The patch itself is on for 60 minutes if you are being treated for postherpetic neuralgia, or 30 minutes if it is being applied to the feet for diabetic peripheral neuropathy.1 Around that, expect skin marking and preparation, an optional topical anesthetic beforehand, and blood pressure monitoring during and after the application. The whole visit runs considerably longer than the patch time.
Qutenza is applied by a clinician in the office. The label states plainly that it is not to be dispensed to patients for self-administration or handling, and that only physicians or health care professionals are to administer it.1
What Qutenza is approved for, and what we confirm first
Qutenza is indicated in adults for the treatment of neuropathic pain associated with postherpetic neuralgia and for neuropathic pain associated with diabetic peripheral neuropathy of the feet.1 It is a TRPV1 channel agonist, not a general-purpose neuropathy patch.
Use for any other neuropathy driver — chemotherapy-related, nutritional, autoimmune, toxic or idiopathic — is off-label. If it is proposed for one of those, that should be stated to you as an off-label decision before anything is applied.
Why the driver is established before the patch is considered
Peripheral neuropathy is primarily diagnosed clinically, through history and neurological assessment of small fiber sensation, large fiber sensation and ulceration risk.2 Neuropathy is a category rather than a diagnosis, so the first part of the visit is establishing which driver is producing your pain and whether the distribution matches an approved indication.
Regenerve performs electrodiagnostic testing (EMG/NCS) on site. Nerve conduction studies are indicated where there are atypical clinical features such as rapid symptom onset, severe neuromotor impairment or asymmetrically abnormal sensation.2 If your history includes shingles, the relevant background is on our page about postherpetic neuralgia and shingles nerve pain.
Before the patch: marking, preparation and the optional anesthetic
The treatment area — the painful area, including regions of hypersensitivity and allodynia — is identified by a physician and marked on the skin.1 Hair may be clipped, not shaved, to help the patch adhere, and the area is washed with mild soap and water and dried thoroughly.1
Pretreatment with a topical anesthetic is optional under the label. Where it is used, it is applied to the whole treatment area plus 1 to 2 cm around it and kept in place until the skin is anesthetized, then wiped off and the area washed again before the patch goes on.1 There is no fixed numbing time; it runs until the skin is ready.
What to bring
- Your current medication list, including pain medicines and supplements.
- Any history of reaction to topical agents.
- Your blood pressure history, particularly if it is unstable or poorly controlled.
During the application
The patch is placed on the marked area and smoothed onto the skin. For diabetic peripheral neuropathy it can be wrapped around the dorsal, lateral and plantar surfaces of each foot to cover the treatment area completely.1 A dressing such as rolled gauze may be used to maintain contact. You are asked not to touch the patch or the treated area.
The recommended dose is up to four topical systems: 60 minutes for postherpetic neuralgia, 30 minutes on the feet for diabetic peripheral neuropathy.1
What it feels like
Expect burning and warmth in the treated field. The label is direct about this: even after a local anesthetic is used, patients may experience substantial procedural pain and burning during application and after removal, and clinicians are told to be prepared to treat that acute pain with local cooling or appropriate analgesic medication.1
Tell the clinician immediately if you feel dizzy or otherwise unwell during the application rather than waiting for the timer to finish.
Blood pressure monitoring
In clinical trials, transient increases in blood pressure occurred during or shortly after exposure to Qutenza. The changes averaged less than 10 mm Hg, though some patients had larger increases, and the changes lasted approximately two hours after removal.1 Blood pressure is monitored periodically during and following the procedure for that reason.
