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Complementary and Alternative Medicine - Cam

Search Health Information    Cayenne

Cayenne

Uses

Common names:
Capsaicin, Capsaicin Cream, Capsicum
Botanical names:
Capsicum annuum, Capsicum frutescens

Parts Used & Where Grown

Originally from South America, the cayenne plant is now used worldwide as a food and spice. Cayenne is very closely related to bell peppers, jalapeños, paprika, and other similar peppers. The fruit is used medicinally.

What Are Star Ratings?

Our proprietary “Star-Rating” system was developed to help you easily understand the amount of scientific support behind each supplement in relation to a specific health condition. While there is no way to predict whether a vitamin, mineral, or herb will successfully treat or prevent associated health conditions, our unique ratings tell you how well these supplements are understood by the medical community, and whether studies have found them to be effective for other people.

For over a decade, our team has combed through thousands of research articles published in reputable journals. To help you make educated decisions, and to better understand controversial or confusing supplements, our medical experts have digested the science into these three easy-to-follow ratings. We hope this provides you with a helpful resource to make informed decisions towards your health and well-being.

3 Stars Reliable and relatively consistent scientific data showing a substantial health benefit.

2 Stars Contradictory, insufficient, or preliminary studies suggesting a health benefit or minimal health benefit.

1 Star For an herb, supported by traditional use but minimal or no scientific evidence. For a supplement, little scientific support.

This supplement has been used in connection with the following health conditions:

Used for Why
3 Stars
Osteoarthritis
Apply 0.025 to 0.075% capsaicin ointment four times per day over painful joints
When rubbed over painful joints, cayenne extract creams containing 0.025 to 0.075% capsaicin may reduce the pain and tenderness of osteoarthritis.
Several double-blind trials have shown that topical use of cayenne extract creams containing 0.025 to 0.075% capsaicin reduces pain and tenderness caused by osteoarthritis.1 , 2 , 3 , 4 These creams are typically applied four times daily for two to four weeks, after which twice daily application may be sufficient.5 Products containing capsicum oleoresin rather than purified capsaicin may not be as effective.6
3 Stars
Pain
Apply 0.025 to 0.075% capsaicin ointment four times per day over painful areas
Capsaicin, an extract of cayenne pepper, appears to work by blocking pain signals and may ease many types of chronic pain when applied regularly to the skin.

Capsaicin is an extract of cayenne pepper that may ease many types of chronic pain when applied regularly to the skin. In animal studies, capsaicin was consistently effective at reducing pain when given by mouth, by injection, or when applied topically.7 , 8 A controlled trial in humans found that application of a solution of capsaicin (0.075%) decreased sensitivity of skin to all noxious stimuli.9 One review article deemed the research on capsaicin’s pain-relieving properties “inconclusive.”10 However, in several uncontrolled and at least five controlled clinical trials, capsaicin has been consistently shown to decrease the pain of many disorders, including trigeminal neuralgia, shingles , diabetic neuropathy, osteoarthritis , and cluster headaches .11 , 12 , 13 , 14 , 15 For treatment of chronic pain, capsaicin ointment or cream (standardized to 0.025 to 0.075% capsaicin) is typically applied to the painful area four times per day.16 It is common to experience stinging and burning at the site of application, especially for the first week of treatment; avoid getting it in the eyes, mouth, or open sores.

3 Stars
Postherpetic Neuralgia and Pain
Apply 0.025 to 0.075% capsaicin ointment four times per day over painful areas
A component of cayenne pepper known as capsaicin can be applied as a cream or ointment to soothe the pain of postherpetic neuralgia.

The hot component of cayenne pepper, known as capsaicin, is used to relieve the pain of postherpetic neuralgia. In a double-blind trial, a cream containing 0.075% capsaicin, applied three to four times per day to the painful area, greatly reduced pain.17 In another study, a preparation containing a lower concentration of capsaicin (0.025%) was also effective.18 Two or more weeks of treatment may be required to get the full benefit of the cream.

3 Stars
Psoriasis
Apply 0.025 to 0.075% capsaicin ointment four times per day over pain areas with unbroken skin
to relieve itching and help heal sores. Cayenne contains capsaicin, which relieves pain and itching and may help heal sores..

