Cayenne

What Is Cayenne?

Cayenne is a hot chili pepper, the pungent fruit of Capsicum annuum, used as a spice and as a warming herb. In Western herbalism it is a circulatory stimulant, added in small amounts to formulas to warm the body and bring blood to the skin.

Capsicum annuum is native from the southern United States through Mexico and Central America to northern South America, and is now grown almost worldwide ^{26Reference 26Flora of North America Editorial CommittCapsicum annuum Linnaeus — native and introduced range — floraView study →}. The same species includes sweet peppers as well as hot ones ^{25Reference 25Zhang et al. · 1994Capsicum annuum Linnaeus — species description, distribution and uses — floraView study →}.

Its heat comes from capsaicinoids, chiefly capsaicin and dihydrocapsaicin ^{27Reference 27Barbero et al. · 2014Evolution of total and individual capsaicinoids in peppers during ripening of the Cayenne pepper plant (Capsicum annuum L.) — analytical studyView study →}. Purified capsaicin is an approved topical medicine for nerve pain, and research has also looked at joint pain, digestion and metabolism ^{1,7,10,17Reference 1Derry et al. · 2013Meta-analysisTopical capsaicin (high concentration) for chronic neuropathic pain in adults — Cochrane systematic review / meta-analysisView study →Reference 7Tshering et al. · 2024Meta-analysisEfficacy and safety of topical capsaicin in the treatment of osteoarthritis pain — systematic review and meta-analysisView study →Reference 10Zsiborás et al. · 2018Meta-analysisCapsaicin and capsiate could be appropriate agents for treatment of obesity — meta-analysis of human studiesView study →Reference 17Bortolotti et al. · 2002RCTThe treatment of functional dyspepsia with red pepper — randomised controlled trialView study →}.

Cayenne is one of many hot forms of the species. Heat varies widely between cultivars, and even between fruits picked from one plant on the same day ^{24Reference 24Kirschbaum-Titze et al. · 2002Pungency in paprika (Capsicum annuum)View study →}.

How Is Cayenne Used?

Cayenne is used as the dried, powdered fruit, as a tincture, and on the skin.

• Powder or capsules — a small pinch added to formulas, or taken with meals.
• Tincture — a few drops added to other remedies.
• Liniments and plasters — applied over aching muscles and joints to warm the skin.
• Capsaicin creams and patches — pharmacy creams (usually 0.025–0.075%) and the prescription 8% patch ^{1,8Reference 1Derry et al. · 2013Meta-analysisTopical capsaicin (high concentration) for chronic neuropathic pain in adults — Cochrane systematic review / meta-analysisView study →Reference 8Laslett et al. · 2014ReviewCapsaicin for osteoarthritis pain — reviewView study →}.
• Food — as a spice.

Traditional Uses

Western Herbal Medicine

Cayenne is used less as a stand-alone remedy than as a small “driving” addition to formulas. A pinch of the powder or a few drops of tincture is added to move blood to the surface, warm a cold constitution and carry other herbs further.

It is also a carminative for sluggish, cold digestion, and a rubefacient in liniments and plasters, applied over aching joints and muscles to draw blood to the skin.

Culinary use. Cayenne is a food-medicine as much as a herb, and most traditional intake is as a spice.

Indications

• Nerve pain after shingles, and diabetic and HIV-related nerve pain [capsaicin, 8% patch]
• Osteoarthritis pain [capsaicin cream]
• Chronic low back pain [capsicum plaster]
• Aching muscles and joints [fruit, in liniments and plasters; Western herbal medicine]
• Functional dyspepsia [fruit powder]
• Sluggish, cold digestion [fruit; Western herbal medicine]
• Cold hands and feet, poor circulation [fruit; Western herbal medicine]
• Raised cholesterol and triglycerides [capsaicin and capsinoids, oral]
• Weight management [capsaicin, oral] ⚠Caution: Pooled trials found a rise in energy expenditure of about 60 kcal a day, seen only in people with a BMI above 25. The trials measured energy use, not weight loss ¹⁰.

