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Cutaneous Manifestations
Capsicum peppers are used worldwide in preparing spicy dishes. Their active ingredient—capsaicin—is used as a topical medicine to treat localized pain. Capsicum peppers can cause irritant contact dermatitis with symptoms of erythema, cutaneous burning, and itch.1
Irritant contact dermatitis is a common occupational skin disorder. Many cooks have experienced the sting of a chili pepper after contact with the hands or eyes. Cases of chronic exposure to Capsicum peppers with persistent burning and pain have been called Hunan hand syndrome.2Capsicum peppers also have induced allergic contact dermatitis in a food production worker.3
Capsicum peppers also are used in pepper spray, tear gas, and animal repellents because of their stinging properties. These agents usually cause cutaneous tingling and burning that soon resolves; however, a review of 31 studies showed that crowd-control methods with Capsicum-containing tear gas and pepper spray can cause moderate to severe skin damage such as a persistent skin rash or erythema, or even first-, second-, or third-degree burns.4
Topical application of capsaicin isolate is meant to cause burning and deplete local neuropeptides, with a cutaneous reaction that ranges from mild to intolerable.5,6 Capsaicin also is found in other products. In one published case report, a 3-year-old boy broke out in facial urticaria when his mother kissed him on the cheek after she applied lip plumper containing capsaicin to her lips.7 Dermatologists should consider capsaicin an active ingredient that can irritate the skin in the garden, in the kitchen, and in topical products.
Obtaining Relief
Capsaicin-induced dermatitis can be relieved by washing the area with soap, detergent, baking soda, or oily compounds that act as solvents for the nonpolar capsaicin.8 Application of ice water or a high-potency topical steroid also may help. If the reaction is severe and persistent, a continuous stellate ganglion block may alleviate the pain of capsaicin-induced contact dermatitis.9
Identifying Features and Plant Facts
The Capsicum genus includes chili peppers, paprika, and red peppers. Capsicum peppers are native to tropical regions of the Americas (Figure). The use of Capsicum peppers in food can be traced to Indigenous peoples of Mexico as early as 7000
Capsicum belongs to the family Solanaceae, which includes tobacco, tomatoes, potatoes, and nightshade plants. There are many varieties of peppers in the Capsicum genus, with 5 domesticated species: Capsicum annuum, Capsicum baccatum, Capsicum chinense, Capsicum frutescens, and Capsicum pubescens. These include bell, poblano, cayenne, tabasco, habanero, and ají peppers, among others. Capsicum species grow as a shrub with flowers that rotate to stellate corollas and rounded berries of different sizes and colors.12 Capsaicin and other alkaloids are concentrated in the fruit; therefore, Capsicum dermatitis is most commonly induced by contact with the flesh of peppers.
Irritant Chemicals
Capsaicin (8-methyl-6-nonanoyl vanillylamide) is a nonpolar phenol, which is why washing skin that has come in contact with capsaicin with water or vinegar alone is insufficient to solubilize it.13 Capsaicin binds to the transient receptor potential vanilloid 1 (TRPV1), a calcium channel on neurons that opens in response to heat. When bound, the channel opens at a lower temperature threshold and depolarizes nerve endings, leading to vasodilation and activation of sensory nerves.14 Substance P is released and the individual experiences a painful burning sensation. When purified capsaicin is frequently applied at an appropriate dose, synthesis of substance P is diminished, resulting in reduced local pain overall.15
Capsaicin does not affect neurons without TRPV1, and administration of capsaicin is not painful if given with anesthesia. An inappropriately high dose of capsaicin destroys cells in the epidermal barrier, resulting in water loss and inducing release of vasoactive peptides and inflammatory cytokines.1 Careful handling of Capsicum peppers and capsaicin products can reduce the risk for irritation.
