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Capsicum Peppers

Scientific Name(s): Capsicum annuum L., Capsicum frutescens L.
Common Name(s): African chilies, Bell pepper, Capsicum, Cayenne pepper, Chile, Chili, Chilli, Chilli pepper, Green pepper, Jalapeno, Louisiana long pepper, Mexican chilies, Paprika, Pimiento, Red, Sweet peppers, Tabasco pepper, Thai peppers

Medically reviewed by Drugs.com. Last updated on Nov 21, 2022.

Clinical Overview

Use

Many varieties are eaten as vegetables, condiments, and spices. The component capsaicin is an irritant and analgesic used in self-defense sprays, and in a variety of conditions associated with pain. Other studies have evaluated a role in weight loss, GI conditions, postoperative nausea, and rhinitis, although limited information for these uses is available.

Dosing

For external uses, capsaicin and capsicum creams are available in several strengths, from 0.025% to 0.075% capsaicin. Clinical trials are lacking to guide dosage for other uses.

Contraindications

Topical capsaicin should not be applied to the face or injured skin.

Pregnancy/Lactation

Generally recognized as safe (GRAS) when used as food. Safety and efficacy for dosages above those in foods are unproven and should be avoided. Studies in animals have shown both positive and negative effects.

Interactions

See Drug Interactions section.

Adverse Reactions

Topical, mucosal, and GI irritations are common. Allergies and cross-sensitization to other allergens have been reported.

Toxicology

Toxicity is evidenced in animal experiments in higher dosages. Controversy exists regarding capsaicin's mutagenicity and tumorigenicity. Toxicity from long-term exposure to chili powder has not been found, and the use of defense sprays likewise has not resulted in reports of toxicity.

Scientific Family

Botany

The genus Capsicum consists of many species and varieties; the fruits can vary greatly in color, size, and shape. Taxonomical confusion exists in part due to extensive plant breeding.

The plant has straight, woody stems and can grow to approximately 3 m tall in tropical conditions. Star-shaped, white flowers are located in the axils of the leaves, which later become the varied-colored peppers. These fruits contain many flat, white seeds that are the primary source of the chili spice.1, 2 The capsicum fruit was probably termed a pepper because of the burning sensation similar to that of black and white pepper spices of the unripened fruit of the unrelated Piper nigrum.

History

Capsicum was first described in the mid-1400s by a physician who accompanied Columbus to the West Indies. The plants derive their names from the Latin capsa (box), which refers to the partially hollow, box-like fruit.

Capsicum has been highly desired as a spice and has been cultivated in some form in almost every society. Peppers are among the most widely consumed spices in the world, with an average daily per capita consumption in some Southeast Asian countries approaching 5 g of red pepper, corresponding to approximately 50 mg of capsaicin.3

Combination homeopathic and natural preparations contain capsicum extracts, and capsicum is used in traditional Korean medicine.4, 5, 6 Over-the-counter products are marketed for relief of oral discomfort or toothache, external analgesia, as a digestive aid, in menstrual conditions, and in cosmetics as cleansers and bath products.4

Chemistry

Capsicum contains approximately 1.5% of the irritant oleoresin. The major component of the oil is capsaicin (0.02%), a very pungent phenolic chemical. Along with several closely related compounds, it is responsible for the pungency of the fruit.4 The structure of capsaicin (8-methyl-N-vanillyl-6-nonenamide)4, 7 is similar to that of eugenol, the active principle in oil of cloves, which can also induce long-lasting local analgesia.8 The pungency appears to be related to the presence of a 4-hydroxy-3-methoxyphenyl substituent.9 It has been noted that the more tropical the climate in which the plant originates, the more pungent the fruit; however, extremely pungent peppers can be grown in any climate.10 The characteristic flavor of capsaicin in aqueous solutions can be detected in concentrations as low as 1 part in 11 million.

Other capsaicinoids present in capsicum include homocapsaicin, norhydrocapsaicin, dihydrocapsaicin, and homodihydrocapsaicin. Flavonoids, fatty acids, carotene, vitamins A and C, citric, tartaric, malic and tannic acids, and thiamine have also been identified in the fruits.4

Uses and Pharmacology

The widespread use of capsicum as a food has made experiments in animals largely irrelevant, aside from those investigating a role in cancer and those attempting to investigate the mechanisms of action.

