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.

Pain Control

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 capsaicin.

• 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.

• Toothache 

Psoriasis

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).

Weight loss

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.

Other

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 stomach ulcers.

Capsaicin is under investigation for the possible use to help treat cystitis (bladder inflammation).

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.

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).

Topical capsaicin should not be applied to cracks or open sores because this could cause a burning sensation.

Pediatric

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.

Adult

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 medicine.

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 cayenne.

If you are currently being treated with any of the following medications, you should not use cayenne preparations without first talking to your healthcare provider.

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 thinning herb.

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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