Cayenne contains a resinous and pungent substance known as capsaicin. This chemical relieves pain and itching by depleting certain neurotransmitters from sensory nerves. In a double-blind trial, application of a capsaicin cream to the skin relieved both the itching and the skin lesions in people with psoriasis.19 Creams containing 0.025 to 0.075% capsaicin are generally used. There may be a burning sensation the first several times the cream is applied, but this usually become less pronounced with each use. The hands must be carefully and thoroughly washed after use, or gloves should be worn, to prevent the cream from accidentally reaching the eyes, nose, or mouth and causing a burning sensation. The cream should not be applied to areas of broken skin.

3 Stars
Type 1 Diabetes and Diabetic Neuropathy
Apply an ointment containing 0.025 to 0.075% capsaicin four times per day to areas of nerve pain
Topically applied capsaicin (from cayenne) has been shown to relieve symptoms of diabetic neuropathy.
Double-blind trials have shown that topical application of creams containing 0.025 to 0.075% capsaicin (from cayenne [Capsicum frutescens]) can relieve symptoms of diabetic nerve damage (neuropathy).20 , 21 Four or more applications per day may be required to relieve severe pain. This should be done only under a doctor’s supervision.
3 Stars
Type 2 Diabetes and Diabetic Neuropathy
Apply an ointment containing 0.025 to 0.075% capsaicin four times a day to areas of nerve pain
Topically applied capsaicin (from cayenne) may help relieve nerve pain.
Double-blind trials have shown that topical application of creams containing 0.025 to 0.075% capsaicin (from cayenne [Capsicum frutescens]) can relieve symptoms of diabetic neuropathy (numbness and tingling in the extremities caused by diabetes).22 , 23 Four or more applications per day may be required to relieve severe pain . This should be done only under a doctor’s supervision.
2 Stars
Cluster Headache
Consult a qualified healthcare practitioner
Capsaicin, a constituent of cayenne pepper, applied inside the nostrils may ease the pain of cluster headaches and reduce recurrences.

Substance P is a nerve chemical involved in pain transmission that may cause some of the symptoms of cluster headache.25 , 26 Capsaicin, a constituent of cayenne pepper, can reduce the levels of substance P in nerves.27 Preliminary clinical trials investigating the use of intranasal capsaicin for the prevention and treatment of cluster headaches report significant decreases in the number of cluster episodes in some of the participants.28 The decreases usually lasted no more than 40 days after the end of treatment,29 although a few patients have experienced relief for up to two years.30 In a double-blind study, patients who received capsaicin intranasally twice daily for seven days during a cluster episode had a significant reduction in pain for the following 15 days.31 As capsaicin can cause burning and irritation, this treatment should be utilized only under the supervision of a qualified doctor.

2 Stars
Obesity
Add 6 to 10 grams to each meal
Incorporating cayenne pepper into the diet may promote weight loss by reducing hunger and calories consumed and increasing the calories the body burns.
Research has suggested that incorporating cayenne pepper into the diet may help people lose weight. Controlled studies report that adding 6 to 10 grams of cayenne to a meal or 28 grams to an entire day’s diet reduces hunger after meals and reduces calories consumed during subsequent meals.32 , 33 Other controlled studies have reported that calorie burning by the body increases slightly when 10 grams of cayenne is added to a meal or 28 grams is added to an entire day’s diet 34 , 35 , 36 However, no studies have been done to see if regularly adding cayenne to the diet has any effect on weight loss.
2 Stars
Rheumatoid Arthritis
Apply 0.025 to 0.075% capsaicin ointment four times per day over painful areas
A cream containing capsaicin, a substance found in cayenne pepper, may help relieve pain when rubbed onto arthritic joints.

A cream containing small amounts of capsaicin, a substance found in cayenne pepper, can help relieve pain when rubbed onto arthritic joints, according to the results of a double-blind trial.37 Capsaicin achieves this effect by depleting nerves of a pain-mediating neurotransmitter called substance P. Although application of capsaicin cream initially causes a burning feeling, the burning lessens with each application and disappears for most people in a few days. Creams containing 0.025–0.075% of capsaicin are available and may be applied to the affected joints three to five times a day. A doctor should supervise this treatment.

