Cayenne

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.

Pain relief

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.

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 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.

Other uses

• 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.

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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 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.

Available forms

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.

Pediatric

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.

Adult

Speak to your health care provider regarding dosing instructions.

Precautions

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.

Possible interactions

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.

Supporting research

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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.

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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.

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Heck AM, DeWitt BA, Lukes AL. Potential interactions between alternative therapies and warfarin. [Review]. Am J Health Syst Pharm. 2000;57(13):1221-1227.

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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.

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Review Date: 6/22/2015  

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.

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