Cough challenge

Capsaicin induces a dose-dependent and reproducible cough and is used in cough-challenge testing.(50) The safety of inhaled capsaicin for this purpose has been reviewed (122 studies were included), with no serious adverse event reported.(51)

Diabetes/Obesity

Animal data

The role of capsicum in diabetes is uncertain.(9, 11) Animal experiments show both positive and negative effects on glucose metabolism and insulin secretion. Limited clinical trials exist. A reduction in postprandial hyperinsulinemia was achieved with 30 g of freshly chopped chili daily over 4 weeks, but no reduction in the glucose area under the curve (AUC) or peak glucose levels were shown.(12)

Clinical data

A small clinical study (n=12) evaluated the effect of oral capsaicin on plasma glucose and insulin levels. Initial reductions in plasma glucose (30 and 45 mins after a 5 g dose) and elevated insulin levels were reported at 60 to 120 minutes.(81)

Antioxidant activity has been demonstrated in vitro and in the clinical setting(13, 14, 15) but with no significant difference in serum lipids, lipoproteins, or total antioxidant status.(14)

Capsicum has been used for weight reduction, although clinical evidence is insufficient to support this use.(9, 29) A clinical trial evaluated the safety of 6 mg/day of capsaicinoids over 12 weeks for weight loss(30) while another used 30 g/day of fresh chili containing approximately 55% cayenne chili for 4 weeks(14); weight loss was not achieved in either trial. Loss of abdominal fat was achieved in the 12-week trial.(30)

Gastrointestinal effects

Animal data

Animal studies suggest capsaicin exerts varying effects on gastric motility and is protectant against mucosal lesions induced by aspirin, ethanol, or hydrochloric acid.(16, 17, 18)

Clinical data

Clinical trials have had varying results, possibly because of the design of the studies. One study found no difference in the healing rate of duodenal ulcers among patients who ingested 3 g of capsicum daily compared with untreated controls.(19)

Red chili ingested daily over 3 weeks resulted in an increased secretion of gastrin, while a chili-rich diet lowered gastrin secretion.(16) Repeated exposure of the esophageal mucosa to red chili pepper sauce initially increased heartburn, but subsequently exerted an analgesic effect(20) and 2.5 g of red pepper daily over 5 weeks resulted in a decrease in the intensity of dyspepsia after 3 weeks. A mechanism of initial sensitization, followed by desensitization of gastric nociceptive C-fibers, has been suggested.(21) In other studies, capsaicin decreased gastric liquid emptying(18) and low-dose capsaicin was suggested to stimulate the swallowing reflex.(22)

A study of the effects of red chili consumption following hemorrhoidectomy concluded that in the postoperative period, the increased extent and duration of typical postoperative symptoms (pain, anal burning, and bleeding) warranted chili consumption as a contraindication.(23) However, a single-dose randomized clinical trial found no effect on hemorrhoidal symptoms.(24) A further clinical trial resulted in increased symptoms of pain and burning, but not pruritus, in patients with acute anal fissures consuming 3 g/day of dried chili powder over 2 weeks.(25)

Although capsaicin has shown inhibitory action on Helicobacter pylori in vitro, an in vivo study does not support this action.(26) The validity of the study has been questioned because of the small number of subjects and the short study duration.(27, 28)

Pain

Capsaicin acts as a selective agonist for the transient receptor potential vanilloid 1 receptor on afferent neurons specialized for the detection of noxious sensations. Topical capsaicin acts primarily on sensory-C fibers to cause depletion of substance P from the nerve terminals. This, in turn, causes desensitization of the sensory afferents.(8, 38)

Clinical data

Most clinical studies report a significant number of adverse events and high drop-out rates associated with the burning sensation induced by topical capsaicin.(31, 32, 33, 34, 35, 36, 37)

The updated American Academy of Neurology practice guideline summary for oral and topical treatment of painful diabetic polyneuropathy (2021) concluded that topical capsaicin is possibly more likely than placebo to improve pain (small effect; low). It recommends that clinicians assess patient preferences for effective oral, topical, nontraditional, and nonpharmacological interventions and offer topical capsaicin in those who prefer topical interventions (Level C).(39) A Cochrane systematic review of studies of herbal therapies for nonspecific lower back pain found moderate evidence of short-term effect for topically applied capsaicin, either as a cream or plaster, in reducing pain and improving function.(40, 82) A review of studies evaluating topical capsaicin in chronic pain calculated a number needed to treat (NNT) value of 5.7 for capsaicin 0.075% cream at 8 weeks for a 50% reduction in pain associated with neuropathic conditions versus placebo, and an NNT of 8.1 for pain of musculoskeletal origin for 0.025% topical capsaicin at 4 weeks.(37) A systematic review on herbal therapies in rheumatoid arthritis found one well-designed trial using 2 different measures of pain in which capsaicin performed better than placebo.(35)