1 Star
Athletic Performance
Refer to label instructions
Capsaicin, a constituent of cayenne, has been shown to reduce pain caused by osteoarthritis and provide relief from chronic low back pain.
Capsaicin ointment , applied four times per day over painful joints in the upper or lower limbs, reduces pain caused by osteoarthritis,38 and a plaster containing capsaicin applied to the low back for several hours per day provided relief from chronic low back pain in one study.39 Other uses of cayenne or capsaicin for sports and fitness have not been studied.
1 Star
Bursitis
Refer to label instructions
Some doctors recommend using the anti-inflammatory herbs boswellia, turmeric, willow, and topical cayenne ointment for bursitis.

While there have been few studies on herbal therapy for bursitis, most practitioners would consider using anti-inflammatory herbs that have proven useful in conditions such as rheumatoid arthritis . These would include boswellia , turmeric , willow , and topical cayenne ointment.

1 Star
Low Back Pain
Refer to label instructions
Topical cayenne pepper has been used for centuries to reduce pain and to diminish localized pain for a number of conditions.

Topical cayenne pepper has been used for centuries to reduce pain , and more recently, to diminish localized pain for a number of conditions,40 including chronic pain,41 although low back pain has not been specifically investigated. Cayenne creams typically contain 0.025–0.075% capsaicin.42 While cayenne cream causes a burning sensation the first few times used, this decreases with each application. Pain relief is also enhanced with use as substance P, the compound that induces pain, is depleted.43 To avoid contamination of the mouth, nose, or eyes, hands should be thoroughly washed after use or gloves should be worn. Do not apply cayenne cream to broken skin.

1 Star
Migraine Headache
Refer to label instructions
Capsaicin, the active constituent of cayenne, may be applied inside the nose as a treatment for acute migraine under a doctor’s supervision.

There is preliminary evidence that capsaicin, the active constituent of cayenne , can be applied inside the nose as a treatment for acute migraine.44 However, as intranasal application of capsaicin produces a burning sensation, it should be used only under the supervision of a doctor familiar with its use.

Traditional Use (May Not Be Supported by Scientific Studies)

The potent, hot fruit of cayenne has been used as medicine for centuries. It was considered helpful by herbalists for various conditions of the gastrointestinal tract, including stomach aches, cramping pains, and gas. Cayenne was frequently used to treat diseases of the circulatory system. It is still traditionally used in herbal medicine as a circulatory tonic (a substance believed to improve circulation). Rubbed on the skin, cayenne is a traditional, as well as modern, remedy for rheumatic pains and arthritis due to what is termed a counterirritant effect. A counterirritant is something that causes irritation to a tissue to which it is applied, thus distracting from the original irritation (such as joint pain in the case of arthritis).

How It Works

Common names:
Capsaicin, Capsaicin Cream, Capsicum
Botanical names:
Capsicum annuum, Capsicum frutescens

How It Works

Cayenne contains a resinous and pungent substance known as capsaicin. Topical application of capsaicin relieves pain and itching by acting on sensory nerves.45 Capsaicin temporarily depletes “substance P”, a chemical in nerves that transmits pain sensations. Without substance P, pain signals can no longer be sent. The effect is temporary. Numerous double-blind trials have proven topically applied capsaicin creams are helpful for a range of conditions, including nerve pain in diabetes (diabetic neuropathy),46 , 47 post-surgical pain,48 , 49 , 50 psoriasis ,51 muscle pain due to fibromyalgia ,52 nerve pain after shingles (postherpetic neuralgia),53 , 54 osteoarthritis pain,55 , 56 and rheumatoid arthritis pain.57

With the aid of a healthcare professional, capsaicin administered via the nose may also be a potentially useful therapy for cluster headaches . This is supported by a double-blind trial.58 Weaker scientific support exists for the use of capsaicin for migraines .59

Injecting capsaicin directly into the urinary bladder has reduced symptoms of one type of bladder dysfunction (neurogenic hyperreflexic bladder)60 that results from spinal cord and other nerve injuries. Capsaicin is not known to help other bladder conditions, such as chronic bladder pain. The placing of cayenne or capsaicin products into the bladder has only been performed in clinical experiments and should only be done by a urologist.

