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Other common
name(s): capsaicin, cayenne, chili pepper, hot pepper,
red pepper, paprika, pimiento, long pepper, conoids
Scientific/medical
name(s): Capsicum
annum, Capsicum
frutescens
Description
Capsicum is the name of a group of annual plants in the
nightshade (Solanaceae) family. They are native to Mexico and Central
America but are cultivated for food in many warmer regions of the
world. Capsicum varieties include the cayenne pepper,
jalapeño pepper, other hot peppers, and paprika. Capsaicin
is the most-studied active ingredient in the plant and has been
approved by the U.S. Food and Drug Administration (FDA) for use on the
skin.
Overview
Although little research has been reported using the whole
Capsicum annum or Capsicum frutescens plant for people with cancer,
capsaicin (a major active ingredient) has been studied in oral and
topical forms. Several studies have shown that capsaicin may be
somewhat useful for managing pain related to surgery and mouth sores
due to chemotherapy and radiation therapy. However, more research is
needed on other uses of capsaicin and to find out whether the whole
herb is helpful for treating or preventing illness.
How is it promoted for use?
Capsaicin in topical form is promoted mainly for pain caused
by conditions such as arthritis and general muscle soreness. The FDA
approved a topical form of capsaicin for treating pain more than twenty
years ago that is still sold without a prescription. There is some
evidence that capsaicin may be useful in managing post-surgical pain
from mastectomy, thoracotomy (chest surgery), amputation, and other
surgery related to mainstream cancer treatment. Researchers have found
that capsaicin may provide temporary relief for pain from mouth sores
caused by chemotherapy and radiation therapy.
Some proponents claim that capsaicin has antioxidant
properties that help to fight the carcinogen nitrosamine, a
cancer-causing agent. An antioxidant is a compound that blocks the
action of free radicals, activated oxygen molecules that can damage
cells. Still others claim that it may prevent DNA damage and lung
cancer due to cigarette smoke. Available evidence does not support
claims of protection from the effects of smoking.
Over the years, the Capsicum annum or Capsicum frutescens herb
has been used by alternative medicine practitioners as a remedy for a
variety of conditions, such as upset stomach, menstrual cramps,
headaches, shingles, diarrhea, loss of appetite, stomach ulcers, poor
digestion, sore throat, itching, alcoholism, motion sickness,
toothache, malaria, and yellow fever. Some practitioners also claim it
can prevent colds, heart disease, and stroke; increase sexual potency;
foster weight loss; and strengthen the heart.
What does it involve?
The capsaicin cream, ointment, gel, lotion, or stick is rubbed
directly onto the skin over painful areas. Depending on the strength of
the preparation, it may be recommended for use for as little as 2 days
or as long as 2 months. It can be obtained with or without a
prescription.
Capsicum is available in health food stores as a tonic, a
capsule, or in tea. There are some recipes available over the Internet
that advocate making a candy with cayenne pepper to relieve the pain of
mouth sores from chemotherapy and radiation. Peppers are available
fresh, canned, frozen, and dried in food stores.
What is the history behind it?
As far back as 5000 BC, Indians in South America ate meals
prepared with hot peppers. Native Mexican Indians and some Chinese
(Hunan and Szechuan) are also known to have used hot peppers in many
dishes and continue to do so. These cultures have also used hot peppers
in herbal medicine to treat numerous conditions over the years.
While foods made with different kinds of peppers are popular
in a variety of ethnic cuisines, it is only in recent years that
interest in using capsaicin from hot peppers to manage pain and other
symptoms or illnesses has grown. Medical researchers are now looking at
the use of capsaicin as a possible cancer treatment.
What is the evidence?
Although there is little available research on the use of the
whole Capsicum herb for people with cancer, capsaicin has been
intensively researched for use on the skin. Extracted chemicals such as
capsaicin are not the same as the whole plant, so study results of
extracts are unlikely to be the same as studies using the whole plant.
