not an over-the-counter capsaicin cream. Not a general analgesic. Not for children under 18. Not for the face, scalp or genital region - application there is contraindicated.

Safety and recovery

What to expect afterwards - honestly.

Qutenza has a well-mapped safety profile when used to protocol. The things worth planning are application-day analgesia, blood pressure monitoring and a repeat cycle at 90 days.

  • Application-site pain and burning

    Universal during application and for 24 to 72 hours after. Pre-treatment analgesia and cool packs help. This is expected, not a side effect.

  • Erythema, oedema, itch

    Redness and mild swelling at the site for 3 to 7 days. Simple emollients and antihistamines help. Skin returns to normal in under a week in most.

  • Blood pressure rise during application

    A transient rise driven by application pain. Blood pressure is monitored during and after, and treatment is adjusted for pre-existing uncontrolled hypertension.

  • Systemic capsaicin risk

    Very low when applied to intact skin for the licensed contact time. Higher if applied to broken skin - one reason it is a clinic-only medicine.

  • Facial and eye irritation

    Vapour from an applied patch is a mucosal irritant. Do not touch the face during or after application; wear gloves at removal.

  • Effect size - realistic expectations

    About 40 to 55 percent of patients get a 30 percent or greater pain reduction lasting 8 to 12 weeks. Not a cure - a useful pillar within a broader neuropathic pain plan.

  • Repeat schedule

    A single cycle can be repeated at 90-day intervals. Response often improves with a second treatment. Long-term repeat use is well tolerated in the licensed indications.

  • Contraindications

    Broken or infected skin, active inflammatory dermatoses at the target site, uncontrolled hypertension, pregnancy and breastfeeding, and use on the face or scalp.

  • Red flags after treatment

    Blistering, spreading rash, sustained BP over 180/110, chest pain or breathlessness need same-day medical review - not a routine call.

Reading your treatment record

Your Qutenza record in four parts. Read the last one first.

Whichever indication and area, the record the clinic sends you keeps to the same shape.

A UK consultant pain physician reviewing a Qutenza treatment record

A quiet reminder

Pain-clinic records can read coldly - we translate them for you.

If you would like us to talk you through the record and the repeat plan, just ask.

  1. 01 Header

    Indication, area treated, patch count

    The licensed or off-label indication, target skin area (with photograph), number of patches used and total treated cm².

  2. 02 Technique

    Pre-treatment, contact time, monitoring

    Any pre-treatment used, exact contact time (30 or 60 minutes), and BP measurements during and after application.

  3. 03 Findings

    Skin reaction and tolerability

    Recorded erythema, oedema, patient-reported peak pain on the visual analogue scale, and use of rescue analgesia.

  4. 04 Impression

    Aftercare, review, repeat at 90 days

    Read this first: your at-home care instructions, telephone review at 4 weeks and criteria for a repeat cycle at 90 days.

Recognised by major UK insurers

BupaAXA HealthVitalityAvivaWPACignaHealixBupaAXA HealthVitalityAvivaWPACignaHealixBupaAXA HealthVitalityAvivaWPACignaHealix

Qutenza cover varies by policy and licensed indication. PHN and painful diabetic peripheral neuropathy of the feet are usually covered; off-label uses may need prior authorisation.

Frequently asked

Everything we get asked about Qutenza.

Quick answers on what it is, how it compares with lidocaine, cost, licensing and safety.

  • What exactly is Qutenza?

    Qutenza is a prescription-only 8% capsaicin cutaneous patch used by pain clinics to treat certain peripheral neuropathic pains. It contains around 100 times the capsaicin of an over-the-counter cream and is not comparable to any home product. Because of that strength, application is a clinic procedure - the patch is placed by trained staff, worn for a defined time (60 minutes on the feet, 30 minutes elsewhere), then removed with a cleansing gel.

  • How is it different from a lidocaine 5% patch?

    Lidocaine 5% is a self-applied medicated plaster worn for 12 hours a day that blocks sodium channels - modest analgesia while worn. Qutenza is a one-off high-strength capsaicin exposure that quietens the pain fibres themselves for 8 to 12 weeks. Different mechanism, different setting, different follow-up. The two are complementary, not competitors.

  • What conditions is it licensed for in the UK?

    The UK licence covers peripheral neuropathic pain in non-diabetic adults (initially post-herpetic neuralgia and other cases from 2010) and painful diabetic peripheral neuropathy of the feet in adults (added in 2020). It is also used off-label in HIV-associated distal sensory polyneuropathy and chronic post-surgical neuropathic pain, where evidence supports its effect.

  • Where can it not be used?

    Not on broken, inflamed or infected skin. Not on the face, scalp or genital region. Not in pregnancy or breastfeeding. Not in uncontrolled hypertension - a transient BP rise during application makes that unsafe. Not in children under 18. Any of those situations means a different pain strategy.

  • How much does private Qutenza cost in the UK?

    Roughly £1,100 to £1,650 for a small single-patch treatment, £1,600 to £2,300 for two patches, and £2,200 to £3,200 for larger areas needing three or four patches. A repeat cycle at 90 days is priced similarly.

  • How quickly does it work and how long does it last?

    Analgesia builds over 1 to 2 weeks after application and typically lasts 8 to 12 weeks. About 40 to 55 percent of patients get a 30 percent or greater pain reduction, and response often improves with a second treatment. It is not a cure, but a durable pillar within a broader neuropathic pain plan.

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