A Cochrane systematic review of topical herbal products for osteoarthritis (OA) found one clinical trial (n = 99) in knee OA, with capsicum extract gel failing to provide a significant benefit versus placebo for pain relief or joint function.(78)

Mixed results have been obtained for the effect of topical capsaicin in pain associated with HIV neuropathy.(33, 34, 41) A high concentration dermal patch (8% w/w capsaicin) showed a reduction in pain for up to 12 weeks after application after a transient, treatment-related increase in pain for the first day. Duration of application of the patch (30, 60, or 90 minutes) was not clearly established in the randomized clinical study.(33) Another smaller trial found no benefit at 4 weeks with 0.075% topical capsaicin.(34)

The instillation of capsaicin powder into the wound during hernia repair has also been evaluated, with analgesic effect demonstrated for up to 3 days after the incision.(36) The use of capsaicin plasters applied to relevant acupuncture points in reducing the requirement for postoperative analgesia has been evaluated, with efficacy being demonstrated against placebo and "sham" pressure points.(5, 42)

Capsaicin cream (either 0.025% or 0.075%) was effective when applied topically in the management of postherpetic neuralgia.(43) It has been evaluated in the management of pain from other causes, including trigeminal and diabetic neuralgia, osteoarthritis, postsurgical neuralgias(4, 44) and vulvar vestibulitis.(45) High-dose (5% to 10%) topical capsaicin has also been investigated in intractable pain.(46) Intravesical capsaicin has decreased frequency and nocturia of patients with severe bladder pain.(47) Repeated instillations of intravesical capsaicin were shown to be effective for 3 to 5 years in treating detrusor hyperreflexia caused by spinal cord disease.(48) Intraureteric capsaicin instillation was shown to provide dramatic symptomatic relief in some patients with loin pain hematuria syndrome.(49)

Postoperative nausea

A limited number of studies suggest capsicum plasters applied to relevant acupuncture pressure points (K-D2 and P6 Korean points) are effective in reducing postoperative nausea.(6, 52, 53)

Pruritus

Topical capsaicin has been shown to effectively treat pruritus associated with psoriasis(54, 55) pityriasis rubra pilaris(56) psoralen-ultraviolet-light (PUVA) treatment(57) prurigo nodularis(58) and pruritus ani.(59) However, large, high-quality clinical trials are lacking.

Psoriasis

An evidence-based review of botanicals for dermatologic conditions pointed out the data from two 6-week clinical trials (n = 241) on the use of capsaicin cream on psoriasis. Capsaicin was superior to placebo for relief of symptoms of scaling, thickness, erythema, and pruritus. Burning at the application site was the most commonly reported adverse effect.(79)

Rhinitis

A Cochrane review of the efficacy of inhaled capsaicin in allergic rhinitis found insufficient evidence to support clinical use.(60) Only one trial met the inclusion criteria for the review, with a lack of adequate randomization being an issue in the other trials. In a small study, rhinitis, sneezing, and congestion were alleviated in 8 volunteers who received repeated nasal sprays of capsaicin.(61) In a placebo-controlled study, intranasal capsaicin was shown to be effective in reducing nasal symptomatology in nonallergic, noninfectious perennial rhinitis without affecting cellular homeostasis up to 9 months after treatment.(62, 63) A randomized, placebo-controlled, 2-week study (n = 42) evaluated a proprietary product, ICX72 or Sinus Buster, in adults with nonallergic rhinitis. Active treatment was significantly better than placebo for the total nasal symptom score, and individual symptoms scores for nasal congestion, sinus pressure, sinus pain, and headache. Results were not significantly better for active treatment compared with placebo for sneezing, rhinorrhea, or rescue medication use.(80)

Dosing

For external uses, capsaicin and capsicum creams are available in several strengths, from capsaicin 0.025% to 0.075%, and are applied up to 3 to 5 times daily.

Capsicum plasters containing powdered capsicum 345.8 mg and capsicum 34.58 mg tincture per sheet (12.2 × 16.4 cm2) have been evaluated for postoperative pain and nausea.5, 6

A high-concentration dermal patch (8% w/w capsaicin) has been used in HIV-associated neuropathy33 and intractable pain.45 Low-strength (0.006%) capsaicin ointment was used in a trial of itching in pruritus ani; higher strengths resulted in anal burning.59

A clinical trial evaluated the safety of capsaicinoids 6 mg/day over 12 weeks for weight loss30 while another used 30 g/day of fresh chili containing approximately 55% of cayenne chili for 4 weeks14 although weight loss was not achieved in either trial.