A study in 1989 found topical capsaicin to have pain-relieving
effects among 50% of a small group of women who had undergone
mastectomies for breast cancer. A 1991 study concluded that capsaicin
cream reduced the amount of pain caused by diabetic neuropathy (a nerve
disorder). Nerve pain (also called neuropathic pain) is often
experienced by patients after cancer surgery and may be felt as
numbness, tingling, burning, shooting, or electric-shock-like pain. In
1994, a review of previous research concluded that while topical
capsaicin is not satisfactory as a therapy by itself, it may be used
with other medicines to ease pain. A 2004 review of 6 clinical trials
of patients with chronic long-term pain found that topical capsaicin
was helpful to some. However, about a third of the patients using
capsaicin had side effects that were not experienced by the placebo
groups. Studies continue on new ways to use capsaicin for pain and
itching.
A small 2006 study tested the effects on cholesterol of chili
peppers using raw chilies. Out of 27 test subjects, one group consumed
raw chopped chilies every day for 4 weeks, and the other group consumed
a bland diet. No differences in cholesterol were noted between the 2
groups.
In a pilot study conducted at the Yale University School of
Medicine, oral capsaicin (mixed with taffy) reduced pain in eleven
patients with mouth sores caused by chemotherapy or radiation therapy.
For most of the patients, however, the pain relief was incomplete and
did not last long. A later controlled study looked at larger doses of
capsaicin for 50 patients with a condition called burning mouth
syndrome. The researchers reported that some patients got relief from
the mouth pain and burning, but more than 30% of patients taking
capsaicin had fairly significant stomach pain. No patients in the
placebo group had stomach complaints.
Studies have also been conducted to examine capsaicin's
potential to relieve itching, reduce the size of nasal polyps, and
protect against substances that cause cancer. However, researchers have
found it difficult to conduct these studies because of the burning
sensation caused by oral or topical use of capsaicin. The discomfort
has caused some patients to stop using it. It also makes it difficult
for researchers to conduct controlled studies of the drug, since the
patient can often tell the active substance from the placebo.
Capsaicin has been shown to slow the growth of prostate cancer
cells in laboratory studies and rodents. Researchers are looking into
the use of capsaicin for prostate cancer in humans. Even though a
treatment may look promising in animal and laboratory studies, further
studies are required to find out whether the results apply to humans.
Available scientific research does not support claims for the
effectiveness of capsicum or whole pepper supplements in preventing or
curing cancer at this time. Claims that capsicum can help addiction,
malaria, yellow fever, heart disease, stroke, weight loss, poor
appetite, and sexual potency are not supported by available scientific
evidence. The pepper extract capsaicin appears to have some value as a
pain reliever, but its side effects limit its usefulness for some
people.
Are there any possible problems or
complications?
This product is sold as a
dietary supplement in the United States. Unlike companies that produce
drugs (which must provide the FDA with results of detailed testing
showing their product is safe and effective before the drug is approved
for sale), the companies that make supplements do not have to show
evidence of safety or health benefits to the FDA before selling their
products. Supplement products without any reliable scientific evidence
of health benefits may still be sold as long as the companies selling
them do not claim the supplements can prevent, treat, or cure any
specific disease. Some such products may not contain the amount of the
herb or substance that is written on the label, and some may include
other substances (contaminants). Though the FDA has written new rules
to improve the quality of manufacturing processes for dietary
supplements and the accurate listing of supplement ingredients, these
rules do not take full effect until 2010. And, the new rules do not
address the safety of supplement ingredients or their effects on health
when proper manufacturing techniques are used.
Most such
supplements have not been tested to find out if they interact with
medicines, foods, or other herbs and supplements. Even though some
reports of interactions and harmful effects may be published, full
studies of interactions and effects are not often available. Because of
these limitations, any information on ill effects and interactions
below should be considered incomplete.
Cayenne and other peppers are considered safe to eat in
moderate amounts for those who are not allergic to peppers. The FDA
includes peppers on their "generally recognized as safe" list of food
ingredients. However, capsicum supplements taken by mouth can cause
stomach upset or diarrhea. Direct contact between peppers and the mouth
or other mucous membranes can cause stinging, burning, or pain.
Sweating, skin flushing, runny nose, and tears are also fairly common
effects of taking capsicum supplements. Long-term use of supplements or
chiles can cause stomach irritation.
