Local Capsaicin Treatment of the Nasal Mucosa Reduces Symptoms in Patients with Nonallergic Nasal Hyperreactivity

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Abstract
Ten patients with nonallergic nasal hyperreactivity were selected from the outpatient department at the ENT clinic of the Karolinska Hospital. Traditional treatment had been ineffective. Local capsaicin treatment (30 μM solution) was performed on 3 consecutive days after careful nasal decongestion and local anesthesia with naphazoline and lidocaine. The treatment was evaluated using a diary where the patients were asked to score their subjective symptoms of nasal discharge, nasal blockage, and sneezing on a visual analogue scale. At the follow-up, the desensitization to local capsaicin application of the nasal mucosa was also tested. After 1 month the patients reported a 63% and 69% reduction of nasal blockage and nasal discharge respectively, which was parallel to a desensitization of the nasal mucosa to capsaicin. The results were similar after 3 months. After 6 months the patients had reverted to a score similar to that before the treatment. At this time the response of the nasal mucosa to capsaicin was normalized. In conclusion, capsaicin treatment of the nasal mucosa in patients with nonallergic nasal hyperreactivity induces a long-lasting reversible desensitization and a parallel subjective reduction of symptoms.