Pregnancy / Lactation

Capsaicin peppers are generally recognized as safe when used as food. Safety and efficacy for dosages above those in foods are unproven and should be avoided.

Studies in animals have shown both positive and negative effects. Capsaicin crosses the placenta and was shown to deplete substance P in the fetus with neurotoxic effect. Growth rates of rat pups were lower, and abnormal testicular descent was noted in pups born to capsaicin-fed rats. However, no differences in rat pup malformations, epididymal or testicular weight, or plasma progesterone were demonstrated in other experiments.4

Interactions

Experimental data exist64 including a case report65 of capsaicin-initiated or exacerbated captopril-induced cough. A mechanism has not been established. A similar interaction could be expected to occur with other ACE inhibitors and capsaicin. Consumption of chili was found to inhibit nonheme iron absorption from an iron-fortified composite meal and is suggested to be caused by binding to phenolic compounds in the chili.66

Capsicum drug interactions (more detail)

Adverse Reactions

Allergies to latex, bananas, kiwi, chestnut, or avocado may predispose people to capsicum (pepper) allergy.67 Allergic reaction to paprika has been seen in patients with "mugwort-celery-spice" syndrome. These patients exhibit allergy to mugwort, birch-pollen, celery, anise, coriander, cumin, fennel, and green and black peppercorns, as well as with fresh bell peppers and dried bell pepper fruits (paprika).68

Capsicum side effects (more detail)

Defense spray

The use of capsicum oleoresin as a defense spray results in burning in the throat, wheezing, dry cough, shortness of breath, gagging, gasping, and, rarely, cyanosis, apnea, and respiratory arrest.4, 69 A review concluded that the effects of capsicum defense spray on the conjunctiva and the cornea are generally mild and temporary, with corneal abrasion noted in approximately 7% of cases.69

Diabetes

Animal experiments show both positive and negative effects on glucose metabolism and insulin secretion. Clinical evidence of adverse effect is lacking.10, 11

Gastrointestinal

Increased extent and duration of typical postoperative symptoms (pain, anal burning, and bleeding) were found in posthemorrhoidectomy and acute anal fissure patients with chili consumption.23, 25 However, a single-dose, randomized clinical trial found no effect on hemorrhoidal symptoms.24 No clinically important adverse events were reported in a clinical trial evaluating capsaicinoids 6 mg/day for 12 weeks. Dyspepsia and bowel irregularities, including diarrhea, were recorded in a few participants.30

Skin

Topical irritation is common, particularly with the use of commercial creams, but contact dermatitis from the fruit has also been reported.4, 70 Most clinical studies report high dropout rates and adverse events associated with the burning sensation induced by capsaicin.31, 32, 33, 34, 35, 36, 37 Topical capsaicin should not be applied to the face or injured skin.79

Toxicology

The toxicology of Capsicum has been reviewed in general and with a focus on its use in the cosmetics industry.4 Short-term oral toxicity of C. annum in rats was considered to be relatively low.4, 70, 71 For C. frutescens, increases in lymphocytes and liver function tests and decreases hemoglobin, red blood cell count, total protein, albumin, cholesterol, and copper were seen with a diet containing Capsicum 10% after 8 weeks.4 Exfoliation of the intestinal epithelium and histological changes in the hepatocytes were also demonstrated at this dosage, but not at lower dosages.4 Some studies of chronic oral toxicity have shown little toxicity, while one study evaluating 5 mg/kg body weight of C. annum powder over a year showed moderate-marked histological changes in rabbit spleen and liver.4

Epidemiological and case-control studies have shown a 2- to 3-fold increase in the risk of cancers, including oral, pharyngeal, esophageal, and laryngeal, and a trend toward an increased risk for gall bladder, stomach, and colon cancers with chili consumption.4, 73 There are mixed results for capsaicin as a carcinogen, cocarcinogen, and anticarcinogen.4, 73, 74, 75, 76, 77

Inhalation

Studies on workers with long-term exposure to chili dust report initial cough, sneezing, and rhinitis, as well as chronic symptoms in some workers. However, chest radiographs were normal and no differences in ventilatory measurements were observed.4, 51

References

Disclaimer

This information relates to an herbal, vitamin, mineral or other dietary supplement. This product has not been reviewed by the FDA to determine whether it is safe or effective and is not subject to the quality standards and safety information collection standards that are applicable to most prescription drugs. This information should not be used to decide whether or not to take this product. This information does not endorse this product as safe, effective, or approved for treating any patient or health condition. This is only a brief summary of general information about this product. It does NOT include all information about the possible uses, directions, warnings, precautions, interactions, adverse effects, or risks that may apply to this product. This information is not specific medical advice and does not replace information you receive from your health care provider. You should talk with your health care provider for complete information about the risks and benefits of using this product.

