Chronic pruritic skin lesions are considered to be one of the late complications of
sulfur mustard exposure. The purpose of this study was to compare the efficacy of topical
capsaicin with that of
betamethasone in the treatment of these lesions. In this investigator-blinded, randomized clinical trial, patients applied
capsaicin cream 0.025% (n=32) or
betamethasone cream 0.1% (n=32) 2 times a day for 6 weeks. Efficacy was based on a dermatologist assessment. The severity of the
pruritus was assessed by pruritic score questionnaire and a visual analog scale before and
after treatment. All patients complained of
pruritus. Both groups showed a significant decrease in
pruritus, scaling, and skin dryness (p<0.05), but burning sensation was not improved significantly in the
capsaicin group. The mean (+/- standard deviation [SD]) baseline pruritic scores in the
capsaicin and
betamethasone groups were 29.4 (13.1) and 33.6 (7.2), respectively (p=0.1). The mean (SD)
pruritus score change from baseline to after the treatment was significantly higher (p<0.001) in the
betamethasone group than in the
capsaicin group, 12.7 (6.4) vs. 6.9 (5.6). Fourteen (35%) patients in the
capsaicin group reported a burning sensation and intolerable odor, but these effects were not serious enough to necessitate discontinuing the treatment. Topical
capsaicin cream 0.025% was much less well tolerated than
betamethasone and inferior to
betamethasone in reducing chronic skin lesions and symptoms from
sulfur mustard exposure.