Capsaicin; Chili pepper; Red pepper
Native Americans have used cayenne (Capsicum annuum, frutescens, or red pepper) as both food and medicine for at least 9,000 years. The hot and spicy taste of cayenne pepper is mostly due to a substance known as capsaicin, which helps reduce pain.
Cayenne pepper is an important spice, particularly in Cajun and Creole cooking, and in the cuisines of Southeast Asia, China, Southern Italy, and Mexico. Cayenne has also been used in traditional Indian Ayurvedic, Chinese, Japanese, and Korean medicines as an oral remedy for stomach problems, poor appetite, and circulatory problems. It has also been applied to the skin for arthritis and muscle pain.
Today, ointments and creams with capsaicin are used in the United States and Europe to relieve pain from arthritis and shingles (Herpes zoster). Capsaicin is also a key ingredient in many pepper sprays.
Capsaicin has powerful pain-relieving properties when applied to the skin. It reduces the amount of substance P, a chemical that carries pain messages to the brain, in your body. When there is less substance P, the pain messages no longer reach the brain, and you feel relief. Capsaicin is often recommended for the following conditions:
- Osteoarthritis and rheumatoid arthritis, as well as joint or muscle pain from fibromyalgia or other causes.
- Nerve pain from shingles and other painful skin conditions (postherpetic neuralgia) that happens even after the skin blisters have gone away. Research is mixed. Check with your doctor to see if trying capsaicin ointment is right for you.
- Pain after surgery, such as a mastectomy or an amputation.
- Pain from nerve damage in the feet or legs from diabetes, called diabetic peripheral neuropathy. However, capsaicin doesn't seem to work for peripheral neuropathy from HIV.
- Low back pain. Several studies suggest capsaicin cream can reduce lower back pain.
Capsaicin cream can reduce itching and inflammation from psoriasis, a long-lasting skin disease that generally appears as patches of raised, red skin covered by a flaky white buildup.
A few studies suggest that cayenne supplements may help suppress appetite and help people feel full. But not all studies agree, and many have looked at cayenne or capsaicin combined with other ingredients, making it impossible to tell whether capsaicin itself was responsible for any weight loss. More studies are needed.
- In extremely diluted homeopathic formulations, capsaicin may help treat ear infections (otitis media).
- Preliminary studies suggest that capsaicin may help treat heartburn. More research is needed.
- Capsaicin is being investigated for treating circulatory problems (for example, heart disease from atherosclerosis or plaque blocking the arteries to the heart) and reducing the risk of an irregular heart rhythm.
- Preliminary studies suggest capsaicin has anti-tumor properties and may play a role in the treatment of certain cancers including colon, prostate, and gastrointestinal cancers.
Cayenne is a shrub that originated in Central and South America and now grows in subtropical and tropical climates. Its hollow fruit grows into long pods that turn red, orange, or yellow when they ripen. The fruit is eaten raw or cooked, or it is dried and powdered into a spice that has been used for centuries in meals and medicines.
What is It Made of?
Capsaicin is the most active ingredient in cayenne. Other important ingredients include vitamins A and C, and flavonoids and carotenoids, pigments that give red, yellow, and orange plants their color and have antioxidant properties.
As a spice, cayenne may be eaten raw or cooked. Dried cayenne pepper is available in powdered form, and you can add it to food, or stir it into juice, tea, or milk. It is also available in capsule form or in creams for external use. Creams should contain at least 0.075% capsaicin.
How to take it
DO NOT apply capsaicin cream to cracked skin or open wounds.
DO NOT give cayenne to children under 2. However, with caution, capsaicin ointment may be used on the skin for older children. DO NOT use topical cayenne ointments for more than 2 days in a row for a child.
Speak to your health care provider regarding dosing instructions.
The use of herbs is a time-honored approach to strengthening the body and treating disease. But herbs can trigger side effects and interact with other herbs, supplements, or medications. For these reasons, you should take herbs under the supervision of a health care provider.
Cayenne does not dissolve easily in water, so it is hard to wash off. Use vinegar to get it off the skin. Capsaicin cream may cause an itching, burning sensation on the skin. These symptoms tend to go away quickly. Test capsaicin cream on a small area of your skin before extended use. If it causes irritation, or if your symptoms do not get better after 2 to 4 weeks, stop using it.
DO NOT use capsaicin with a heating pad, and DO NOT apply capsaicin cream immediately before or after a hot shower. After using capsaicin, wash your hands well and avoid touching your eyes. If you are using cayenne around children, make sure they wash their hands thoroughly after handling cayenne and DO NOT touch their eyes or nose.