Oleoresin of capsicum (OC), commonly called “pepper
spray,” is used in spray form as a way to incapacitate people
in threatening situations. Usually the spray causes burning of the
eyes, nose, mouth, and skin. Some people cough and have trouble
breathing for a short time. Those with asthma or other breathing
problems may have worse effects. Generally, pepper spray does not cause
permanent damage, but there are exceptions. Deaths have been reported
due to pepper spray.
Some animal studies have shown that capsicum induced liver
tumors, and capsaicin caused cancerous tumors (adenocarcinomas) of the
intestine, although these effects have not been shown in humans.
Capsaicin in cream or other topical form often causes
temporary stinging, burning, or itching when applied directly to the
skin. In severe cases, blisters or rash may result. Capsaicin cream can
increase the absorption of other substances through the skin, so other
chemicals, lotions, and substances should be kept away from
capsaicin-treated areas. Contact with eyes, mucous membranes, or broken
skin should be avoided, as severe burning and irritation can occur.
After applying the cream, wash hands thoroughly (unless applying to the
hands). Some recommend using plastic gloves when applying the cream.
In addition, possible interactions between herbs and drugs or
other herbs should be considered. Capsicum supplements may cause the
body to absorb more theophylline (an asthma medicine) and acetaminophen
(pain medicine). They can also interfere with or worsen side effects of
certain blood pressure medicines and other drugs. Some combinations may
be dangerous. Always tell your doctor and pharmacist about any herbs
you are taking.
Those who are allergic to peppers should not take or use
capsaicin or other pepper extracts. Children and women who are pregnant
or breastfeeding should avoid taking this supplement internally.
Relying on this type of treatment alone and avoiding or delaying
conventional medical care for cancer may have serious health
consequences.
Additional Resources
More information from your American Cancer
Society
The following information on complementary and alternative
therapies may also be helpful to you. These materials may be found on
our Web site (www.cancer.org)
or ordered from our toll-free number (1-800-ACS-2345).
References
Ahuja KD, Ball MJ. Effects of daily ingestion of chilli on
serum lipoprotein oxidation in adult men and women. Br J Nutr.
2006;96:239-242.
Berger A, Henderson M, Nadoolman W, Duffy V, Cooper D,
Saberski L, Bartoshuk L. Oral capsaicin provides temporary relief for
oral mucositis pain secondary to chemotherapy/radiation therapy. J Pain Symptom Manage.
1995;10:243-248.
Erratum in:
J Pain Symptom Manage.
1996;11:331.
Capsaicin. Memorial Sloan-Kettering Cancer Center Web site.
http://www.mskcc.org/mskcc/html/69162.cfm. Accessed June 4, 2008.
Cayenne. Memorial Sloan-Kettering Cancer Center Web site.
http://www.mskcc.org/mskcc/html/69167.cfm. Accessed June 4, 2008.
Commission on Life Sciences. Carcinogens and Anticarcinogens
in the Human Diet: A Comparison of Naturally Occurring and Synthetic
Substances. Washington DC: National Academy Press;
1996:360.
Dini D, Bertelli G, Gozza A, Forno GG. Treatment of the
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Ellison N, Loprinzi CL, Kugler J, Hatfield AK, Miser A, Sloan
JA, Wender DB, Rowland KM, Molina R, Cascino TL, Vukov AM, Dhaliwal HS,
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Mori A, Lehmann S, O'Kelly J, Kumagai T, Desmond JC, Pervan M,
McBride WH, Kizaki M, Koeffler HP. Capsaicin, a component of red
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Olajos EJ, Salem H. Riot control agents: pharmacology,
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Petruzzi M, Lauritano D, De Benedittis M, Baldoni M, Serpico
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Watson CP, Evans RJ. The postmastectomy pain syndrome and
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Note:
This
information may not cover all possible claims, uses, actions,
precautions, side effects or interactions. It is not intended as
medical advice, and should not be relied upon as a substitute for
consultation with your doctor, who is familiar with your medical
situation.
Last Medical Review: 11/01/2008
Last Revised: 11/01/2008
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