Medicinal Use
On-/Off-Label and Potential Uses—Capsaicin is US Food and Drug Administration approved for use in arthritis and musculoskeletal pain. It also is used to treat diabetic neuropathy,5 postherpetic neuralgia,6 psoriasis,16 and other conditions. Studies have shown that capsaicin might be useful in treating trigeminal neuralgia,17 fibromyalgia,18 migraines,14 cluster headaches,9 and HIV-associated distal sensory neuropathy.5
Delivery of Capsaicin—Capsaicin preferentially acts on C-fibers, which transmit dull, aching, chronic pain.19 The compound is available as a cream, lotion, and large bandage (for the lower back), as well as low- and high-dose patches. Capsaicin creams, lotions, and the low-dose patch are uncomfortable and must be applied for 4 to 6 weeks to take effect, which may impact patient adherence. The high-dose patch, which requires administration under local anesthesia by a health care worker, brings pain relief with a single use and improves adherence.11 Synthetic TRPV1-agonist injectables based on capsaicin have undergone clinical trials for localized pain (eg, postoperative musculoskeletal pain); many patients experience pain relief, though benefit fades over weeks to months.20,21
Use in Traditional Medicine—Capsicum peppers have been used to aid digestion and promote healing in gastrointestinal conditions, such as dyspepsia.22 The peppers are a source of important vitamins and minerals, including vitamins A, C, and E; many of the B complex vitamins; and magnesium, calcium, and iron.23
Use as Cancer Therapy—Studies of the use of capsaicin in treating cancer have produced controversial results. In cell and animal models, capsaicin induces apoptosis through downregulation of the Bcl-2 protein; upregulation of oxidative stress, tribbles-related protein 3 (TRIB3), and caspase-3; and other pathways.19,24-26 On the other hand, consumption of Capsicum peppers has been associated with cancer of the stomach and gallbladder.27 Capsaicin might have anticarcinogenic properties, but its mechanism of action varies, depending on variables not fully understood.
Final Thoughts
Capsaicin is a neuropeptide-active compound found in Capsicum peppers that has many promising applications for use. However, dermatologists should be aware of the possibility of a skin reaction to this compound from handling peppers and using topical medicines. Exposure to capsaicin can cause irritant contact dermatitis that may require clinical care.
- Otang WM, Grierson DS, Afolayan AJ. A survey of plants responsible for causing irritant contact dermatitis in the Amathole district, Eastern Cape, South Africa. J Ethnopharmacol. 2014;157:274-284. doi:10.1016/j.jep.2014.10.002
- Weinberg RB. Hunan hand. N Engl J Med. 1981;305:1020.
- Lambrecht C, Goossens A. Occupational allergic contact dermatitis caused by capsicum. Contact Dermatitis. 2015;72:252-253. doi:10.1111/cod.12345
- Haar RJ, Iacopino V, Ranadive N, et al. Health impacts of chemical irritants used for crowd control: a systematic review of the injuries and deaths caused by tear gas and pepper spray. BMC Public Health. 2017;17:831. doi:10.1186/s12889-017-4814-6
- Simpson DM, Robinson-Papp J, Van J, et al. Capsaicin 8% patch in painful diabetic peripheral neuropathy: a randomized, double-blind, placebo-controlled study. J Pain. 2017;18:42-53. doi:10.1016/j.jpain.2016.09.008
- Yong YL, Tan LT-H, Ming LC, et al. The effectiveness and safety of topical capsaicin in postherpetic neuralgia: a systematic review and meta-analysis. Front Pharmacol. 2016;7:538. doi:10.3389/fphar.2016.00538
- Firoz EF, Levin JM, Hartman RD, et al. Lip plumper contact urticaria. J Am Acad Dermatol. 2009;60:861-863. doi:10.1016/j.jaad.2008.09.028
- Jones LA, Tandberg D, Troutman WG. Household treatment for “chile burns” of the hands. J Toxicol Clin Toxicol. 1987;25:483-491. doi:10.3109/15563658708992651