Botany

Cayenne is a form of Capsicum annuum, a member of the nightshade family (Solanaceae), which also includes tomato, potato and tobacco. The species grows as a small shrub or as an annual or perennial herb, 20–80 cm tall ^{25Reference 25Zhang et al. · 1994Capsicum annuum Linnaeus — species description, distribution and uses — floraView study →}.

Its leaves are oval to lance-shaped, 4–13 cm long, with smooth edges. The flowers grow singly or in small clusters, each with a white corolla about 1 cm across and purplish anthers ^{25Reference 25Zhang et al. · 1994Capsicum annuum Linnaeus — species description, distribution and uses — floraView study →}.

The fruit is a berry, mostly red but orange, yellow or purple in cultivated forms, and up to 15 cm long. Its seeds are pale yellow, flat and 3–5 mm across ^{25Reference 25Zhang et al. · 1994Capsicum annuum Linnaeus — species description, distribution and uses — floraView study →}.

The species includes both sweet and pungent forms, and long cultivation has produced many cultivars with very different fruit ^{25Reference 25Zhang et al. · 1994Capsicum annuum Linnaeus — species description, distribution and uses — floraView study →}. The Flora of China includes plants often called C. frutescens within C. annuum, because the characters used to separate them occur in both ^{25Reference 25Zhang et al. · 1994Capsicum annuum Linnaeus — species description, distribution and uses — floraView study →}.

Pungency varies even within one plant. Fruits from a single plant, harvested at the same time, contain widely different amounts of capsaicinoids, though the ratio between the individual capsaicinoids stays fairly uniform ^{24Reference 24Kirschbaum-Titze et al. · 2002Pungency in paprika (Capsicum annuum)View study →}.

Distribution

Capsicum annuum is native to the southern United States, Mexico, the West Indies, Central America and South America north of the Amazon ^{26Reference 26Flora of North America Editorial CommittCapsicum annuum Linnaeus — native and introduced range — floraView study →}. It has been introduced almost worldwide, and is widely cultivated and naturalised ^{25,26Reference 25Zhang et al. · 1994Capsicum annuum Linnaeus — species description, distribution and uses — floraView study →Reference 26Flora of North America Editorial CommittCapsicum annuum Linnaeus — native and introduced range — floraView study →}.

It is grown as a food and spice crop across the tropical and warm-temperate world.

Growing Conditions

Cultivation snapshot for Cayenne

Lifetender perennial, grown as an annualZoneUSDA 9-11 (perennial); annual elsewhereSunfull sunWatermedium, even moisture; dislikes drying out

Habitbushy subshrub or herb, 20–80 cm tall ^{25Reference 25Zhang et al. · 1994Capsicum annuum Linnaeus — species description, distribution and uses — floraView study →}.

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Phytochemistry

Cayenne’s heat comes from the capsaicinoids, a family of pungent compounds. In cayenne pepper the five main ones are capsaicin, dihydrocapsaicin, nordihydrocapsaicin, homocapsaicin and homodihydrocapsaicin ^{27Reference 27Barbero et al. · 2014Evolution of total and individual capsaicinoids in peppers during ripening of the Cayenne pepper plant (Capsicum annuum L.) — analytical studyView study →}.

Capsaicin and dihydrocapsaicin together make up 79–90% of total capsaicinoids, depending on ripeness ^{27Reference 27Barbero et al. · 2014Evolution of total and individual capsaicinoids in peppers during ripening of the Cayenne pepper plant (Capsicum annuum L.) — analytical studyView study →}. Total capsaicinoids build up to a peak as the fruit develops and then fall by about a third as it ripens further ^{27Reference 27Barbero et al. · 2014Evolution of total and individual capsaicinoids in peppers during ripening of the Cayenne pepper plant (Capsicum annuum L.) — analytical studyView study →}.

Capsaicin acts on TRPV1, the heat- and pain-sensing receptor on sensory nerves ^{1Reference 1Derry et al. · 2013Meta-analysisTopical capsaicin (high concentration) for chronic neuropathic pain in adults — Cochrane systematic review / meta-analysisView study →}.

The ripe fruit’s colour comes from carotenoids, including the red pigments capsanthin and capsorubin and provitamin-A β-carotene.

