Native Americans have used cayenne (or red pepper) as both food and medicine
for at least 9,000 years. The hot and spicy taste of cayenne pepper is primarily
due to an ingredient known as capsaicin. Although it tastes hot, capsaicin
actually stimulates a region of the brain that lowers body temperature. In fact,
many people in subtropical and tropical climates consume cayenne pepper
regularly because it helps them tolerate the heat.
The popularity of cayenne pepper has spread throughout the world, and it has
become an important spice, particularly in Cajun and Creole cooking, and in the
cuisines of Southeast Asia, China, Southern Italy, and Mexico. As well as being
an important spice in many ethnic cuisines, cayenne has also been used in
traditional Indian Ayurvedic, Chinese, Japanese, and Korean medicines as a
remedy for digestive problems, appetite stimulation, muscle pain, and frostbite.
Today, topical preparations of cayenne are used in the United States and Europe
primarily to relieve pain associated with certain conditions such as arthritis,
shingles (Herpes zoster), and cancer. Capsaicin is also a key ingredient in many
personal defense sprays.
Capsaicin in cayenne pepper has very powerful pain-relieving properties when
applied to the surface of the skin. Laboratory studies have found that capsaicin
relieves pain by destroying a chemical known as substance P that normally
carries pain messages to the brain. This appears to be true when applied
topically for the following conditions:
Osteoarthritis and Rheumatoid arthritis, as well as joint or
muscle pain from other causes.
Shingles and other painful skin conditions; pain from shingles
can continue to recur even after the skin blisters have disappeared. Capsaicin
may help this latter pain, which is called post-herpetic neuralgia, as well, but
not all studies agree and the research is somewhat limited. Whether your
post-herpetic neuralgia improves or disappears using capsaicin may be very
individual. Check with your healthcare provider to see it is safe and
appropriate for you to try this topical treatment.
Following surgery from, for example, a mastectomy (breast
removal for breast cancer) or pain after an amputation.
Chronic headaches, including Cluster headaches (a severe
one-sided headache that tends to occur in clusters, happening repeatedly every
day at the same time for possibly several weeks); for this purpose the capsaicin
is placed inside the nose.
Pain from Peripheral Neuropathy (nerve damage experienced in
the feet and/or legs) due to diabetes; peripheral neuropathy pain from human
immunodeficiency virus (HIV), however, does not seemed to be relieved from
Low back pain: Homeopathic gels of capsaicin are available for
this purpose. Capsaicin, however, is not generally considered a first-line
homeopathic remedy for low back pain because other homeopathic remedies have
fewer side effects.
Capsaicin cream can reduce itching and inflammation associated with psoriasis
(a chronic skin disease that generally appears as patches of raised red skin
covered by a flaky white buildup).
Capsaicin is also considered a thermogenic substance, which means that it
allows you to burn more calories from food, particularly when eating a high fat
meal. For this reason, some weight loss supplements contain capsaicin. There are
no studies examining the safety and effectiveness of capsaicin for helping
people lose weight, however.
Capsaicin as a homeopathic remedy has been compared to standard treatment of
ear infections (otitis media) and has shown promise.
Early evidence is encouraging regarding the possible use of capsaicin for
Capsaicin is under investigation for the possible use to help treat cystitis
Very preliminary test-tube and animal studies suggest that capsaicin may have
some value in improving blood flow to the heart (for example, in the case of
heart disease from atherosclerosis [plaque] blocking the arteries to the heart)
and reducing risk of an irregular heart rhythm.
More research is needed in all of these areas, particularly heart disease,
before determining if cayenne has any value for these conditions.
Cayenne is a shrub that grows in subtropical and tropical climates. Its fruit
grows into long pods that turn red, orange, or yellow when they ripen. The fruit
is eaten raw or cooked, or is dried and powdered into the spice that has been
used for centuries in certain meals and medicines.
What's It Made Of?
Capsaicin is the most active ingredient in cayenne, but other important
ingredients include carotenoids, vitamins A and C, and flavonoids.
Cayenne may be eaten raw or cooked. Dried cayenne pepper is available in
powdered form, and may be added to food, stirred into juice, tea, or milk. It is
also available in capsule form or as creams for external use (should contain at
least 0.02% capsaicin).
How to Take It
Topical capsaicin should not be applied to cracks or open sores because this
could cause a burning sensation.
Cayenne should not be used by children under two years of age. However,
cayenne may be used externally in older children as an ointment (standardized to
contain 0.02% to 0.05% capsaicin) for the treatment of muscle pain and as a
deterrent for thumb sucking. Topical cayenne ointments should not be used for
more than two consecutive days in children.