- Saxena AK, Mandhyan R. Multimodal approach for the management of Hunan hand syndrome: a case report. Pain Pract. 2013;13:227-230. doi:10.1111/j.1533-2500.2012.00567.x
- Cordell GA, Araujo OE. Capsaicin: identification, nomenclature, and pharmacotherapy. Ann Pharmacother. 1993;27:330-336. doi:10.1177/106002809302700316
- Baranidharan G, Das S, Bhaskar A. A review of the high-concentration capsaicin patch and experience in its use in the management of neuropathic pain. Ther Adv Neurol Disord. 2013;6:287-297. doi:10.1177/1756285613496862
- Carrizo García C, Barfuss MHJ, Sehr EM, et al. Phylogenetic relationships, diversification and expansion of chili peppers (Capsicum, Solanaceae). Ann Bot. 2016;118:35-51. doi:10.1093/aob/mcw079
- Basharat S, Gilani SA, Iftikhar F, et al. Capsaicin: plants of the genus Capsicum and positive effect of Oriental spice on skin health. Skin Pharmacol Physiol. 2020;33:331-341. doi:10.1159/000512196
- Hopps JJ, Dunn WR, Randall MD. Vasorelaxation to capsaicin and its effects on calcium influx in arteries. Eur J Pharmacol. 2012;681:88-93. doi:10.1016/j.ejphar.2012.02.019
- Burks TF, Buck SH, Miller MS. Mechanisms of depletion of substance P by capsaicin. Fed Proc. 1985;44:2531-2534.
- Ellis CN, Berberian B, Sulica VI, et al. A double-blind evaluation of topical capsaicin in pruritic psoriasis. J Am Acad Dermatol. 1993;29:438-442. doi:10.1016/0190-9622(93)70208-b
- Fusco BM, Alessandri M. Analgesic effect of capsaicin in idiopathic trigeminal neuralgia. Anesth Analg. 1992;74:375-377. doi:10.1213/00000539-199203000-00011
- Casanueva B, Rodero B, Quintial C, et al. Short-term efficacy of topical capsaicin therapy in severely affected fibromyalgia patients. Rheumatol Int. 2013;33:2665-2670. doi:10.1007/s00296-012-2490-5
- Bley K, Boorman G, Mohammad B, et al. A comprehensive review of the carcinogenic and anticarcinogenic potential of capsaicin. Toxicol Pathol. 2012;40:847-873. doi:10.1177/0192623312444471
- Jones IA, Togashi R, Wilson ML, et al. Intra-articular treatment options for knee osteoarthritis. Nat Rev Rheumatol. 2019;15:77-90. doi:10.1038/s41584-018-0123-4
- Campbell JN, Stevens R, Hanson P, et al. Injectable capsaicin for the management of pain due to osteoarthritis. Molecules. 2021;26:778.
- Maji AK, Banerji P. Phytochemistry and gastrointestinal benefits of the medicinal spice, Capsicum annum L. (chilli): a review. J Complement Integr Med. 2016;13:97-122. doi:10.1515jcim-2015-0037
- Baenas N, Belovié M, Ilie N, et al. Industrial use of pepper (Capsicum annum L.) derived products: technological benefits and biological advantages. Food Chem. 2019;274:872-885. doi:10.1016/j.foodchem.2018.09.047
- Lin RJ, Wu IJ, Hong JY, et al. Capsaicin-induced TRIB3 upregulation promotes apoptosis in cancer cells. Cancer Manag Res. 2018;10:4237-4248. doi:10.2147/CMAR.S162383
- Jung MY, Kang HJ, Moon A. Capsaicin-induced apoptosis in SK-Hep-1 hepatocarcinoma cells involves Bcl-2 downregulation and caspase-3 activation. Cancer Lett. 2001;165:139-145. doi:10.1016/s0304-3835(01)00426-8
- Ito K, Nakazato T, Yamato K, et al. Induction of apoptosis in leukemic cells by homovanillic acid derivative, capsaicin, through oxidative stress: implication of phosphorylation of p53 at Ser-15 residue by reactive oxygen species. Cancer Res. 2004;64:1071-1078. doi:10.1158/0008-5472.can-03-1670
- Báez S, Tsuchiya Y, Calvo A, et al. Genetic variants involved in gallstone formation and capsaicin metabolism, and the risk of gallbladder cancer in Chilean women. World J Gastroenterol. 2010;16:372-378. doi:10.3748/wjg.v16.i3.372
Cutaneous Manifestations
Capsicum peppers are used worldwide in preparing spicy dishes. Their active ingredient—capsaicin—is used as a topical medicine to treat localized pain. Capsicum peppers can cause irritant contact dermatitis with symptoms of erythema, cutaneous burning, and itch.1