A related group of non-pungent compounds, the capsinoids (such as capsiate), has been studied alongside capsaicin for energy expenditure ^{10Reference 10Zsiborás et al. · 2018Meta-analysisCapsaicin and capsiate could be appropriate agents for treatment of obesity — meta-analysis of human studiesView study →}.

Constituent Summary

Capsaicinoid shares are of total capsaicinoids in cayenne fruit ^{27Reference 27Barbero et al. · 2014Evolution of total and individual capsaicinoids in peppers during ripening of the Cayenne pepper plant (Capsicum annuum L.) — analytical studyView study →}.

Pharmacology & Research

Most of the research is on purified capsaicin. Topical capsaicin has the largest body of evidence: a Cochrane review and several meta-analyses of the 8% patch for nerve pain, meta-analyses of low-strength creams for osteoarthritis, and a trial of a capsicum plaster for back pain ^{1,2,7,8,9Reference 1Derry et al. · 2013Meta-analysisTopical capsaicin (high concentration) for chronic neuropathic pain in adults — Cochrane systematic review / meta-analysisView study →Reference 2Liu et al. · 2020Meta-analysisThe treatment of topical drugs for postherpetic neuralgia: a network meta-analysis — systematic reviewView study →Reference 7Tshering et al. · 2024Meta-analysisEfficacy and safety of topical capsaicin in the treatment of osteoarthritis pain — systematic review and meta-analysisView study →Reference 8Laslett et al. · 2014ReviewCapsaicin for osteoarthritis pain — reviewView study →Reference 9Keitel et al. · 2001RCTCapsicum pain plaster in chronic non-specific low back pain — randomised controlled trialView study →}.

The crude fruit has been tested by mouth in one five-week trial of red-pepper powder for functional dyspepsia ^{17Reference 17Bortolotti et al. · 2002RCTThe treatment of functional dyspepsia with red pepper — randomised controlled trialView study →}.

Trials of oral capsaicin and capsinoids have looked at energy expenditure, appetite and blood lipids ^{10,11,12,13,14Reference 10Zsiborás et al. · 2018Meta-analysisCapsaicin and capsiate could be appropriate agents for treatment of obesity — meta-analysis of human studiesView study →Reference 11Rigamonti et al. · 2018RCTAcute administration of capsaicin increases resting energy expenditure in young obese subjects — randomised controlled trialView study →Reference 12Reinbach et al. · 2009RCTEffects of capsaicin, green tea and CH-19 sweet pepper on appetite and energy intake in humans — randomised controlled trialView study →Reference 13Yang et al. · 2025Meta-analysisThe effect of capsaicin, capsinoids, and pepper-based interventions on lipid profiles in overweight or obese individuals — systematic review and meta-analysis of randomised controlled trialsView study →Reference 14Jiang et al. · 2022Systematic reviewLipid-lowering efficacy of capsaicin in patients with metabolic syndrome — systematic reviewView study →}. Large cohort studies have linked eating chili with lower mortality ^{15,16Reference 15Ofori-Asenso et al. · 2021Meta-analysisAssociation of spicy chilli food consumption with cardiovascular and all-cause mortality — meta-analysis of cohort studies (systematic review)View study →Reference 16Ao et al. · 2022ReviewSpicy food and chili peppers and multiple health outcomes — umbrella reviewView study →}, and anticancer work is in cells and animals ^{19,20,23Reference 19A comprehensive review of capsaicin et al. · 2024ReviewA comprehensive review of capsaicin and its role in cancer prevention and treatment (2024) — review. Drug Research. https://pubmed.ncbi.nlm.nih.gov/38729182/View study →Reference 20Capsaicin promotes apoptosis et al. · 2024In vitroCapsaicin promotes apoptosis and inhibits cell migration (2024) — in vitro study. Cureus. https://pubmed.ncbi.nlm.nih.gov/39435241/View study →Reference 23Capsaicin reverses cisplatin resistance · 2024In vitroCapsaicin reverses cisplatin resistance in tongue squamous cell carcinoma (2024) — in vitro and animal study. Cell Biology International. https://pubmed.ncbi.nlm.nih.gov/38706122/View study →}.

