Short answer: Capsaicin cream is no longer available in the UK because both licensed products — Axsain (capsaicin 0.075%) and Zacin (capsaicin 0.025%) — have been discontinued. Supply first became intermittent, then collapsed entirely when the manufacturer went into administration. The NHS issued a Medicine Supply Notification confirming there is no licensed capsaicin cream on the UK market, and GPs were advised to move patients on to something else. Unlicensed imports can still be ordered as a special, but lead times are long and the price is high.
If you were using Axsain or Zacin for burning feet, diabetic nerve pain, post-shingles pain or arthritic joints, you have probably already had the awkward conversation at the pharmacy counter — the one where they tell you it is "out of stock", then a few months later stop saying "out of stock" and start saying "discontinued". This page explains exactly what happened, what your options actually are in 2026, and what most people have quietly switched to.
What happened to Axsain and Zacin?
For years the UK had two licensed capsaicin creams, both derived from chilli pepper extract:
- Zacin (capsaicin 0.025%) — licensed for osteoarthritis pain.
- Axsain (capsaicin 0.075%) — the stronger one, licensed for painful diabetic neuropathy and post-herpetic neuralgia (nerve pain after shingles).
The trouble started with intermittent supply. Pharmacies were told stock would return "by the end of the month", then the next month, then the one after. Community pharmacy bulletins were still publishing shortage guidance while patients were being turned away week after week.
Then it stopped being a shortage. The manufacturer entered administration, and both licensed presentations were formally discontinued. That is the crucial distinction most people miss: this was not a clinical decision. Nobody decided capsaicin had stopped working, or that it was unsafe. A company went under, and a treatment that thousands of people depended on went with it.
Is capsaicin cream coming back to the UK?
Possibly — but not soon, and nobody will put a date on it.
At least one UK supplier has said publicly that it hopes to manufacture capsaicin-based creams again, while making clear it is "likely to be some time" because of the legal and regulatory work involved. Bringing a licensed medicine back to market is not a matter of restarting a production line: it means marketing authorisation, manufacturing licences and quality approvals, all of which take years rather than months.
So the honest position in 2026 is this: there is no licensed capsaicin cream you can walk into Boots or Holland & Barrett and buy, there is no confirmed return date, and planning your pain management around one is not realistic.
What about unlicensed imports and "specials"?
Your GP can, in principle, prescribe an unlicensed imported capsaicin cream as a special order. In practice this comes with three problems:
- Lead time. Specials are sourced on demand and can take weeks to arrive.
- Cost. Unlicensed specials are significantly more expensive than the product they replace, and many prescribing formularies discourage them on cost grounds.
- Willingness. Prescribers carry extra responsibility when prescribing unlicensed medicines, so a lot of GPs will simply decline and offer you something else.
You should absolutely ask — but go in expecting to be offered an alternative rather than a replacement.
What are people using instead?
Here is what UK patients are actually being offered, and the honest trade-off with each.
| Option | What it does | The catch |
|---|---|---|
| Oral nerve medication (gabapentin, pregabalin, amitriptyline, duloxetine) | Acts on nerve signalling throughout the body | Systemic. Drowsiness, brain fog, weight gain and dependency are common reasons people stop |
| Lidocaine plasters | Numbs a defined patch of skin | Usually restricted to post-shingles pain; awkward on feet; numbing, not relief |
| Menthol and camphor rubs (Deep Heat, Tiger Balm) | Creates a hot or cold sensation on the skin | Distraction, not treatment. Wears off in under an hour and does nothing for nerve pain |
| NSAID gels (Voltarol, ibuprofen gel) | Reduces local inflammation | Built for joints and muscles. Nerve pain is not an inflammatory problem, so results are usually poor |
| Topical magnesium | Delivers magnesium through the skin to the tissue around the nerve | Most magnesium sprays and oils sit on the skin and sting. Absorption depends entirely on the carrier used |
Why so many people moved to topical magnesium
Capsaicin worked by depleting substance P — repeatedly firing the pain nerve until it ran out of the chemical it uses to signal. That is why it burned before it helped, and why so many people gave up on it in the first fortnight.
Topical magnesium approaches the same nerve from the opposite direction. Rather than exhausting the nerve, it targets the magnesium the nerve needs to hold a stable resting charge. A nerve short of magnesium misfires — and misfiring is what you feel as burning, tingling, pins and needles and shooting pain.
The catch, and it is a big one, is delivery. Magnesium chloride on its own struggles to get past the outer layer of skin, which is why so many magnesium sprays sting, leave a chalky film and do very little. It needs a carrier. MSM (methylsulfonylmethane) is the one that changes the outcome: it increases skin permeability, so the magnesium actually reaches the tissue around the nerve rather than drying on top of it.
That is the formulation logic behind NuraCalm Total Relief — magnesium chloride carried by MSM, with arnica and vitamin B6. No menthol, no capsaicin, no burn. It was built specifically for the people the capsaicin withdrawal left behind, and it is backed by a 90-day money-back guarantee, which matters when you have already wasted money on things that did nothing.
Frequently asked questions
Why is capsaicin cream no longer available in the UK?
Both licensed capsaicin creams, Axsain 0.075% and Zacin 0.025%, were discontinued after their manufacturer went into administration. It was a commercial and supply failure, not a safety withdrawal.
Can I still buy capsaicin cream over the counter in the UK?
No. There is no licensed capsaicin cream on sale in UK pharmacies, including Boots and Holland & Barrett. Products sold online from overseas are unlicensed in the UK and are not quality-assured for the UK market.
Is Zostrix the same as Axsain?
Zostrix is a capsaicin brand sold in other markets, including the US. It is not licensed in the UK, so buying it here means importing an unlicensed product.
What can I use instead of capsaicin cream for nerve pain?
Your GP will usually offer oral nerve medication such as gabapentin, pregabalin or amitriptyline, or lidocaine plasters for post-shingles pain. If you want to stay topical and avoid systemic side effects, magnesium-based creams with an MSM carrier are the closest like-for-like swap.
Will capsaicin cream come back?
A UK supplier has said it hopes to produce capsaicin creams again, but has warned it will take time because of regulatory requirements. There is no confirmed return date.
This article is for general information and is not medical advice. Do not stop or change prescribed medication without speaking to your GP or pharmacist.