Irritant contact dermatitis is a common occupational skin disorder. Many cooks have experienced the sting of a chili pepper after contact with the hands or eyes. Cases of chronic exposure to Capsicum peppers with persistent burning and pain have been called Hunan hand syndrome.2Capsicum peppers also have induced allergic contact dermatitis in a food production worker.3
Capsicum peppers also are used in pepper spray, tear gas, and animal repellents because of their stinging properties. These agents usually cause cutaneous tingling and burning that soon resolves; however, a review of 31 studies showed that crowd-control methods with Capsicum-containing tear gas and pepper spray can cause moderate to severe skin damage such as a persistent skin rash or erythema, or even first-, second-, or third-degree burns.4
Topical application of capsaicin isolate is meant to cause burning and deplete local neuropeptides, with a cutaneous reaction that ranges from mild to intolerable.5,6 Capsaicin also is found in other products. In one published case report, a 3-year-old boy broke out in facial urticaria when his mother kissed him on the cheek after she applied lip plumper containing capsaicin to her lips.7 Dermatologists should consider capsaicin an active ingredient that can irritate the skin in the garden, in the kitchen, and in topical products.
Obtaining Relief
Capsaicin-induced dermatitis can be relieved by washing the area with soap, detergent, baking soda, or oily compounds that act as solvents for the nonpolar capsaicin.8 Application of ice water or a high-potency topical steroid also may help. If the reaction is severe and persistent, a continuous stellate ganglion block may alleviate the pain of capsaicin-induced contact dermatitis.9
Identifying Features and Plant Facts
The Capsicum genus includes chili peppers, paprika, and red peppers. Capsicum peppers are native to tropical regions of the Americas (Figure). The use of Capsicum peppers in food can be traced to Indigenous peoples of Mexico as early as 7000
Capsicum belongs to the family Solanaceae, which includes tobacco, tomatoes, potatoes, and nightshade plants. There are many varieties of peppers in the Capsicum genus, with 5 domesticated species: Capsicum annuum, Capsicum baccatum, Capsicum chinense, Capsicum frutescens, and Capsicum pubescens. These include bell, poblano, cayenne, tabasco, habanero, and ají peppers, among others. Capsicum species grow as a shrub with flowers that rotate to stellate corollas and rounded berries of different sizes and colors.12 Capsaicin and other alkaloids are concentrated in the fruit; therefore, Capsicum dermatitis is most commonly induced by contact with the flesh of peppers.
Irritant Chemicals
Capsaicin (8-methyl-6-nonanoyl vanillylamide) is a nonpolar phenol, which is why washing skin that has come in contact with capsaicin with water or vinegar alone is insufficient to solubilize it.13 Capsaicin binds to the transient receptor potential vanilloid 1 (TRPV1), a calcium channel on neurons that opens in response to heat. When bound, the channel opens at a lower temperature threshold and depolarizes nerve endings, leading to vasodilation and activation of sensory nerves.14 Substance P is released and the individual experiences a painful burning sensation. When purified capsaicin is frequently applied at an appropriate dose, synthesis of substance P is diminished, resulting in reduced local pain overall.15
Capsaicin does not affect neurons without TRPV1, and administration of capsaicin is not painful if given with anesthesia. An inappropriately high dose of capsaicin destroys cells in the epidermal barrier, resulting in water loss and inducing release of vasoactive peptides and inflammatory cytokines.1 Careful handling of Capsicum peppers and capsaicin products can reduce the risk for irritation.