Modest reductions in appetite have been found in healthy Japanese women and white men when they consumed 10 grams of cayenne pepper along with meals in a double-blind trial.61 A similar trial found that cayenne could increase metabolism of dietary fats in Japanese women.62 These trials suggest cayenne may help in the treatment of obesity .

In a double-blind study of people with dyspepsia ( heartburn ), supplementation with 833 mg of cayenne powder in capsules, three times per day before meals, reduced heartburn symptoms by 48%, compared with a placebo. However, two of 15 individuals receiving cayenne discontinued it because of abdominal pain.63

How to Use It

Topical creams containing 0.025 to 75% capsaicin are generally used.64 People often apply the cream to the affected area three or four times per day. A burning sensation may occur the first several times the cream is applied. However, this should gradually decrease with each use. The hands must be carefully and thoroughly washed after use, or gloves should be worn, to prevent the cream from accidentally reaching the eyes, nose, or mouth, which would cause a burning sensation. Do not apply the cream to areas of broken skin. For internal use, cayenne tincture (0.3–1 ml) can be taken three times per day. An infusion can be made by pouring 1 cup (250 ml) of boiling water onto 1/2–1 teaspoon (2.5 to 5 grams) of cayenne powder and let set for 10 minutes. A teaspoon of this infusion can be mixed with water and taken three to four times daily. In the treatment of heartburn, researchers have used 833 mg of cayenne powder in capsule form, taken three times per day before meals.65

Interactions

Common names:
Capsaicin, Capsaicin Cream, Capsicum
Botanical names:
Capsicum annuum, Capsicum frutescens

Interactions with Supplements, Foods, & Other Compounds

At the time of writing, there were no well-known supplement or food interactions with this supplement.

Interactions with Medicines

Certain medicines interact with this supplement.

Types of interactions: Beneficial Adverse Check

Replenish Depleted Nutrients

  • none

Reduce Side Effects

  • none

Support Medicine

  • Aspirin

    Cayenne (Capsicum annuum, Capsicum frutescens) contains the potent chemical capsaicin, which acts on special nerves found in the stomach lining. In two rat studies, researchers reported that stimulation of these nerves by capsaicin might protect against the damage aspirin can cause to the stomach.66 , 67 In a study of 18 healthy human volunteers, a single dose of 600 mg aspirin taken after ingestion of 20 grams of chili pepper was found to cause less damage to the lining of the stomach and duodenum (part of the small intestine) than aspirin without chili pepper.68 However, cayenne may cause stomach irritation in some individuals with stomach inflammation ( gastritis ) or ulcers and should be used with caution.

Reduces Effectiveness

  • none

Potential Negative Interaction

  • none

Explanation Required

  • none

The Drug-Nutrient Interactions table may not include every possible interaction. Taking medicines with meals, on an empty stomach, or with alcohol may influence their effects. For details, refer to the manufacturers’ package information as these are not covered in this table. If you take medications, always discuss the potential risks and benefits of adding a supplement with your doctor or pharmacist.

Side Effects

Common names:
Capsaicin, Capsaicin Cream, Capsicum
Botanical names:
Capsicum annuum, Capsicum frutescens

Side Effects

Besides causing a mild burning during the first few applications (or severe burning if accidentally placed in sensitive areas, such as the eyes), side effects are few with the use of capsaicin cream.69 As with anything applied to the skin, some people may have an allergic reaction to the cream, so the first application should be to a very small area of skin. Do not attempt to use capsaicin cream intra-nasally for headache treatment without professional guidance.

When consumed as food—one pepper per day for many years—cayenne may increase the risk of stomach cancer, according to one study.70 A different human study found that people who ate the most cayenne actually had lower rates of stomach cancer.71 Overall, the current scientific evidence is contradictory. Thus, the relationship between cayenne consumption and increased risk of stomach cancer remains unclear.72 Oral intake of even 1 ml of tincture three times per day can cause burning in the mouth and throat, and can cause the nose to run and eyes to water. People with ulcers , heartburn , or gastritis should use any cayenne-containing product cautiously as it may worsen their condition.

