Abstract: Objective To observe the therapeutic effects of capsaicin on hypertrophic scar ( HS). Methods 12 patients with hypertrophic scar within 3 months were randomly selected for a double-blind study. Each patient received two treatments, 0.05% capsaicin cream for one area of HS, cream vehicle for adjacent HS. The scores of pruritus and side effects of capsaicin were evaluated. Skin biopsies were collected, routine pathological examination, immunohistochemical staining for substance P and special staining for collagen fiber were also performed. Results Capsaicin definitely has an anti-pruritus effect on HS, which is correlated with the decline of content of substance P in scar tissue. The color, texture, thickness of hypertrophic scar and distribution of collagen fiber in HS tissue seemed to be similar between two groups. Conclusion Capsaicin is a good anti-pruritus drug for HS with no severe side effect, but it does not inhibit hypertrophy of scars.