1. Topical Neuropathic Pain

A Cochrane review of high-concentration (8%) topical capsaicin pooled four trials (1,272 people) in nerve pain after shingles and two (801 people) in HIV-related nerve pain. Against a low-strength capsaicin control, more people on the 8% patch reported feeling much or very much better. The number needed to treat was 7.0 at 12 weeks after shingles, and the review judged the extra proportion helped to be not large ^{1Reference 1Derry et al. · 2013Meta-analysisTopical capsaicin (high concentration) for chronic neuropathic pain in adults — Cochrane systematic review / meta-analysisView study →}.

A network meta-analysis of topical drugs for nerve pain after shingles found high-concentration capsaicin more effective than placebo, though lidocaine ranked first ^{2Reference 2Liu et al. · 2020Meta-analysisThe treatment of topical drugs for postherpetic neuralgia: a network meta-analysis — systematic reviewView study →}.

In a single-blind crossover trial in 11 people with spinal-cord-injury nerve pain, the 8% patch cut pain by 35% at two weeks and 29% at four weeks compared with a 0.025% control patch ^{3Reference 3Olusanya et al. · 2023RCTCapsaicin 8% patch for spinal cord injury focal neuropathic pain — randomised controlled trialView study →}. A pooled analysis of 12 studies of the patch for nerve pain after surgery found a large reduction in pain (Cohen’s d 1.09) ^{22Reference 22The efficacy of topical 8% capsaicin pat · 2024Systematic reviewThe efficacy of topical 8% capsaicin patches for the treatment of postsurgical neuropathic pain (2024) — systematic review. Pain Management. https://pubmed.ncbi.nlm.nih.gov/39589498/View study →}.

For painful diabetic neuropathy, the 8% patch is an approved second-line treatment with a modest effect ^{4Reference 4D’Souza et al. · 2022Systematic reviewEvidence-based treatment of painful diabetic neuropathy — systematic reviewView study →}. A review found the 8% patch and 0.075% cream effective, but not 0.025% gel, with application-site burning and redness the most common side effects ^{5Reference 5Goodwin et al. · 2023Systematic reviewTopical capsaicin for the management of painful diabetic neuropathy — narrative systematic reviewView study →}. A 2026 meta-analysis of seven studies in HIV-related nerve pain found a reduction in pain (d 0.99), with high heterogeneity between studies ^{6Reference 6Goodwin et al. · 2026Meta-analysisGoodwin, B. J., et al. (2026). 8% capsaicin patches for HIV-induced polyneuropathy — systematic review and meta-analysis. Pain Management. https://pubmed.ncbi.nlm.nih.gov/42237588/View study →}.

The patch works by desensitising the pain-sensing nerve endings in the skin. Applied at high strength, capsaicin first heightens and then reduces sensitivity, and a single application gives relief expected to last about 12 weeks ^{1Reference 1Derry et al. · 2013Meta-analysisTopical capsaicin (high concentration) for chronic neuropathic pain in adults — Cochrane systematic review / meta-analysisView study →}.

Gap: the 8% patch is a prescription product applied in a clinic, normally under local anaesthetic ^{1Reference 1Derry et al. · 2013Meta-analysisTopical capsaicin (high concentration) for chronic neuropathic pain in adults — Cochrane systematic review / meta-analysisView study →}. No trial has tested cayenne cream, oil or plaster at herbal strength for nerve pain.

2. Topical Osteoarthritis & Musculoskeletal Pain

A 2024 meta-analysis of eight double-blind RCTs (498 patients) found that topical capsaicin, at 0.0125–5%, reduced osteoarthritis pain compared with placebo (standardised mean difference −0.84) over follow-ups of up to three months. It also made burning at the application site more likely (number needed to harm three), and the certainty of the evidence was low to very low ^{7Reference 7Tshering et al. · 2024Meta-analysisEfficacy and safety of topical capsaicin in the treatment of osteoarthritis pain — systematic review and meta-analysisView study →}.