This product may adversely interact with certain health and medical conditions, other prescription and over-the-counter drugs, foods, or other dietary supplements. This product may be unsafe when used before surgery or other medical procedures. It is important to fully inform your doctor about the herbal, vitamins, mineral or any other supplements you are taking before any kind of surgery or medical procedure. With the exception of certain products that are generally recognized as safe in normal quantities, including use of folic acid and prenatal vitamins during pregnancy, this product has not been sufficiently studied to determine whether it is safe to use during pregnancy or nursing or by persons younger than 2 years of age.

1. Capsicum annuum L. USDA, NRCS. 2007. The PLANTS Database (http://plants.usda.gov, May, 2009). National Plant Data Center, Baton Rouge, LA 70874-4490 USA.
2. Leung AY. Encyclopedia of Common Natural Ingredients Used in Food, Drugs and Cosmetics. New York, NY: Wiley; 1980.
3. Buck SH, Burks. Capsaicin: hot new pharmacological tool. Tips. 1983;4:84-87.
4. No authors listed. Final report on the safety assessment of Capsicum annuum extract, Capsicum annuum fruit extract, Capsicum annuum resin, Capsicum annuum fruit powder, Capsicum frutescens fruit, Capsicum frutescens fruit extract, Capsicum frutescens resin, and capsaicin. Int J Toxicol. 2007;26(suppl 1):3-106.17365137
5. Kim KS, Kim KN, Hwang KG, Park CJ. Capsicum plaster at the Hegu point reduces postoperative analgesic requirement after orthognathic surgery. Anesth Analg. 2009;108(3):992-996.19224815
6. Kim KS, Koo MS, Jeon JW, Park HS, Seung IS. Capsicum plaster at the korean hand acupuncture point reduces postoperative nausea and vomiting after abdominal hysterectomy. Anesth Analg. 2002;95(4):1103-1107.12351304
7. Gonzalez R, et al. Effect of capsaicin-containing red pepper sauce suspension on upper gastrointestinal motility in healthy volunteers. Dig Dis Sci. 1998;43(6):1165-1171.9635602
8. Hot peppers and substance P. Lancet. 1983;B335:1198.
9. Alevizos A, Mihas C, Mariolis A, Larios G. Insulin secretion and capsaicin. Am J Clin Nutr. 2007;85(4):1165-1166.17413122
10. Tyler VE, Brady LR, Robbers JE. Pharmacognosy. 8th ed. Philadelphia, PA: Lea & Febiger; 1981.
11. Weber CE. Does capsaicin in chili cause diabetes? Med Hypotheses. 2008;71(2):323-324.18562129
12. Ahuja KD, Robertson IK, Geraghty DP, Ball MJ. Effects of chili consumption on postprandial glucose, insulin, and energy metabolism. Am J Clin Nutr. 2006;84(1):63-69.16825682
13. Sun T, Xu Z, Wu CT, Janes M, Prinyawiwatkul W, No HK. Antioxidant activities of different colored sweet bell peppers (Capsicum annuum L.). J Food Sci. 2007;72(2):S98-102.17995862
14. 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):239-242.16923216
15. Lim K, Yoshioka M, Kikuzato S, et al. Dietary red pepper ingestion increases carbohydrate oxidation at rest and during exercise in runners. Med Sci Sports Exerc. 1997;29(3):355-361.9139174
16. Ericson A, Nur EM, Petersson F, Kechagias S. The effects of capsaicin on gastrin secretion in isolated human antral glands: before and after ingestion of red chilli. Dig Dis Sci. 2009;54(3):491-498.18668366
17. Yeoh KG, Kang JY, Yap I, et al. Chili protects against aspirin-induced gastroduodenal mucosal injury in humans. Dig Dis Sci. 1995;40(3):580-583.7895549
18. Rodriguez-Stanley S, Collings KL, Robinson M, Owen W, Miner PB Jr. The effects of capsaicin on reflux, gastric emptying and dyspepsia. Aliment Pharmacol Ther. 2000;14(1):129-134.10632656