Medicinal Use
On-/Off-Label and Potential Uses—Capsaicin is US Food and Drug Administration approved for use in arthritis and musculoskeletal pain. It also is used to treat diabetic neuropathy,5 postherpetic neuralgia,6 psoriasis,16 and other conditions. Studies have shown that capsaicin might be useful in treating trigeminal neuralgia,17 fibromyalgia,18 migraines,14 cluster headaches,9 and HIV-associated distal sensory neuropathy.5
Delivery of Capsaicin—Capsaicin preferentially acts on C-fibers, which transmit dull, aching, chronic pain.19 The compound is available as a cream, lotion, and large bandage (for the lower back), as well as low- and high-dose patches. Capsaicin creams, lotions, and the low-dose patch are uncomfortable and must be applied for 4 to 6 weeks to take effect, which may impact patient adherence. The high-dose patch, which requires administration under local anesthesia by a health care worker, brings pain relief with a single use and improves adherence.11 Synthetic TRPV1-agonist injectables based on capsaicin have undergone clinical trials for localized pain (eg, postoperative musculoskeletal pain); many patients experience pain relief, though benefit fades over weeks to months.20,21
Use in Traditional Medicine—Capsicum peppers have been used to aid digestion and promote healing in gastrointestinal conditions, such as dyspepsia.22 The peppers are a source of important vitamins and minerals, including vitamins A, C, and E; many of the B complex vitamins; and magnesium, calcium, and iron.23
Use as Cancer Therapy—Studies of the use of capsaicin in treating cancer have produced controversial results. In cell and animal models, capsaicin induces apoptosis through downregulation of the Bcl-2 protein; upregulation of oxidative stress, tribbles-related protein 3 (TRIB3), and caspase-3; and other pathways.19,24-26 On the other hand, consumption of Capsicum peppers has been associated with cancer of the stomach and gallbladder.27 Capsaicin might have anticarcinogenic properties, but its mechanism of action varies, depending on variables not fully understood.
Final Thoughts
Capsaicin is a neuropeptide-active compound found in Capsicum peppers that has many promising applications for use. However, dermatologists should be aware of the possibility of a skin reaction to this compound from handling peppers and using topical medicines. Exposure to capsaicin can cause irritant contact dermatitis that may require clinical care.
Cutaneous Manifestations
Capsicum peppers are used worldwide in preparing spicy dishes. Their active ingredient—capsaicin—is used as a topical medicine to treat localized pain. Capsicum peppers can cause irritant contact dermatitis with symptoms of erythema, cutaneous burning, and itch.1
Irritant contact dermatitis is a common occupational skin disorder. Many cooks have experienced the sting of a chili pepper after contact with the hands or eyes. Cases of chronic exposure to Capsicum peppers with persistent burning and pain have been called Hunan hand syndrome.2Capsicum peppers also have induced allergic contact dermatitis in a food production worker.3
Capsicum peppers also are used in pepper spray, tear gas, and animal repellents because of their stinging properties. These agents usually cause cutaneous tingling and burning that soon resolves; however, a review of 31 studies showed that crowd-control methods with Capsicum-containing tear gas and pepper spray can cause moderate to severe skin damage such as a persistent skin rash or erythema, or even first-, second-, or third-degree burns.4
Topical application of capsaicin isolate is meant to cause burning and deplete local neuropeptides, with a cutaneous reaction that ranges from mild to intolerable.5,6 Capsaicin also is found in other products. In one published case report, a 3-year-old boy broke out in facial urticaria when his mother kissed him on the cheek after she applied lip plumper containing capsaicin to her lips.7 Dermatologists should consider capsaicin an active ingredient that can irritate the skin in the garden, in the kitchen, and in topical products.