An earlier review of trials using 0.025–0.075% creams four times daily found a moderate effect over four weeks (effect size 0.44). Mild burning affected 35–100% of users, peaking in the first week ^{8Reference 8Laslett et al. · 2014ReviewCapsaicin for osteoarthritis pain — reviewView study →}.

For chronic low back pain, a double-blind trial in 154 patients found that 60.8% responded to a capsicum plaster over three weeks, against 42.1% on placebo ^{9Reference 9Keitel et al. · 2001RCTCapsicum pain plaster in chronic non-specific low back pain — randomised controlled trialView study →}.

The trials used pharmaceutical creams and plasters, and the studies were small and short.

3. Metabolism, Weight & Energy Expenditure

A meta-analysis of nine studies found that capsaicin or capsinoids raised energy expenditure by about 59 kcal a day and increased fat oxidation. The effect appeared only in studies of people with a BMI above 25 ^{10Reference 10Zsiborás et al. · 2018Meta-analysisCapsaicin and capsiate could be appropriate agents for treatment of obesity — meta-analysis of human studiesView study →}.

In young people with obesity, a single 2 mg dose of capsaicin raised resting energy expenditure after a meal, but did not change food intake or hunger ^{11Reference 11Rigamonti et al. · 2018RCTAcute administration of capsaicin increases resting energy expenditure in young obese subjects — randomised controlled trialView study →}.

In a trial of 27 people, capsaicin combined with green tea reduced energy intake during a period of overeating, and capsaicin and green tea increased fullness more during calorie restriction ^{12Reference 12Reinbach et al. · 2009RCTEffects of capsaicin, green tea and CH-19 sweet pepper on appetite and energy intake in humans — randomised controlled trialView study →}.

Gap: the pooled trials measured energy expenditure over hours to weeks, not weight loss, and the one trial in young people with obesity found no effect on appetite ^{10,11Reference 10Zsiborás et al. · 2018Meta-analysisCapsaicin and capsiate could be appropriate agents for treatment of obesity — meta-analysis of human studiesView study →Reference 11Rigamonti et al. · 2018RCTAcute administration of capsaicin increases resting energy expenditure in young obese subjects — randomised controlled trialView study →}.

4. Lipids & Cardiometabolic Markers

A 2025 meta-analysis of 12 RCTs in overweight or obese people found that capsaicin, capsinoids and pepper-based products lowered triglycerides (by 14.3 mg/dL) and total cholesterol (by 10.0 mg/dL), with no effect on LDL or HDL cholesterol. The effect was stronger at doses of 10 mg a day or more and over 12 weeks or longer ^{13Reference 13Yang et al. · 2025Meta-analysisThe effect of capsaicin, capsinoids, and pepper-based interventions on lipid profiles in overweight or obese individuals — systematic review and meta-analysis of randomised controlled trialsView study →}.

A 2022 meta-analysis of nine RCTs (461 patients) in metabolic syndrome found lower total and LDL cholesterol, but no overall change in triglycerides or HDL ^{14Reference 14Jiang et al. · 2022Systematic reviewLipid-lowering efficacy of capsaicin in patients with metabolic syndrome — systematic reviewView study →}.

The pooled effects are modest and vary between trials, most of which used purified capsaicinoids.

5. Cardiovascular & All-Cause Mortality (Dietary)

A meta-analysis of four prospective cohorts from the United States, China, Italy and Iran (564,748 adults, median follow-up 9.7 years) found that regular spicy-food eaters had a 12% lower risk of death from any cause and an 18% lower risk of death from heart disease. There was no significant link with death from stroke ^{15Reference 15Ofori-Asenso et al. · 2021Meta-analysisAssociation of spicy chilli food consumption with cardiovascular and all-cause mortality — meta-analysis of cohort studies (systematic review)View study →}.

An umbrella review of 11 meta-analyses judged the overall health effect of chili unclear. It found lower risks for metabolic disease, mortality and cardiovascular disease, but higher risks for oesophageal, gastric and gallbladder cancer ^{16Reference 16Ao et al. · 2022ReviewSpicy food and chili peppers and multiple health outcomes — umbrella reviewView study →}.