19. Kumar N, Vij JC, Sarin SK, Anand BS. Do chillies influence healing of duodenal ulcer? BMJ. 1984;288(6433):1803-1804.6428553
20. Bortolotti M, Coccia G, Grossi G, Miglioli M. The treatment of functional dyspepsia with red pepper. Aliment Pharmacol Ther. 2002;16(6):1075-1082.12030948
21. Bortolotti M, Coccia G, Grossi G. Red pepper and functional dyspepsia. N Engl J Med. 2002;346(12):947-948.11907302
22. Ebihara T, Sekizawa K, Nakazawa H, Sasaki H. Capsaicin and swallowing reflex. Lancet. 1993;341(8842):432.8094188
23. Gupta PJ. Effect of red chili consumption on postoperative symptoms during the post-hemorrhoidectomy period: randomized, double-blind, controlled study. World J Surg. 2007;31(9):1822-1826.17647055
24. Altomare DF, Rinaldi M, La Torre F, et al. Red hot chili pepper and hemorrhoids: the explosion of a myth: results of a prospective, randomized, placebo-controlled, crossover trial. Dis Colon Rectum. 2006;49(7):1018-1023.16708161
25. Gupta PJ. Consumption of red-hot chili pepper increases symptoms in patients with acute anal fissures. A prospective, randomized, placebo-controlled, double blind, crossover trial. Arq Gastroenterol. 2008;45(2):124-127.18622465
26. Graham DY, Anderson SY, Lang T. Garlic or jalapeño peppers for treatment of Helicobacter pylori infection. Am J Gastroenterol. 1999;94(5):1200-1202.10235193
27. Mahady GB, Pendland S. Garlic and Helicobacter pylori. Am J Gastroenterol. 2000;95(1):309.10638609
28. Calvet X, Carod C, Gene E. Re: Peppers at treatment of Helicobacter pylori infection. Am J Gastroenterol. 2000;95(3):820-821.10710088
29. Kang JH, Kim CS, Han IS, Kawada T, Yu R. Capsaicin, a spicy component of hot peppers, modulates adipokine gene expression and protein release from obese-mouse adipose tissues and isolated adipocytes, and suppresses the inflammatory responses of adipose tissue macrophages. FEBS Lett. 2007;581(23):4389-4396.17719033
30. Snitker S, Fujishima Y, Shen H, et al. Effects of novel capsinoid treatment on fatness and energy metabolism in humans: possible pharmacogenetic implications. Am J Clin Nutr. 2009;89(1):45-50.19056576
31. GenDerm capsaicin for shingles pain relief. F-D-C Reports. Feb 27, 1989.
32. Reinharth D. Capsaicin cream unpopular with patients. Arch Intern Med. 2005;165(6):702.15795352
33. Simpson DM, Brown S, Tobias J, NGX-4010 C107 Study Group. Controlled trial of high-concentration capsaicin patch for treatment of painful HIV neuropathy. Neurology. 2008;70(24):2305-2313.18541884
34. Liu JP, Manheimer E, Yang M. Herbal medicines for treating HIV infection and AIDS. Cochrane Database Syst Rev. 2005;(3):CD003937.
35. Little CV, Parsons T. Herbal therapy for treating rheumatoid arthritis. Cochrane Database Syst Rev. 2001;(1):CD002948.11279784
36. White PF. Red-hot chili peppers: a spicy new approach to preventing postoperative pain. Anesth Analg. 2008;107(1):6-8.18635459
37. Mason L, Moore RA, Derry S, Edwards JE, McQuay HJ. Systematic review of topical capsaicin for the treatment of chronic pain. BMJ. 2004;328(7446):991.15033881
38. Sang CN, Gracely RH, Max MB, Bennett GJ. Capsaicin-evoked mechanical allodynia and hyperalgesia cross nerve territories. Evidence for a central mechanism. Anesthesiology. 1996;85(3):491-496.8853078
39. Price R, Smith D, Franklin G, et al. Oral and topical treatment of painful diabetic polyneuropathy: Practice guideline update summary: Report of the AAN guideline subcommittee. Neurology. 2022;98(1):31-43. doi:10.1212/WNL.000000000001303834965987
40. Gagnier JJ, Oltean H, van Tulder MW, Berman BM, Bombardier C, Robbins CB. Herbal medicine for low back pain: a Cochrane review. Spine (Phila Pa 1976). 2016;41(2):116-33.26630428