Application-site reactions
Across all controlled clinical trials, the most common adverse reactions occurring in at least 5% of treated patients and more often than in controls were application site erythema, application site pain and application site pruritus.1 In the postherpetic neuralgia trials, application site erythema occurred in 63% of patients treated with Qutenza compared with 54% of controls, and application site pain in 42% compared with 21%.1
After the patch comes off
The patch is removed slowly by rolling it inward, and cleansing gel is applied to the treated area and wiped off with dry gauze. Patients are advised that the treated area may be sensitive for a few days to heat — hot showers or baths, direct sunlight and vigorous exercise.1
Contact the clinic if you develop anything beyond expected local sensitivity. The label carries specific warnings about severe application site burns and about reductions in sensory function, which are generally minor and temporary but are assessed before each subsequent application.1
How often it can be repeated
Treatment may be repeated every three months, or as warranted by the return of pain, and not more frequently than every three months.1 That is a ceiling on frequency, not a promise about how long relief lasts, and how long any individual patient goes between applications varies.
Where the patch sits in a larger plan
Qutenza acts locally on the pain signal in the treated skin. It does not address whatever is injuring the nerve, which is why the application is scheduled alongside driver-directed work rather than instead of it.
That work at Regenerve can include class 4 photobiomodulation, class 3B cold laser, whole-body infrared, and metabolic and nutritional care, chosen against the driver identified during evaluation. Orthobiologic injections (PRP and BMAC) are offered. Where balance or dizziness is part of the picture, VNG (videonystagmography) may be used as a diagnostic test of inner-ear balance function; it is not a treatment.
Patch specifications
Each Qutenza topical system is 14 cm x 20 cm (280 cm²) and contains 8% capsaicin, 640 mcg per cm², for a total of 179 mg of capsaicin per system — 8% in the adhesive, 80 mg per gram of adhesive.1 It can be cut before the release liner is removed to match the size and shape of the treatment area.1
Being evaluated in St. Louis
Regenerve is at 4477 Woodson Rd #104, St. Louis, MO 63134, minutes from St. Louis Lambert International Airport, and is led by Dr. Gurpreet Singh Padda, MD, MBA, MHP. The practice serves the St. Louis region, Missouri and Illinois.
Call or text (314) 886-5902, or email info@regenerve.com. Office hours are Monday through Thursday 9:00 to 16:00 and Friday 9:00 to 13:30.
Before scheduling anything, the Nerve Damage Score is a free five-question assessment that helps identify which driver is behind your symptoms and whether an approved indication is even in play.
Frequently asked questions
How long does the Qutenza patch stay on?
Sixty minutes for postherpetic neuralgia, and 30 minutes when applied to the feet for diabetic peripheral neuropathy, using up to four topical systems. The visit itself runs longer because of marking, optional anesthetic time, removal, cleansing and monitoring. See our Qutenza capsaicin 8% patch page.
How often can Qutenza be repeated?
Every three months, or as warranted by the return of pain, and not more frequently than every three months. Whether a repeat application is appropriate depends on your response and on whether your diagnosis still fits the approved indication. See diabetic peripheral neuropathy treatment in St. Louis.
What side effects are common?
Application site erythema, application site pain and application site pruritus are the most common reactions across controlled trials, and transient blood pressure increases averaging less than 10 mm Hg were seen during and shortly after treatment. That is why blood pressure is checked during the visit. See our neuropathy treatment FAQ.
Is Qutenza used for small fiber or idiopathic neuropathy?
Not within the approved indication. Qutenza is labeled for adults with neuropathic pain from postherpetic neuralgia and from diabetic peripheral neuropathy of the feet; any other driver is an off-label use and should be described that way. See small fiber neuropathy symptoms and testing.
Can I get the patch to use at home?
No. The label states that Qutenza is not to be dispensed to patients for self-administration or handling, and that only physicians or health care professionals administer it. Unintended capsaicin exposure can cause severe irritation of the eyes, mucous membranes, airway and skin. See the hidden drivers of peripheral neuropathy.
Sources
- Averitas Pharma, Inc. QUTENZA (capsaicin) topical system — full prescribing information. Updated July 2026. DailyMed
- Bodman MA, Dreyer MA, Varacallo MA. Diabetic Peripheral Neuropathy. StatPearls. StatPearls Publishing. 2024. NCBI Bookshelf NBK442009