Capsaicin capsules may cause stomach irritation. People with ulcers or heartburn should talk to their provider before using capsaicin. Eating too much capsaicin could cause stomach pain.
People who are allergic to latex, bananas, kiwi, chestnuts, and avocado may also have an allergy to cayenne.
Eating cayenne in food is considered safe during pregnancy. But pregnant women should not take cayenne as a supplement. Cayenne does pass into breast milk, so nursing mothers should avoid cayenne as a supplement.
Capsaicin may make some of the dangerous side effects of cocaine worse.
DO NOT use capsaicin on open wounds or broken skin.
If you are currently being treated with any of the following medications, you should not use cayenne supplements without first talking to your doctor.
ACE inhibitors: Using capsaicin cream may raise the risk of developing a cough, which is one of the side effects of ACE inhibitors. These medications are used to treat high blood pressure (hypertension). People who take ACE inhibitors should talk to their doctor before taking cayenne. ACE inhibitors include:
- Captopril (Capoten)
- Elaropril (Vasotec)
- Fosinopril (Monopril)
- Lisinopril (Zestril)
Stomach acid reducers: Capsaicin can increase stomach acid, making these drugs less effective. These drugs include:
- Cimetidine (Tagamet)
- Esomeprazole (Nexium)
- Famotidine (Pepcid)
- Omeprazole (Prilosec)
- Ranitidine (Zantac)
- Over-the-counter drugs such as Maalox, Rolaids, Tums
- Nonprescription versions of Tagamet, Pepcid, Zantac, and Prilosec
Aspirin: Capsaicin may make aspirin less effective as a pain reliever. It may also increase the risk of bleeding associated with aspirin.
Blood-thinning medications and herbs: Capsaicin may increase the risk of bleeding associated with certain blood-thinning medications such as warfarin (Coumadin), clopidogrel (Plavix), and herbs such as ginkgo, ginger, ginseng, and garlic.
Medications for diabetes: Capsaicin lowers blood sugar levels, raising the risk of low blood sugar (hypoglycemia). If you have diabetes, ask your doctor before using capsaicin.
Theophylline: Regular use of cayenne may cause your body to absorb too much theophylline, which is a medication used to treat asthma. This could be dangerous.
Ahuja KD, Robertson IK, Geraghty DP, Ball MJ. Effects of chilli consumption on postprandial glucose, insulin, and energy metabolism. Am J Clin Nutr. 2006;84(1):63-69.
Ahuja KD, Ball MJ. Effects of daily ingestion of chilli on serum lipoprotein oxidation in adult men and women. Br J Nutr. 2006;96(2):239-242.
Ahuja KD, Robertson IK, Geraghty DP, Ball MJ. The effect of 4-week chilli supplementation on metabolic and arterial function in humans. Eur J Clin Nutr. 2007;61(3):326-333.
Allison DB, Fontaine KR, Heshka S, Mentore JL, Heymsfield SB. Alternative treatments for weight loss: a critical review. Crit Rev Food Sci Nutr. 2001;41(1):1-28; discussion 39-40.
Attal N. Chronic neuropathic pain: mechanisms and treatment [Review]. Clin J Pain. 2000;16(3 Suppl):S118-S130.
Bouraoui A, Toumi A, Mustapha HB, et al. Effects of capsicum fruit on theophylline absorption and bioavailability in rabbits. Drug-Nutrient Interact. 1988;5:345-350.
Chrubasik S, Weiser T, Beime B. Effectiveness and safety of topical capsaicin cream in the treatment of chronic soft tissue pain. Phytother Res. 2010 Dec;24(12):1877-1885.
D'Alonzo AJ, Grover GJ, Darbenzio RB, et al. In vitro effects of capsaicin: antiarrhythmic and antiischemic activity. Eur J Pharmacol. 1995;272(2-3):269-278.
Deal CL, Schnitzer TJ, Lipstein E, et al. Treatment of arthritis with topical capsaicin: a double-blind trial. Clin Ther. 1991;13(3):383-395.
Ellison N, Loprinzi CL, Kugler J, et al. Phase III placebo-controlled trial of capsaicin cream in the management of surgical neuropathic pain in cancer patients. J Clin Oncol. 1997;15(8):2974-2980.
Friese KH. Acute otitis media in children: a comparison of conventional and homeopathic treatment. Biomedical Therapy. 1997;15(4):462-466.
Fusco BM, Marabini S, Maggi CA, Fiore G, Geppetti P. Preventative effect of repeated nasal applications of capsaicin in cluster headache. Pain. 1994;59(3):321-325.
Gagnier JJ, van Tulder M, Berman B, Bombardier C. Herbal medicine for low back pain. Cochrane Database Syst Rev. [Review]. 2006 Apr 19;(2):CD004504.