41. Herrmann DN, Bromberg MB. Chili peppers, nerve regeneration, and clinical trial design. Neurology. 2007;68(16):1247-1248.17438212
42. Kim KS, Kim DW, Yu YK. The effect of Capsicum plaster in pain after inguinal hernia repair in children. Paediatr Anaesth. 2006;16(10):1036-1041.16972832
43. Bernstein JE, Bickers DR, Dahl MV, Roshal JY. Treatment of chronic postherpetic neuralgia with topical capsaicin. A preliminary study. J Am Acad Dermatol. 1987;17(1):93-96.3611458
44. Altman RD, et al. Capsaicin cream 0.025% as monotherapy for osteoarthritis: A double-blind study. Sem Arthritis Rheumatism. 1994;23(6 suppl 3):25-33.
45. Steinberg AC, Oyama IA, Rejba AE, Kellogg-Spadt S, Whitmore KE. Capsaicin for the treatment of vulvar vestibulitis. Am J Obstet Gynecol. 2005;192(5):1549-1553.15902156
46. Robbins WR, Staats PS, Levine J, et al. Treatment of intractable pain with topical large-dose capsaicin: preliminary report. Anesth Analg. 1998;86(3):579-583.9495419
47. Lazzeri M, Beneforti P, Benaim G, Maggi CA, Lecci A, Turini D. Intravesical capsaicin for treatment of severe bladder pain: a randomized placebo controlled study. J Urol. 1996;156(3):947-952.8709370
48. De Ridder D, Chandiramani V, Dasgupta P, Van Poppel H, Baert L, Fowler CJ. Intravesical capsaicin as a treatment for refractory detrusor hyperreflexia: a dual center study with long-term followup. J Urol. 1997;158(6):2087-2092.9366318
49. Armstrong T, McLean AD, Hayes M, Morgans BT, Tulloch DN. Early experience of intra-ureteric capsaicin infusion in loin pain haematuria syndrome. BJU Int. 2000;85(3):233-237.10671874
50. Doherty MJ, Mister R, Pearson MG, Calverley PM. Capsaicin responsiveness and cough in asthma and chronic obstructive pulmonary disease. Thorax. 2000;55(8):643-649.10899239
51. Dicpinigaitis PV, Alva RV. Safety of capsaicin cough challenge testing. Chest. 2005;128(1):196-202.16002935
52. Agarwal A, Dhiraaj S, Tandon M, Singh PK, Singh U, Pawar S. Evaluation of capsaicin ointment at the Korean hand acupressure point K-D2 for prevention of postoperative nausea and vomiting. Anaesthesia. 2005;60(12):1185-1188.16288616
53. Sumit K. A response to 'Evaluation of capsaicin ointment at the Korean hand acupressure point K-D2 for prevention of postoperative nausea and vomiting'. Anaesthesia. 2006;61(6):617.16704621
54. Ellis CN, Berberian B, Sulica VI, et al. A double-blind evaluation of topical capsaicin in pruritic psoriasis. J Am Acad Dermatol. 1993;29(3):438-442.7688774
55. Krogstad AL, Lönnroth P, Larson G, Wallin BG. Capsaicin treatment induces histamine release and perfusion changes in psoriatic skin. Br J Dermatol. 1999;141(1):87-93.10417520
56. Neess CM, Hinrichs R, Dissemond J, et al. Treatment of pruritus by capsaicin in a patient with pityriasis rubra pilaris receiving RE-PUVA therapy. Clin Exp Dermatol. 2000;25(3):209-211.10844497
57. Kirby B, Rogers S. Treatment of PUVA itch with capsaicin. Br J Dermatol. 1997;137(1):152.9274648
58. Ständer S, Luger T, Metze D. Treatment of prurigo nodularis with topical capsaicin. J Am Acad Dermatol. 2001;44(3):471-478.11209117
59. Lysy J, Sistiery-Ittah M, Israelit Y, et al. Topical capsaicin--a novel and effective treatment for idiopathic intractable pruritus ani: a randomised, placebo controlled, crossover study. Gut. 2003;52(9):1323-1326.12912865
60. Cheng J, Yang XN, Liu X, Zhang SP. Capsaicin for allergic rhinitis in adults. Cochrane Database Syst Rev. 2006;(2):CD004460.16625604
61. Snider M. Chili peppers heat up a cure for runny noses. USA Today. March 18, 1992:A1.