Obtaining Relief
Capsaicin-induced dermatitis can be relieved by washing the area with soap, detergent, baking soda, or oily compounds that act as solvents for the nonpolar capsaicin.8 Application of ice water or a high-potency topical steroid also may help. If the reaction is severe and persistent, a continuous stellate ganglion block may alleviate the pain of capsaicin-induced contact dermatitis.9
Identifying Features and Plant Facts
The Capsicum genus includes chili peppers, paprika, and red peppers. Capsicum peppers are native to tropical regions of the Americas (Figure). The use of Capsicum peppers in food can be traced to Indigenous peoples of Mexico as early as 7000
Capsicum belongs to the family Solanaceae, which includes tobacco, tomatoes, potatoes, and nightshade plants. There are many varieties of peppers in the Capsicum genus, with 5 domesticated species: Capsicum annuum, Capsicum baccatum, Capsicum chinense, Capsicum frutescens, and Capsicum pubescens. These include bell, poblano, cayenne, tabasco, habanero, and ají peppers, among others. Capsicum species grow as a shrub with flowers that rotate to stellate corollas and rounded berries of different sizes and colors.12 Capsaicin and other alkaloids are concentrated in the fruit; therefore, Capsicum dermatitis is most commonly induced by contact with the flesh of peppers.
Irritant Chemicals
Capsaicin (8-methyl-6-nonanoyl vanillylamide) is a nonpolar phenol, which is why washing skin that has come in contact with capsaicin with water or vinegar alone is insufficient to solubilize it.13 Capsaicin binds to the transient receptor potential vanilloid 1 (TRPV1), a calcium channel on neurons that opens in response to heat. When bound, the channel opens at a lower temperature threshold and depolarizes nerve endings, leading to vasodilation and activation of sensory nerves.14 Substance P is released and the individual experiences a painful burning sensation. When purified capsaicin is frequently applied at an appropriate dose, synthesis of substance P is diminished, resulting in reduced local pain overall.15
Capsaicin does not affect neurons without TRPV1, and administration of capsaicin is not painful if given with anesthesia. An inappropriately high dose of capsaicin destroys cells in the epidermal barrier, resulting in water loss and inducing release of vasoactive peptides and inflammatory cytokines.1 Careful handling of Capsicum peppers and capsaicin products can reduce the risk for irritation.
Medicinal Use
On-/Off-Label and Potential Uses—Capsaicin is US Food and Drug Administration approved for use in arthritis and musculoskeletal pain. It also is used to treat diabetic neuropathy,5 postherpetic neuralgia,6 psoriasis,16 and other conditions. Studies have shown that capsaicin might be useful in treating trigeminal neuralgia,17 fibromyalgia,18 migraines,14 cluster headaches,9 and HIV-associated distal sensory neuropathy.5
Delivery of Capsaicin—Capsaicin preferentially acts on C-fibers, which transmit dull, aching, chronic pain.19 The compound is available as a cream, lotion, and large bandage (for the lower back), as well as low- and high-dose patches. Capsaicin creams, lotions, and the low-dose patch are uncomfortable and must be applied for 4 to 6 weeks to take effect, which may impact patient adherence. The high-dose patch, which requires administration under local anesthesia by a health care worker, brings pain relief with a single use and improves adherence.11 Synthetic TRPV1-agonist injectables based on capsaicin have undergone clinical trials for localized pain (eg, postoperative musculoskeletal pain); many patients experience pain relief, though benefit fades over weeks to months.20,21
Use in Traditional Medicine—Capsicum peppers have been used to aid digestion and promote healing in gastrointestinal conditions, such as dyspepsia.22 The peppers are a source of important vitamins and minerals, including vitamins A, C, and E; many of the B complex vitamins; and magnesium, calcium, and iron.23
Use as Cancer Therapy—Studies of the use of capsaicin in treating cancer have produced controversial results. In cell and animal models, capsaicin induces apoptosis through downregulation of the Bcl-2 protein; upregulation of oxidative stress, tribbles-related protein 3 (TRIB3), and caspase-3; and other pathways.19,24-26 On the other hand, consumption of Capsicum peppers has been associated with cancer of the stomach and gallbladder.27 Capsaicin might have anticarcinogenic properties, but its mechanism of action varies, depending on variables not fully understood.
