Cayenne pepper is best known as a cooking spice, but did you know it is also an effective medicine for pain? The component that makes it spicy hot called capsaicin is also a well-known ingredient in topical pain medication (analgesics.) This chemical is naturally present in the family of capsicum hot peppers that have been studied extensively for their health benefits. When applied topically, capsaicin lowers a chemical called Substance P. Substance P is a complex pain neuropeptide that regulates how much pain a nerve (neuron) signals to the brain. When less Substance P is present, less “pain” signal gets transmitted, and pain relief is achieved.
Let’s get technical with Substance P for a minute – this neuropeptide was originally identified in 1931 as a pain transmitter of a part of the nerve signaling pathway called the dorsal horn. It modulates nerve pain receptors called nociceptors that respond to chemical, mechanical or temperature induced damage. (They are what make you pull your hand away from getting burned, and what tell your brain you feel the pain of the burn.) Research from 2001 evidenced that Substance P is found not only in these peripheral nerve receptors, but is actually found throughout the Central Nervous System including the limbic system, hypothalamus and amygdala. These areas of the brain are associated with emotions and emotional behavior, indicating that Substance P levels may also may also play a role in the emotional pain of stress and anxiety!
A cream made with 0.025% capsaicin is available over the counter at our pharmacy. Capsaicin cream is recommended for two types of pain. This product is great for any burning pain syndromes including neuralgias, carpal tunnel, and post-herpetic (shingles) pain. It can also be used for sciatica. Capsaicin cream is also used to reduce pain associated with osteoarthritis. It is applied 2-3 times per day for best results. As this product is made from cayenne pepper, it is very important to wash your hands immediately after use, or to use gloves. You will want to avoid touching any areas of the body with mucus membranes like the eyes, nose, mouth and genitals as it burns when applied to the wrong spots!
A topical product can be compounded in our laboratory with up to 2.0% capsaicin, if the lower dose does not work or stops working. For very sensitive patients, we can also compound it in lower doses, or mix it with a topical anesthetic to reduce the warm/burning sensation that can accompany the application. One of the great advantages of a compounding pharmacy is we can create very specific dosages, and titrate them up or down as needed for patient care. Topical pain creams can also be compounded containing multiple pain medications by a prescribing professional. These topical formulas can reduce the pill burden for people suffering from chronic pain. For more information, ask our compounding pharmacist Joe Lorello RPh. about topical pain medications and OTC capsaicin.
References:
Prescription for Herbal Healing. Phyllis A. Balch. Penguin Putnam Inc New York 2002 p. 43
http://www.medscape.com/viewarticle/409781
http://www.med.nyu.edu/content?ChunkIID=21645
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Coastal Pharmacy & Wellness Staff