References

1. McCarthy GM, McCarty DJ. Effect of topical capsaicin in the therapy of painful osteoarthritis of the hands. J Rheumatol 1992;19:604-7.

2. Altman RD, Aven A, Holmburg CE, et al. Capsaicin cream 0.025% as monotherapy for osteoarthritis: a double-blind study. Sem Arth Rheum 1994;23(Suppl 3):25-33.

3. Deal CL, Schnitzer TJ, Lipstein E, et al. Treatment of arthritis with topical capsaicin: A double-blind trial. Clin Ther 1991;13:383-95.

4. Schnitzer T, Morton C, Coker S. Topical capsaicin therapy for osteoarthritis pain: achieving a maintenance regimen. Sem Arth Rheum 1994;23(Suppl 3):34-40.

5. Schnitzer T, Morton C, Coker S. Topical capsaicin therapy for osteoarthritis pain: achieving a maintenance regimen. Sem Arth Rheum 1994;23(Suppl 3):34-40.

6. Deal CL. The use of topical capsaicin in managing arthritis pain: a clinician's perspective. Sem Arth Rheum 1994;23(Suppl 3):48-52.

7. Santos AR, Calixto JB. Ruthenium red and capsazepine antinociceptive effect in formalin and capsaicin models of pain in mice. Neurosci Lett. 1997;235:73-6.

8. Otsuki T, Nakahama H, Niizuma H, Suzuki J. Evaluation of the analgesic effects of capsaicin using a new rat model for tonic pain. Brain Res 1986;365:235-40.

9. Nolano M, Simone DA, Wendelschafer-Crabb G, et al. Topical capsaicin in humans: parallel loss of epidermal nerve fibers and pain sensation. Pain 1999;81:135-45.

10. Kingery WS. A critical review of controlled clinical trials for peripheral neuropathic pain and complex regional pain syndromes. Pain 1997;73:123-39 [review].

11. Hautkappe M, Roizen MF, Toledano A, et al. Review of the effectiveness of capsaicin for painful cutaneous disorders and neural dysfunction. Clin J Pain 1998;14:97-106 [review].

12. Fusco BM, Giacovazzo M. Peppers and pain. The promise of capsaicin. Drugs 1997;53:909-14 [review].

13. Robbins WR, Staats PS, Levine J, et al. Treatment of intractable pain with topical large-dose capsaicin: preliminary report. Anesth Analg 1998;86:579-83.

14. Zhang WY, Li Wan Po A. The effectiveness of topically applied capsaicin. A meta-analysis. Eur J Clin Pharmacol 1994;46:517-22 [review].

15. 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;15:2974-80.

16. Rains C, Bryson HM. Topical capsaicin. A review of its pharmacological properties and therapeutic potential in post-herpetic neuralgia, diabetic neuropathy and osteoarthritis. Drugs Aging 1995;7:317-28 [review].

17. Bernstein JE, Korman NJ, Bickers DR, et al. Topical capsaicin treatment of chronic postherpetic neuralgia. J Am Acad Dermatol 1989;21:265-70.

18. Bernstein JE, Bickers DR, Dahl MV, Roshal JY. Treatment of chronic postherpetic neuralgia with topical capsaicin. J Am Acad Dermatol 1987;17:93-6.

19. Ellis CN, Berberian B, Sulica VI, et al. A double-blind evaluation of topical capsaicin in pruritic psoriasis. J Am Acad Dermatol 1993;29:438-42.

20. [No authors listed.] Treatment of painful diabetic neuropathy with topical capsaicin. A multicenter, double-blind, vehicle-controlled study. The Capsaicin Study Group. Arch Intern Med 1991;151:2225-9.

21. [No authors listed.] Effect of treatment with capsaicin on daily activities of patients with painful diabetic neuropathy. Capsaicin Study Group. Diabetes Care 1992;15:159-65.