Gap: these are cohort associations, not trials. Chili intake goes with diet, region and lifestyle, and no trial has tested whether adding cayenne changes these outcomes.

6. Digestive & Gastroprotective

In a double-blind trial, 30 patients with functional dyspepsia took 2.5 g/day of red-pepper powder or placebo before meals for five weeks. From the third week, symptom scores were lower on the pepper, falling by about 60% by the end against under 30% on placebo. The authors attribute the effect to desensitisation of pain-sensing nerve fibres in the stomach ^{17Reference 17Bortolotti et al. · 2002RCTThe treatment of functional dyspepsia with red pepper — randomised controlled trialView study →}.

In rats, capsaicin given before haemorrhagic shock, and four weeks of chili powder in the diet, both reduced injury to the stomach lining. The protection disappeared when the capsaicin-sensitive sensory nerves were destroyed ^{18Reference 18Teng et al. · 1998Protective action of capsaicin and chilli on haemorrhagic shock-induced gastric mucosal injury — animal comparative studyView study →}.

The human evidence is one small trial, and the protective data are from animals.

7. Anticancer

In laboratory studies, capsaicin triggers cancer-cell death, slows cell migration and inhibits tumour growth ^{19Reference 19A comprehensive review of capsaicin et al. · 2024ReviewA comprehensive review of capsaicin and its role in cancer prevention and treatment (2024) — review. Drug Research. https://pubmed.ncbi.nlm.nih.gov/38729182/View study →}. In oral cancer cells it lowered viability and migration through the TNF-α and NF-κB pathway ^{20Reference 20Capsaicin promotes apoptosis et al. · 2024In vitroCapsaicin promotes apoptosis and inhibits cell migration (2024) — in vitro study. Cureus. https://pubmed.ncbi.nlm.nih.gov/39435241/View study →}. In cisplatin-resistant tongue cancer cells, and in animals, capsaicin combined with cisplatin restored the drug’s effect through mitochondrial cell death ^{23Reference 23Capsaicin reverses cisplatin resistance · 2024In vitroCapsaicin reverses cisplatin resistance in tongue squamous cell carcinoma (2024) — in vitro and animal study. Cell Biology International. https://pubmed.ncbi.nlm.nih.gov/38706122/View study →}.

In population studies, higher chili intake has been linked with higher risks of oesophageal, gastric and gallbladder cancer ^{16Reference 16Ao et al. · 2022ReviewSpicy food and chili peppers and multiple health outcomes — umbrella reviewView study →}.

Gap: the anticancer work is in cells and animals only, and there is no clinical evidence that cayenne or capsaicin prevents or treats cancer.

Mechanisms

Capsaicin activates TRPV1, the heat- and pain-sensing receptor on sensory nerves. Brief exposure causes burning, and high or repeated exposure desensitises the nerve endings, which is how the 8% patch relieves pain for about 12 weeks after one application ^{1Reference 1Derry et al. · 2013Meta-analysisTopical capsaicin (high concentration) for chronic neuropathic pain in adults — Cochrane systematic review / meta-analysisView study →}.

Taken by mouth, capsaicin has been studied for raising energy expenditure and fat oxidation ^{10Reference 10Zsiborás et al. · 2018Meta-analysisCapsaicin and capsiate could be appropriate agents for treatment of obesity — meta-analysis of human studiesView study →}, and for protecting the stomach lining through capsaicin-sensitive nerves ^{18Reference 18Teng et al. · 1998Protective action of capsaicin and chilli on haemorrhagic shock-induced gastric mucosal injury — animal comparative studyView study →}.

Clinical Trials

Topical capsaicin is heavily trialled. A ClinicalTrials.gov search for capsaicin in pain returns 235 registered studies, almost all testing purified capsaicin products rather than cayenne fruit. A multicentre trial in finger osteoarthritis with nerve-type pain is among the recently registered ^{21Reference 21Fan et al. · 2025RCTCADOR (Capsaicin in neuropathic-like pain in digital osteoarthritis) — multicentre randomised trial protocolView study →}.

Last checked: July 2026.

