Purpose: To demonstrate the therapeutic efficacy, the tolerability and the security of 0.025% capsaicin cream in the control of chronic post-herpetic (HZO) trigeminal neuralgia. Patients and methods: A total of 17 patients with chronic post-herpetic neuralgia were treated with capsaicin cream 0.025%. Study population consisted of 11 (64.7%) men and 6 (35.3%) women with a mean age at presentation of 63.8 years (range, 54-76 years). The median follow-up time on therapy was 8.5 months (range, 6-14 months) and the mean number of capsaicin cream applications was 4.6 per week per patient (range, 2-7 applications per week). Results: Thirteen (75.4%) patients experienced significant neuralgia relief. The mean time to achieve partial or total relief of «tic douloureux» (score: 0-2) was 3.2 weeks (range, 1-5 weeks). The most common side effect observed with capsaicin was stinging (31.5%), followed by local burning sensation (26.3%), both of which were experienced immediately after application. Skin erythema accounted for 15.7% of cases, not impending the continuation of therapy. Conclusions: Treatment with 0.025% capsaicin cream resulted to be an efficacious, well tolerated and safe therapeutic alternative for patients with chronic post-herpetic neuralgia.