Final Thoughts
Capsaicin is a neuropeptide-active compound found in Capsicum peppers that has many promising applications for use. However, dermatologists should be aware of the possibility of a skin reaction to this compound from handling peppers and using topical medicines. Exposure to capsaicin can cause irritant contact dermatitis that may require clinical care.
- Otang WM, Grierson DS, Afolayan AJ. A survey of plants responsible for causing irritant contact dermatitis in the Amathole district, Eastern Cape, South Africa. J Ethnopharmacol. 2014;157:274-284. doi:10.1016/j.jep.2014.10.002
- Weinberg RB. Hunan hand. N Engl J Med. 1981;305:1020.
- Lambrecht C, Goossens A. Occupational allergic contact dermatitis caused by capsicum. Contact Dermatitis. 2015;72:252-253. doi:10.1111/cod.12345
- Haar RJ, Iacopino V, Ranadive N, et al. Health impacts of chemical irritants used for crowd control: a systematic review of the injuries and deaths caused by tear gas and pepper spray. BMC Public Health. 2017;17:831. doi:10.1186/s12889-017-4814-6
- Simpson DM, Robinson-Papp J, Van J, et al. Capsaicin 8% patch in painful diabetic peripheral neuropathy: a randomized, double-blind, placebo-controlled study. J Pain. 2017;18:42-53. doi:10.1016/j.jpain.2016.09.008
- Yong YL, Tan LT-H, Ming LC, et al. The effectiveness and safety of topical capsaicin in postherpetic neuralgia: a systematic review and meta-analysis. Front Pharmacol. 2016;7:538. doi:10.3389/fphar.2016.00538
- Firoz EF, Levin JM, Hartman RD, et al. Lip plumper contact urticaria. J Am Acad Dermatol. 2009;60:861-863. doi:10.1016/j.jaad.2008.09.028
- Jones LA, Tandberg D, Troutman WG. Household treatment for “chile burns” of the hands. J Toxicol Clin Toxicol. 1987;25:483-491. doi:10.3109/15563658708992651
- Saxena AK, Mandhyan R. Multimodal approach for the management of Hunan hand syndrome: a case report. Pain Pract. 2013;13:227-230. doi:10.1111/j.1533-2500.2012.00567.x
- Cordell GA, Araujo OE. Capsaicin: identification, nomenclature, and pharmacotherapy. Ann Pharmacother. 1993;27:330-336. doi:10.1177/106002809302700316
- Baranidharan G, Das S, Bhaskar A. A review of the high-concentration capsaicin patch and experience in its use in the management of neuropathic pain. Ther Adv Neurol Disord. 2013;6:287-297. doi:10.1177/1756285613496862
- Carrizo García C, Barfuss MHJ, Sehr EM, et al. Phylogenetic relationships, diversification and expansion of chili peppers (Capsicum, Solanaceae). Ann Bot. 2016;118:35-51. doi:10.1093/aob/mcw079
- Basharat S, Gilani SA, Iftikhar F, et al. Capsaicin: plants of the genus Capsicum and positive effect of Oriental spice on skin health. Skin Pharmacol Physiol. 2020;33:331-341. doi:10.1159/000512196
- Hopps JJ, Dunn WR, Randall MD. Vasorelaxation to capsaicin and its effects on calcium influx in arteries. Eur J Pharmacol. 2012;681:88-93. doi:10.1016/j.ejphar.2012.02.019
- Burks TF, Buck SH, Miller MS. Mechanisms of depletion of substance P by capsaicin. Fed Proc. 1985;44:2531-2534.