62. Blom HM, Van Rijswijk JB, Garrelds IM, Mulder PG, Timmermans T, Gerth van Wijk R. Intranasal capsaicin is efficacious in non-allergic, non-infectious perennial rhinitis. A placebo-controlled study. Clin Exp Allergy. 1997;27(7):796-801.9249272
63. Blom HM, Severijnen LA, Van Rijswijk JB, Mulder PG, Van Wijk RG, Fokkens WJ. The long-term effects of capsaicin aqueous spray on the nasal mucosa. Clin Exp Allergy. 1998;28(11):1351-1358.9824407
64. Morice AH, Lowry R, Brown MJ, Higenbottam T. Angiotensin-converting enzyme and the cough reflex. Lancet. 1987;2(8568):1116-1118.2890021
65. Hakas JF Jr. Topical capsaicin induces cough in patient receiving ACE inhibitor. Ann Allergy. 1990;65(4):322-323.2221491
66. Tuntipopipat S, Judprasong K, Zeder C, et al. Chili, but not turmeric, inhibits iron absorption in young women from an iron-fortified composite meal. J Nutr. 2006;136(12):2970-2974.17116705
67. Gallo R, Cozzani E, Guarrera M. Sensitization to pepper (Capsicum annuum) in a latex-allergic patient. Contact Dermatitis. 1997;37(1):36-37.9255486
68. Ebner C, Jensen-Jarolim E, Leitner A, Breiteneder H. Characterization of allergens in plant-derived spices: Apiaceae spices, pepper ( Piperaceae), and paprika (bell peppers, Solanaceae). Allergy. 1998;53(46 suppl):52-54.9825999
69. Smith J, Greaves I. The use of chemical incapacitant sprays: a review. J Trauma. 2002;52(3):595-600.11901348
70. Williams SR, Clark RF, Dunford JV. Contact dermatitis associated with capsaicin: Hunan hand syndrome. Ann Emerg Med. 1995;25(5):713-715.7741356
71. Winek CL, Markie DC, Shanor SP. Pepper sauce toxicity. Drug Chem Toxicol. 1982;5:89-113.7128479
72. Monsereenusorn Y. Subchronic toxicity studies of capsaicin and Capsicum in rats. Res Commun Chem Pathol Pharmacol. 1983;41(1):95-110.6622833
73. Surh YJ, Lee SS. Capsaicin in hot chili pepper: carcinogen, co-carcinogen or anticarcinogen? Food Chem Toxicol. 1996;34(3):313-316.8621114
74. Park KK, Chun KS, Yook JI, Surh YJ. Lack of tumor promoting activity of capsaicin, a principal pungent ingredient of red pepper, in mouse skin carcinogenesis. Anticancer Res. 1998;18(6A):4201-4205.9891468
75. Oikawa S, Nagao E, Sakano K, Kawanishi S. Mechanism of oxidative DNA damage induced by capsaicin, a principal ingredient of hot chili pepper. Free Radic Res. 2006;40(9):966-973.17015277
76. Macho A, Lucena C, Sancho R, et al. Non-pungent capsaicinoids from sweet pepper synthesis and evaluation of the chemopreventive and anticancer potential. Eur J Nutr. 2003;42(1)2-9.12594536
77. Jun HS, Park T, Lee CK, et al. Capsaicin induced apoptosis of B16-F10 melanoma cells through down-regulation of Bcl-2. Food Chem Toxicol. 2007;45(5):708-715.17306913
78. Cameron M, Chrubasik S. Topical herbal therapies for treating osteoarthritis. Cochrane Database Syst Rev. 2013;5:CD010538.2372870110.1002/14651858.CD010538
79. Reuter J, Merfort I, Schempp CM. Botanicals in dermatology: an evidence-based review. Am J Clin Dermatol. 2010;11(4):247-267.20509719
80. Bernstein JA, Davis BP, Picard JK, Cooper JP, Zheng S, Levin LS. A randomized, double-blind, parallel trial comparing capsaicin nasal spray with placebo in subjects with a significant component of nonallergic rhinitis. Ann Allergy Asthma Immunol. 2011;107(2):171-178.21802026
81. Chaiyasit K, Khovidhunkit W, Wittayalertpanya S. Pharmacokinetic and the effect of capsaicin in Capsicum frutescens on decreasing plasma glucose level. J Med Assoc Thai. 2009;92(1):108-13.19260251
82. Oltean H, Robbins C, van Tulder MW, Berman BM, Bombardier C, Gagnier JJ. Herbal medicine for low back pain. Cochrane Database Syst Rev. 2014;12:CD004504.25536022

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