Herb library · Spice · Capsicum annuum, Capsicum frutescens
Cayenne (chili pepper)
Dried, ground hot chili peppers, native to the Americas. Their heat comes from capsaicin. Capsicum plasters and creams are an EU-recognized use for muscle pain, and a strong prescription capsaicin patch helps some people with nerve pain. Eaten, chili is generally safe; its long-term health effects are unclear.
Traditional use
Chilies were a condiment of the Indigenous peoples of the Caribbean and the Americas when Columbus's fleet reached Hispaniola, and Spanish and Portuguese ships carried them to India and Europe in the 1500s. In the 1800s European doctors used capsicum plasters and liniments for rheumatic and nerve pains and gargles for sore throats. In China they became an everyday condiment. Today capsaicin is sold in pain creams, and capsules have been studied for metabolism and weight. Among the Tewa of the Rio Grande pueblos, a 1916 study recorded chiles strung on yucca and dried for winter, ground on a metate and cooked with meat or eaten as a sauce with tortillas. In 1756 Browne recorded that West Indians dried bird pepper and pounded it with salt into "Cayan pepper", and mixed pepper into a relish called mandram.
Traditional energetics
Caribbean folk tradition
Counted as heating. The Civil and Natural History of Jamaica (1756), p. 176 (opens in a new tab)
What studies show
- Established
Muscle pain such as low back pain, with capsicum plasters and creams applied to the skin: the European Medicines Agency classes this as a well-established use, based on published studies. The plasters are worn for 4 to 12 hours a day, for up to 3 weeks at a time.
- Limited
Nerve pain, with the prescription 8% capsaicin patch (a drug, not the spice): a 2017 Cochrane review of 8 studies found that about 10% more people with shingles-related nerve pain, HIV nerve damage or diabetic nerve pain got moderate or substantial relief than with a very weak capsaicin control. The quality of the evidence was moderate to very low.
- Insufficient
Pain, with low-concentration capsaicin creams like those sold over the counter: a 2017 Cochrane overview rated the evidence for them as very low quality, and more people stopped using them because of side effects than stopped a placebo (15% vs 3%).
- Limited
Metabolism and weight: a 2021 review of 13 placebo-controlled trials found that capsaicin-type compounds raised resting calorie burn by about 34 calories a day and increased fat burning. The authors call for better studies, and a change of that size is small.
- Insufficient
Eating chili and long-term health: a 2022 umbrella review of 11 reviews found the overall health effect unclear. Chili eating has been linked with lower death and heart-disease rates in some studies and with higher rates of cancers of the esophagus, stomach and gallbladder in others; these studies show associations, not cause.
Be careful of
Cautions
- NoteOn the skin, capsaicin causes burning and irritation. With low-concentration creams, local side effects were common in Cochrane's review; the 8% patch causes such intense burning that it is applied under controlled conditions in a clinic, often after a numbing medicine.
- AmountThe 8% patch holds about 100 times more capsaicin than ordinary creams and is a prescription product.
- NoteEating chili is typically safe, according to a 2022 umbrella review, though some studies link heavy spicy-food eating with certain digestive-tract cancers.
- ConditionThe EMA says capsicum skin products should not be used on broken skin, wounds or eczema, near the eyes or on mucous membranes, or by anyone under 18, and extra heat (a heating pad, hot water, sun) should be avoided while using them. Wash your hands after touching them.
- AllergyPeople allergic to chili or other pepper plants should not use capsicum skin products. Rarely, the plaster causes hives or blisters; stop it at once if that happens.
- PregnancyCapsaicin crosses the placenta and may pass into breast milk. The EMA says capsicum skin products should be used in pregnancy or while breastfeeding only after a careful weighing of risks and benefits. No information was found on capsaicin supplements in pregnancy.
- Ask a clinicianTalk with a clinician or pharmacist before using this if you take prescription medicines, are pregnant or breastfeeding, or are giving it to a child.
From the old books
What herbals and dispensaries of the past printed. History, in their words.
“The pods of this last sort dried, and pounded with a sufficient quantity of salt, is the Cayan pepper or butter of the West-Indians.”
“Chiles are strung on yucca slips and dried for winter use, ground to powder on a metate, and cooked with meat or eaten as sauce with tortillas.”
“Chanca, physician to the fleet of Columbus in his second voyage to the West Indies, notices them among the productions of Hispaniola as a condiment used by the natives under the name of Agi, which is still the common name for them in Spanish.”
Sources
- European Union herbal monograph on Capsicum annuum L. var. minimum (Miller) Heiser and small fruited varieties of Capsicum frutescens L., fructus (EMA/HMPC/674139/2013) (opens in a new tab) · EMA · read September 25, 2026
- Topical capsaicin (high concentration) for chronic neuropathic pain in adults (Cochrane Database Syst Rev, 2017) — PubMed record (opens in a new tab) · NIH · read September 25, 2026
- Topical analgesics for acute and chronic pain in adults — an overview of Cochrane Reviews (Cochrane Database Syst Rev, 2017) — PubMed record (opens in a new tab) · NIH · read September 25, 2026
- The effect of Capsaicinoids or Capsinoids in red pepper on thermogenesis in healthy adults: A systematic review and meta-analysis (Phytother Res, 2021) — PubMed record (opens in a new tab) · NIH · read September 25, 2026
- Spicy Food and Chili Peppers and Multiple Health Outcomes: Umbrella Review (Mol Nutr Food Res, 2022) — PubMed record (opens in a new tab) · NIH · read September 25, 2026
Reviewed September 25, 2026.