Hakas JF Jr. Topical capsaicin induces cough in patient receiving ACE inhibitor. Ann Allergy. 1990;65:322.
Hautkappe M, Roizen MF, Toledano A, Roth S, Jeffries JA, Ostermeier AM. Review of the effectiveness of capsaicin for painful cutaneous disorders and neural dysfunction. [Review]. Clin J Pain. 1998;14(2):97-106.
Heck AM, DeWitt BA, Lukes AL. Potential interactions between alternative therapies and warfarin. [Review]. Am J Health Syst Pharm. 2000;57(13):1221-1227.
Jensen PG, Larson JR. Management of painful diabetic neuropathy [Review]. Drugs Aging. 2001;18(10):737-749.
Jin J, Lin G, Huang H, et al. Capsaicin mediates cell cycle arrest and apoptosis in human colon cancer cells via stabilizing and activating p53. Int J Biol Sci. 2014;10(3):285-95.
Kang JH, Goto T, Han IS, Kawada T, Kim YM, Yu R. Dietary capsaicin reduces obesity-induced insulin resistance and hepatic steatosis in obese mice fed a high-fat diet. Obesity (Silver Spring). 2010 Apr;18(4):780-787.
Kenney JK, Jamjian C, Wheeler MM. Prevention and management of pain associated with Herpes zoster. Journal of Pharmaceutical Care in Pain and Symptom Control. 1999;7(3):7-26.
Laslett LL, Jones G. Capsaicin for osteoarthritis pain. Prog Drug Res. 2014;68:277-91.
Leung FW. Capsaicin as an anti-obesity drug. Prog Drug Res. 2014;68:171-9.
Mozsik G. Capsaicin as new orally applicable gastroprotective and therapeutic drug alone or in combination with nosteroidal anti-inflammatory drugs in healthy human subjects and in patients. Prog Drug Res. 2014;68:209-58.
Nicholas JJ. Physical modalities in rheumatological rehabilitation. Archives of Physical and Medical Rehabilitation. 1994;75(9):994-1001.
Paice JA, Ferrens CE, Lashley FR, Shott S, Vizgirda V, Pitrak D. Topical capsaicin in the management of HIV-associated peripheral neuropathy. J Pain Symtom Manage. 2000;19(1):45-52.
Petersen KL, Fields HL, Brennum J, Sandroni P, Rowbotham MC. Capsaicin evoked pain and allodynia in post-herpetic neuralgia. Pain. 2000;88:125-133.
Rains C, Bryson HM. Topical Capsaicin. A review of its pharmacological properties and therapeutic potential in post-herpetic neuralgia, diabetic neuropathy and osteoarthritis. Drugs and Aging. 1998;7(4):317-328.
Reinbach HC, Smeets A, Martinussen T, Møller P, Westerterp-Plantenga MS. Effects of capsaicin, green tea and CH-19 sweet pepper on appetite and energy intake in humans in negative and positive energy balance. Clin Nutr. 2009 Jun;28(3):260-265.
Robbins W. Clinical applications of capsaicinoids [Review]. Clin J Pain. 2000;16(2 Suppl):S86-S89.
Sharma SK, Vij AS, Sharma M. Mechanisms and clinical uses of capsaicin. Eur J Pharmacol. 2013;720(1-3):55-62.
Stam C, Bonnet MS, van Haselen RA. The efficacy and safety of a homeopathic gel in the treatment of acute low back pain: a multi-centre, randomised, double-blind comparative clinical trial. Br Homeopath J. 2001;90(1):21-28.
Stander S, Luger T, Metze D. Treatment of prurigo nodularis with topical capsaicin. J Am Acad Dermatol. 2001;44(3):471-478.
Stankus SJ, Dlugopolski M, Packer D. Management of herpes zoster (shingles) and postherpetic neuralgia. [Review]. Am Fam Physician. 2000;61(8):2437-44, 2447-2448.
Volmink J, Lancaster T, Gray S, Silagy C. Treatments for postherpetic neuralgia--a systematic review of randomized controlled trials. Fam Pract. 1996;13(1):84-91.
Yeoh KG, Kang JY, Yap I, et al. Chili protects against aspirin-induced gastroduodenal mucosal injury in humans. Dig Dis Sci. 1995;40:580-583.
Yoshioka M, St-Pierre S, Suzuki M, Tremblay A. Effects of red pepper added to high-fat and high-carbohydrate meals on energy metabolism and substrate utilization in Japanese women. Br J Nutr. 1998;80(6):503-510.
Zhang WY, Li Wan Po A. The effectiveness of topically applied capsaicin. Eur J Clin Pharmacol. 1994;46:517-522.