For shingles, psoriasis, arthritis, or toothache: Capsaicin cream (0.025 to
0.075% capsaicin) may be applied directly to the affected area up to four times
a day. May cause some initial burning or itching, but these symptoms should
disappear quickly. Because cayenne works by first stimulating and then
decreasing the intensity of pain in the body, the pain may increase slightly at
first, but then should diminish greatly over the next few days. It usually takes
between 3 and 7 days before noticeable pain relief begins.
For digestive problems: Capsaicin may be taken in capsules (30 to 120 mg,
three times daily), or as an infusion (a tea) by adding 1/4 to 1/2 tsp of powder
to a cup of boiling water.
The use of herbs is a time-honored approach to strengthening the body and
treating disease. Herbs, however, contain active substances that can trigger
side effects and that can interact with other herbs, supplements, or
medications. For these reasons, herbs should be taken with care, under the
supervision of a practitioner knowledgeable in the field of botanical
Wash hands well after use and avoid touching the eyes. Cayenne does not
dissolve easily in water, so vinegar should be used to remove this substance
from the skin. Capsaicin cream may cause an itching, burning sensation on the
skin, but these symptoms tend to subside quickly. It is best to test capsaicin
cream on a small area of the skin before extended use. If it causes irritation,
or if symptoms do not resolve after 2 to 4 weeks, discontinue use. Do not to use
capsaicin with a heating pad and do not to apply capsaicin cream immediately
before or after hot showers.
Capsaicin capsules may cause stomach irritation.
People who are allergic to latex, bananas, kiwi, chestnuts, and avocado may
also have an allergy to peppers.
It is considered safe for use during pregnancy, but it is not known whether
the spicy compounds are transferred through breastfeeding. For this reason,
nursing mothers should be very cautious about using
If you are currently being treated with any of the following medications, you
should not use cayenne preparations without first talking to your healthcare
ACE-Inhibitors Using capsaicin cream on the skin may increase
the risk of cough associated with angiotensin-converting enzyme (ACE)
inhibitors, medications used to regulate blood pressure including captopril,
enalapril, and lisinopril. If individuals using capsaicin cream while on these
medications develop a cough, use of the cream should be discontinued.
Aspirin One study found that capsaicin (when taken together
with aspirin) reduced irritation and damage to the stomach normally associated
with this medication.
Blood-thinning medications and herbs In theory, capsaicin may
increase the risk of bleeding associated with certain blood-thinning medications
(such as warfarin and low molecular weight heparin) and herbs (such as ginkgo
and garlic). However, this theory has not been tested. Until more information is
available, extreme care should be taken if considering use of capsaicin when on
a blood thinning medication, in a class known as anticoagulants, or blood
Theophylline Regular use of cayenne may increase the
absorption of theophylline, a medication used to treat asthma, thereby
increasing the risk of toxicity associated with this medication.
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Review Date: April 2002
Reviewed By: Participants in the review process include: Shiva Barton, ND (April 1999),
Wellspace, Cambridge, MA; Jacqueline A. Hart, MD, Department of Internal
Medicine, Newton-Wellesley Hospital, Harvard University and Senior Medical
Editor Integrative Medicine, Boston, MA; Gary Kracoff, RPh (Pediatric Dosing
section February 2001), Johnson Drugs, Natick, MA; Steven Ottariono, RPh,
Veteran's Administrative Hospital, Londonderry, NH; David Winston, Herbalist
(April 1999), Herbalist and Alchemist, Inc., Washington, NJ; Tom Wolfe, P.AHG
(April 1999), Smile Herb Shop, College Park, MD. All interaction sections have
also been reviewed by a team of experts including Joseph Lamb, MD (July 2000),
The Integrative Medicine Works, Alexandria, VA;Enrico Liva, ND, RPh (August
2000), Vital Nutrients, Middletown, CT; Brian T Sanderoff, PD, BS in Pharmacy
(March 2000), Clinical Assistant Professor, University of Maryland School of
Pharmacy; President, Your Prescription for Health, Owings Mills, MD; R. Lynn
Shumake, PD (March 2000), Director, Alternative Medicine Apothecary, Blue
Mountain Apothecary & Healing Arts, University of Maryland Medical Center,
Glenwood, MD; Ira Zunin, MD, MPH, MBA (July 2000), President and Chairman,
Hawaii State Consortium for Integrative Medicine, Honolulu,
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