22. [No authors listed.] Treatment of painful diabetic neuropathy with topical capsaicin. A multicenter, double-blind, vehicle-controlled study. The Capsaicin Study Group. Arch Intern Med 1991;151:2225-9.

23. [No authors listed.] Effect of treatment with capsaicin on daily activities of patients with painful diabetic neuropathy. Capsaicin Study Group. Diabetes Care 1992;15:159-65.

24. 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;52:1323-6.

25. Sicuteri F, Renzi D, Geppetti P. Substance P and enkephalins: a creditable tandem in the pathophysiology of cluster headache and migraine. Adv Exp Med Biol 1986;198B:145-52.

26. Sicuteri F, Fanciullacci M, Nicolodi M, et al. Substance P theory: a unique focus on the painful and painless phenomena of cluster headache. Headache 1990;30:69-79 [review].

27. Lynn B. Capsaicin. Actions on nociceptive C-fibers and therapeutic potential. Pain 1990;41:61-9.

28. Sicuteri F, Fusco BM, Marabini S, et al. Beneficial effect of capsaicin application to the nasal mucosa in cluster headache. Clin J Pain 1989;5:49-53.

29. Fusco BM, Marabini S, Maggi C, et al. Preventative effect of repeated nasal applications of capsaicin in cluster headache. Pain 1994;59:321-5.

30. Fusco BM, Fiore G, Gallo F, et al. “Capsaicin-sensitive” sensory neurons in cluster headache: pathophysiological aspects and therapeutic indication. Headache 1994;34:132-7.

31. Marks DR, Papoport A, Padla D, et al. A double-blind placebo-controlled trial of intranasal capsaicin for cluster headache. Cephalalgia 1993;13:114-6.

32. Yoshioka M, Doucet E, Drapeau V, et al. Combined effects of red pepper and caffeine consumption on 24 h energy balance in subjects given free access to foods. Br J Nutr 2001;85:203-11.

33. Yoshioka M, St-Pierre S, Drapeau V, et al. Effects of red pepper on appetite and energy intake. Br J Nutr 1999;82:115-23.

34. Yoshioka M, Doucet E, Drapeau V, et al. Combined effects of red pepper and caffeine consumption on 24 h energy balance in subjects given free access to foods. Br J Nutr 2001;85:203-11.

35. 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;80:503-10.

36. Yoshioka M, Lim K, Kikuzato S, et al. Effects of red-pepper diet on the energy metabolism in men. J Nutr Sci Vitaminol (Tokyo) 1995;41:647-56.

37. Deal CL, Schnitzer TJ, Lipstein E, et al. Treatment of arthritis with topical capsaicin: A double-blind trial. Clin Ther 1991;13:383-95.

38. Fusco BM, Giacovazzo M. Peppers and pain. The promise of capsaicin. Drugs 1997;53:909-14 [review].

39. Keitel W, Frerick H, Kuhn U, et al. Capsicum plaster in chronic non-specific low back pain. Arzneimittelforschung 2001;51:896-903.

40. Fusco BM, Giacovazzo M. Peppers and pain. The promise of capsaicin. Drugs 1997;53:909-14 [review].

41. Schnitzer TJ. Non-NSAID pharmacologic treatment options for the management of chronic pain. Am J Med 1998;105:45S-52S [review].

42. Siften DW (ed). Physicians' Desk Reference for Nonprescription Drugs. Montvale, NJ: Medical Economics, 1998, 790-1.

43. Rumsfield JA, West DP. Topical capsaicin in dermatologic and peripheral pain disorders. DICP 1991;25:381-7 [review].

44. Levy RL. Intranasal capsaicin for acute abortive treatment of migraine without aura. Headache 1995;35:277 [letter].

45. Lynn B. Capsaicin. Actions on nociceptive C-fibers and therapeutic potential. Pain 1990;41:61-9.

46. [No authors listed.] Treatment of painful diabetic neuropathy with topical capsaicin. A multicenter, double-blind, vehicle-controlled study. The Capsaicin Study Group. Arch Intern Med 1991;151:2225-9.

47. [No authors listed.] Effect of treatment with capsaicin on daily activities of patients with painful diabetic neuropathy. Capsaicin Study Group. Diabetes Care 1992;15:159-65.