Dosage

Research doses and traditional doses are given separately. Most trials used purified capsaicin in a patch or cream; only the dyspepsia trial used the crude powder.

Research Doses

Traditional Dosage

Traditional internal doses are small, because cayenne is usually a minor part of a formula.

Safety & Pregnancy

Cayenne is well tolerated as a spice, and capsaicin is an approved topical medicine. Its side effects are local irritation rather than harm to the organs.

Full Safety & Interactions Detail

Topical use. Capsaicin commonly causes burning, stinging and redness where it is applied. In osteoarthritis trials, one extra person in three had application-site burning compared with placebo ^{7Reference 7Tshering et al. · 2024Meta-analysisEfficacy and safety of topical capsaicin in the treatment of osteoarthritis pain — systematic review and meta-analysisView study →}, and mild burning affected 35–100% of cream users, peaking in the first week ^{8Reference 8Laslett et al. · 2014ReviewCapsaicin for osteoarthritis pain — reviewView study →}.

The 8% patch. It is applied in a clinic, normally under local anaesthetic, because of the intense burning it causes ^{1Reference 1Derry et al. · 2013Meta-analysisTopical capsaicin (high concentration) for chronic neuropathic pain in adults — Cochrane systematic review / meta-analysisView study →}. Pain and blood pressure can rise briefly during application. It is a regulated medicine and should not be equated with home-strength cayenne cream.

By mouth. Large amounts can cause heartburn, stomach burning and gut upset.

Handling. Contact with the eyes, broken skin or mucous membranes is intensely painful, and inhaled powder irritates the airways. Wash hands after handling.

Interactions. No human drug-interaction trials exist for cayenne or capsaicin, and no clinically significant CYP450 effect is established. Additive effects with antiplatelet or anticoagulant drugs are a theoretical concern that has not been tested.

