Christensen JD, Vecchio SL, Andersen HH, et al. - Pretreatment with local anesthetics, such as EMLA (eutectic mixture of lidocaine 2.5% and prilocaine 2.5%), is considered to avert pain linked with 8% capsaicin application. However, contradicting evidence is there concerning the effects of local analgesia on capsaicin-induced desensitization. In session 1, researchers randomized two skin areas in each forearm of 24 healthy volunteers to 2-hour pretreatment with EMLA/placebo cream. Following pretreatment, application of 8% capsaicin patches was done for 3 hours in one placebo and one EMLA pretreated area, yielding the following four areas: Capsaicin+EMLA, Capsaicin+Placebo, EMLA alone, and Placebo. During the 3-h application of capsaicin, assessment of pain intensity scores was done. Measurement of warmth detection, heat pain sensitivity, and micro-vascular reactivity was done following the removal of capsaicin. After 24 hours, in session 2, histamine application was performed in each area to determine itch intensity and neurogenic flare. Irrespective of pretreatment, capsaicin induced heat hyperalgesia immediately following the application. Per findings, normalization of heat pain sensitivity occured 24 h post application. EMLA results in significant decreases in capsaicin-induced pain relative to placebo. EMLA improved capsaicin-induced superficial blood perfusion. Capsaicin lowered the neurogenic flare produced by histamine compared with EMLA. No interference of topical analgesic pretreatment with capsaicin desensitization was observed.