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Cayenne

Also listed as: Capsaicin; Chili pepper; Red pepper

Overview
Plant Description
What's It Made Of?
Available Forms
 
How to Take It
Precautions
Possible Interactions
Supporting Research

Overview

Native Americans have used cayenne (Capsicum annuum or 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 digestive 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 primarily to relieve pain from arthritis and shingles (Herpes zoster). Capsaicin is also a key ingredient in many personal defense sprays.

Pain relief

Capsaicin has very 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 topical application 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, and it may be that it works for some people and not others. Check with your doctor to see if trying this topical treatment is right for you.
  • Pain after surgery, such as a mastectomy (breast removal for breast cancer) 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. However, homeopaths may not prescribe a capsaicin gel as the first treatment, because other homeopathic remedies have fewer side effects.

Psoriasis

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.

Weight loss

A few studies suggest that cayenne may help suppress appetite and help people fell full. But not all studies agree, and they have either 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.

Other uses

  • In extremely diluted homeopathic formulations, capsaicin may help treat ear infections (otitis media).
  • One well-designed study found that capsaicin may help treat heartburn, but 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 risk of an irregular heart rhythm.

Plant Description

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 is dried and powdered into a spice that has been used for centuries in meals and medicines.

What's 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.

Available Forms

As a spice, 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 in creams for external use. Creams should contain at least 0.075% capsaicin.

How to Take It

Don’t apply capsaicin cream to cracked skin or open wounds.

Pediatric

Don’t give cayenne to children under 2. However, capsaicin ointment may be used on the skin with caution in older children. Don’t use topical cayenne ointments for more than 2 days in a row in children.

Adult

For shingles, psoriasis, arthritis, or muscle pain: Capsaicin cream (0.025 - 0.075% capsaicin) may be applied directly to the affected area up to 4 times a day. Pain may slightly increase at first, but then may get better over the next few days. Capsaicin should be applied regularly several times a day. It usually takes 3 - 7 days before you notice substantial pain relief.

For digestive problems: Capsaicin may be taken in capsules (30 - 120 mg, 3 times daily).

Precautions

The use of herbs is a time-honored approach to strengthening the body and treating disease. Herbs, however, can trigger side effects and can interact with other herbs, supplements, or medications. For these reasons, you should take herbs with care, under the supervision of a health care provider.

Cayenne does not dissolve easily in water, so it’s hard to wash off. Use vinegar to get it off the skin. Capsaicin cream may cause an itching, burning sensation on the skin, but these symptoms tend to go away quickly. Test capsaicin cream on a small area of the skin before extended use. If it causes irritation, or if symptoms do not improve after 2 - 4 weeks, stop using it.

Do not use capsaicin with a heating pad, and do not apply capsaicin cream immediately before or after hot showers. After using capsaicin, wash your hands well and avoid touching your eyes. If you're 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 health care 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 both as a spice and a supplement.

Possible Interactions

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

ACE inhibitors -- Using capsaicin cream may raise the risk of developing a cough, one of the side effects of ACE inhibitors. These medications are used to treat high blood pressure. 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 cause an increase in 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 also may 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) and herbs such as ginkgo, ginger, ginseng, and garlic.

Medications for diabetes -- Capsaicin lower blood sugar levels, raising the risk of low blood sugar or hypoglycemia. Ask your doctor before using capsaicin if you have diabetes.

Theophylline -- Regular use of cayenne may cause your body to absorb too much theophylline, a medication used to treat asthma. This could be dangerous.

Supporting Research

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):63-9.

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):239-42.

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):326-33.

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):S118-30.

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):1877-85.

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.

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):780-7.

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.

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):260-5.

Robbins W. Clinical applications of capsaicinoids [Review]. Clin J Pain. 2000;16(2 Suppl):S86-89.

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.


Review Date: 12/12/2010
Reviewed By: Steven D. Ehrlich, NMD, Solutions Acupuncture, a private practice specializing in complementary and alternative medicine, Phoenix, AZ. Review provided by VeriMed Healthcare Network.
The information provided herein should not be used during any medical emergency or for the diagnosis or treatment of any medical condition. A licensed medical professional should be consulted for diagnosis and treatment of any and all medical conditions. Call 911 for all medical emergencies. Links to other sites are provided for information only -- they do not constitute endorsements of those other sites. © 1997- A.D.A.M., Inc. Any duplication or distribution of the information contained herein is strictly prohibited.
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