48. 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;15:2974-80.

49. Watson CPN, Evans RJ, Watt VR. The postmastectomy pain syndrome and the effect of topical capsaicin. Pain 1989;38:177-86.

50. Watson CPN, Evans RJ. The postmastectomy pain syndrome and topical capsaicin: a randomized trial. Pain 1992;51:375-9.

51. Bernstein JE, Parish LC, Rapaport M, et al. Effects of topically applied capsaicin on moderate and severe psoriasis vulgaris. J Am Acad Dermatol 1986;15:504-7.

52. McCarty DJ, Csuka M, McCarthy G, et al. Treatment of pain due to fibromyalgia with topical capsaicin: A pilot study. Semin Arth Rhem 1994;23:41-7.

53. Watson CP, Tyler KL, Bickers DR, et al. A randomized vehicle-controlled trial of topical capsaicin in the treatment of postherpetic neuralgia. Clin Ther 1993;15:510-26.

54. Watson CP, Evans RJ, Watt VR. Postherpetic neuralgia and topical capsaicin. Pain 1988;33:333-40.

55. McCarthy GM, McCarty DJ. Effect of topical capsaicin in the therapy of painful osteoarthritis of the hands. J Rheumatol 1992;19:604-7.

56. Deal CL, Schnitzer TJ, Lipstein E, et al. Treatment of arthritis with topical capsaicin: A double-blind trial. Clin Ther 1991;13:383-95.

57. Deal CL, Schnitzer TJ, Lipstein E, et al. Treatment of arthritis with topical capsaicin: A double-blind trial. Clin Ther 1991;13:383-95.

58. Marks DR, Papoport A, Padla D, et al. A double-blind placebo-controlled trial of intranasal capsaicin for cluster headache. Cephalalgia 1993;13:114-6.

59. Levy RL. Intranasal capsaicin for acute abortive treatment of migraine without aura. Headache 1995;35:277 [letter].

60. de Seze M, Wiart L, Ferrier JM, et al. Intravesical instillation of capsaicin in urology: A review of the literature. Eur Urol 1999;36:267-77 [review].

61. Yoshioka M, St-Pierre S, Drapeau V, et al. Effects of red pepper on appetite and energy intake. Br J Nutr 1999;82:115-23.

62. 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;80:503-10.

63. Bortolotti M, Coccia G, Grossi G. Red pepper and functional dyspepsia. N Engl J Med 2002;346:947-8 [letter].

64. Siften DW (ed). Physicians' Desk Reference for Nonprescription Drugs. Montvale, NJ: Medical Economics, 1998, 790-1.

65. Bortolotti M, Coccia G, Grossi G. Red pepper and functional dyspepsia. N Engl J Med 2002;346:947-8 [letter].

66. Abdel Salam OME, Mószik G, Szolcsányi J. Studies on the effect of intragastric capsaicin on gastric ulcer and on the prostacyclin-induced cytoprotection in rats. Pharmacol Res 1995;32:209-15.

67. Holzer P, Pabst MA, Lippe IT. Intragastric capsaicin protects against aspirin-induced lesion formation and bleeding in the rat gastric mucosa. Gastroenterology 1989;96:1425-33.

68. Yeoh KG, Kang JY, Yap I, et al. Chili protects against aspirin-induced gastroduodenal mucosal injury in humans. Dig Dis Sci 1995;40(3):580-3.

69. Siften DW (ed). Physicians' Desk Reference for Nonprescription Drugs. Montvale, NJ: Medical Economics, 1998, 790-1.

70. Lopez-Carrillo L, Avila M, Dubrow R. Chili pepper consumption and gastric cancer in Mexico: A case-control study. Amer J Epidem 1994;139:263-71.

71. Buiatti E, Palli D, Decarli A, et al. A case-control study of gastric cancer and diet in Italy. Int J Cancer 1989;44:611-6.

72. Surh YJ, Lee SS. Capsaicin in hot chili pepper: Carcinogen, co-carcinogen or anticarcinogen? Food Chem Toxic 1996;34:313-6.

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