- Ellis CN, Berberian B, Sulica VI, et al. A double-blind evaluation of topical capsaicin in pruritic psoriasis. J Am Acad Dermatol. 1993;29:438-442. doi:10.1016/0190-9622(93)70208-b
- Fusco BM, Alessandri M. Analgesic effect of capsaicin in idiopathic trigeminal neuralgia. Anesth Analg. 1992;74:375-377. doi:10.1213/00000539-199203000-00011
- Casanueva B, Rodero B, Quintial C, et al. Short-term efficacy of topical capsaicin therapy in severely affected fibromyalgia patients. Rheumatol Int. 2013;33:2665-2670. doi:10.1007/s00296-012-2490-5
- Bley K, Boorman G, Mohammad B, et al. A comprehensive review of the carcinogenic and anticarcinogenic potential of capsaicin. Toxicol Pathol. 2012;40:847-873. doi:10.1177/0192623312444471
- Jones IA, Togashi R, Wilson ML, et al. Intra-articular treatment options for knee osteoarthritis. Nat Rev Rheumatol. 2019;15:77-90. doi:10.1038/s41584-018-0123-4
- Campbell JN, Stevens R, Hanson P, et al. Injectable capsaicin for the management of pain due to osteoarthritis. Molecules. 2021;26:778.
- Maji AK, Banerji P. Phytochemistry and gastrointestinal benefits of the medicinal spice, Capsicum annum L. (chilli): a review. J Complement Integr Med. 2016;13:97-122. doi:10.1515jcim-2015-0037
- Baenas N, Belovié M, Ilie N, et al. Industrial use of pepper (Capsicum annum L.) derived products: technological benefits and biological advantages. Food Chem. 2019;274:872-885. doi:10.1016/j.foodchem.2018.09.047
- Lin RJ, Wu IJ, Hong JY, et al. Capsaicin-induced TRIB3 upregulation promotes apoptosis in cancer cells. Cancer Manag Res. 2018;10:4237-4248. doi:10.2147/CMAR.S162383
- Jung MY, Kang HJ, Moon A. Capsaicin-induced apoptosis in SK-Hep-1 hepatocarcinoma cells involves Bcl-2 downregulation and caspase-3 activation. Cancer Lett. 2001;165:139-145. doi:10.1016/s0304-3835(01)00426-8
- Ito K, Nakazato T, Yamato K, et al. Induction of apoptosis in leukemic cells by homovanillic acid derivative, capsaicin, through oxidative stress: implication of phosphorylation of p53 at Ser-15 residue by reactive oxygen species. Cancer Res. 2004;64:1071-1078. doi:10.1158/0008-5472.can-03-1670
- Báez S, Tsuchiya Y, Calvo A, et al. Genetic variants involved in gallstone formation and capsaicin metabolism, and the risk of gallbladder cancer in Chilean women. World J Gastroenterol. 2010;16:372-378. doi:10.3748/wjg.v16.i3.372
- Otang WM, Grierson DS, Afolayan AJ. A survey of plants responsible for causing irritant contact dermatitis in the Amathole district, Eastern Cape, South Africa. J Ethnopharmacol. 2014;157:274-284. doi:10.1016/j.jep.2014.10.002
- Weinberg RB. Hunan hand. N Engl J Med. 1981;305:1020.
- Lambrecht C, Goossens A. Occupational allergic contact dermatitis caused by capsicum. Contact Dermatitis. 2015;72:252-253. doi:10.1111/cod.12345
- Haar RJ, Iacopino V, Ranadive N, et al. Health impacts of chemical irritants used for crowd control: a systematic review of the injuries and deaths caused by tear gas and pepper spray. BMC Public Health. 2017;17:831. doi:10.1186/s12889-017-4814-6
- Simpson DM, Robinson-Papp J, Van J, et al. Capsaicin 8% patch in painful diabetic peripheral neuropathy: a randomized, double-blind, placebo-controlled study. J Pain. 2017;18:42-53. doi:10.1016/j.jpain.2016.09.008
- Yong YL, Tan LT-H, Ming LC, et al. The effectiveness and safety of topical capsaicin in postherpetic neuralgia: a systematic review and meta-analysis. Front Pharmacol. 2016;7:538. doi:10.3389/fphar.2016.00538
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Practice Points
- Capsicum peppers—used worldwide in food preparation, pepper spray, and cosmetic products—can cause irritant dermatitis from the active ingredient capsaicin.
- Capsaicin, which is isolated as a medication to treat musculoskeletal pain, postherpetic neuralgia, and more, can cause a mild local skin reaction.