References

1. Derry, S., Rice, A. S. C., Cole, P., Tan, T., & Moore, R. A. (2013). Topical capsaicin (high concentration) for chronic neuropathic pain in adults — Cochrane systematic review / meta-analysis. Cochrane Database of Systematic Reviews. https://pubmed.ncbi.nlm.nih.gov/23450576/
2. Liu, X., et al. (2020). The treatment of topical drugs for postherpetic neuralgia: a network meta-analysis — systematic review. Pain Physician. https://pubmed.ncbi.nlm.nih.gov/33185370/
3. Olusanya, A., et al. (2023). Capsaicin 8% patch for spinal cord injury focal neuropathic pain — randomised controlled trial. Pain Medicine. https://pubmed.ncbi.nlm.nih.gov/35799365/
4. D’Souza, R. S., et al. (2022). Evidence-based treatment of painful diabetic neuropathy — systematic review. Current Pain and Headache Reports. https://pubmed.ncbi.nlm.nih.gov/35716275/
5. Goodwin, B., et al. (2023). Topical capsaicin for the management of painful diabetic neuropathy — narrative systematic review. Pain Management. https://pubmed.ncbi.nlm.nih.gov/37435696/
6. Goodwin, B. J., et al. (2026). 8% capsaicin patches for HIV-induced polyneuropathy — systematic review and meta-analysis. Pain Management. https://pubmed.ncbi.nlm.nih.gov/42237588/
7. Tshering, G., et al. (2024). Efficacy and safety of topical capsaicin in the treatment of osteoarthritis pain — systematic review and meta-analysis. Phytotherapy Research. https://pubmed.ncbi.nlm.nih.gov/38761115/
8. Laslett, L. L., & Jones, G. (2014). Capsaicin for osteoarthritis pain — review. Progress in Drug Research. https://pubmed.ncbi.nlm.nih.gov/24941673/
9. Keitel, W., et al. (2001). Capsicum pain plaster in chronic non-specific low back pain — randomised controlled trial. Arzneimittelforschung. https://pubmed.ncbi.nlm.nih.gov/11765591/
10. Zsiborás, C., et al. (2018). Capsaicin and capsiate could be appropriate agents for treatment of obesity — meta-analysis of human studies. Critical Reviews in Food Science and Nutrition. https://pubmed.ncbi.nlm.nih.gov/28001433/
11. Rigamonti, A. E., et al. (2018). Acute administration of capsaicin increases resting energy expenditure in young obese subjects — randomised controlled trial. Nutrition Research. https://pubmed.ncbi.nlm.nih.gov/29530622/
12. Reinbach, H. C., et al. (2009). Effects of capsaicin, green tea and CH-19 sweet pepper on appetite and energy intake in humans — randomised controlled trial. Clinical Nutrition. https://pubmed.ncbi.nlm.nih.gov/19345452/
13. Yang, Q., et al. (2025). The effect of capsaicin, capsinoids, and pepper-based interventions on lipid profiles in overweight or obese individuals — systematic review and meta-analysis of randomised controlled trials. Diabetes Research and Clinical Practice. https://pubmed.ncbi.nlm.nih.gov/40939866/
14. Jiang, Z., et al. (2022). Lipid-lowering efficacy of capsaicin in patients with metabolic syndrome — systematic review. Frontiers in Nutrition. https://pubmed.ncbi.nlm.nih.gov/35299764/
15. Ofori-Asenso, R., et al. (2021). Association of spicy chilli food consumption with cardiovascular and all-cause mortality — meta-analysis of cohort studies (systematic review). Angiology. https://pubmed.ncbi.nlm.nih.gov/33657876/
16. Ao, Z., et al. (2022). Spicy food and chili peppers and multiple health outcomes — umbrella review. Molecular Nutrition & Food Research. https://pubmed.ncbi.nlm.nih.gov/36111960/
17. Bortolotti, M., et al. (2002). The treatment of functional dyspepsia with red pepper — randomised controlled trial. Alimentary Pharmacology & Therapeutics. https://pubmed.ncbi.nlm.nih.gov/12030948/
18. Teng, C. H., et al. (1998). Protective action of capsaicin and chilli on haemorrhagic shock-induced gastric mucosal injury — animal comparative study. Journal of Gastroenterology and Hepatology. https://pubmed.ncbi.nlm.nih.gov/9835316/
19. A comprehensive review of capsaicin and its role in cancer prevention and treatment (2024) — review. Drug Research. https://pubmed.ncbi.nlm.nih.gov/38729182/
20. Capsaicin promotes apoptosis and inhibits cell migration (2024) — in vitro study. Cureus. https://pubmed.ncbi.nlm.nih.gov/39435241/
21. Fan, A., et al. (2025). CADOR (Capsaicin in neuropathic-like pain in digital osteoarthritis) — multicentre randomised trial protocol. BMJ Open. https://pubmed.ncbi.nlm.nih.gov/40050054/
22. The efficacy of topical 8% capsaicin patches for the treatment of postsurgical neuropathic pain (2024) — systematic review. Pain Management. https://pubmed.ncbi.nlm.nih.gov/39589498/
23. Capsaicin reverses cisplatin resistance in tongue squamous cell carcinoma (2024) — in vitro and animal study. Cell Biology International. https://pubmed.ncbi.nlm.nih.gov/38706122/
24. Kirschbaum-Titze, P., Mueller-Seitz, E., & Petz, M. (2002). Pungency in paprika (Capsicum annuum). 2. Heterogeneity of capsaicinoid content in individual fruits from one plant. Journal of Agricultural and Food Chemistry, 50(5), 1264-6. https://pubmed.ncbi.nlm.nih.gov/11853515/
25. Zhang, Z. Y., Lu, A., & D’Arcy, W. G. (1994). Capsicum annuum Linnaeus — species description, distribution and uses — flora. In Wu, Z. Y., & Raven, P. H. (eds.), Flora of China, Vol. 17 (Solanaceae). http://www.efloras.org/florataxon.aspx?flora_id=2&taxon_id=200020513
26. Flora of North America Editorial Committee (eds.) (n.d.). Capsicum annuum Linnaeus — native and introduced range — flora. In Flora of North America North of Mexico, Vol. 14 (Solanaceae). http://www.efloras.org/florataxon.aspx?flora_id=1&taxon_id=200020513
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