Chili Pepper: Benefits, Dosage, Contraindications

Diabetic Neuropathy
✪✪✪✪✪

Clinical studies have validated the effectiveness of capsaicin, the main active component in chili peppers, in treating diabetic neuropathy and other forms of neuropathies. A notable approach is the use of a specific patch containing 8% capsaicin (Qutenza, NeurogesX Inc.). The European Medicines Agency (EMA) has approved the 8% capsaicin patch (brand name Qutenza) for the treatment of peripheral neuropathic pain in non-diabetic adults, either as monotherapy or in combination with other analgesics. A single application of this patch on the painful parts of the feet for 30 to 90 minutes, following pretreatment with topical anesthetics, reduces pain for up to 12 weeks compared to placebo, significantly improving sleep quality and reducing pain by 28% versus 21% with placebo. Capsaicin, used in cream form at 0.075%, 4 times a day, has been studied in several clinical trials for its effectiveness in treating neuropathies, notably diabetic neuropathy. In a significant study, 277 patients with diabetic neuropathy applied this cream or a placebo for 8 weeks. The results showed superior improvement with capsaicin: 69% of treated patients experienced pain relief compared to 53% in the placebo group. A meta-analysis indicates that this formulation is as effective as the medicated plaster with 5% lidocaine for pain reduction. Another study compared the capsaicin cream to amitriptyline in 235 patients, revealing similar pain intensity reduction in both groups. However, less frequent use (less than 4 times a day) or lower concentrations of capsaicin seem less beneficial.

Posologie

Cutaneous route

0.3 - 8 %

8 - weeks

patch, cream

Joint Pain
✪✪✪✪✪

Capsaicin, applied as a cream or patch, is widely recognized for its effectiveness in treating joint pain, including osteoarthritis and rheumatoid arthritis. Various clinical studies have demonstrated its significant analgesic potential. A double-blind randomized study involved 70 patients with osteoarthritis and 31 with rheumatoid arthritis, treated with a 0.025% capsaicin cream for four weeks. The results showed significant pain reductions, superior to placebo, with improvement observed as early as the second week of treatment. In particular, for osteoarthritis, the pain reduction was 33%, and for rheumatoid arthritis, it was 57%. Meta-analyses have consolidated these results, highlighting a favorable response in treating osteoarthritis with a 0.025% capsaicin cream. In a study involving 113 patients with knee, ankle, elbow, wrist, or shoulder osteoarthritis, 81% of treated patients showed notable improvement against 54% under placebo after twelve weeks of treatment. The effectiveness of capsaicin has also been proven in studies on musculoskeletal pain, where the 0.025% cream showed significant advantages over placebo. For example, a clinical study conducted on patients with acute pain related to trauma shows that the topical application of a gel containing 0.05% capsaicin three times a day for three days reduces pain by at least 50% in 87% of patients, compared to 63% in those using a 0.5% piroxicam gel. The number of patients whose final pain score is less than or equal to 4 is also significantly higher. In the capsaicin group, only 12% of patients met none of these criteria, compared to 31% in the piroxicam group. In summary, capsaicin, well-tolerated and effective, could be a promising therapeutic solution for a variety of joint and musculoskeletal pains.

Posologie

Cutaneous route

0.025 - 0.05 %

4 - weeks

patch, cream

Back Pain
✪✪✪✪✪

In the treatment of back pain, the topical use of capsaicin, extracted from capsicum, shows positive results. Patches containing 11 mg of capsaicin significantly reduce pain when applied each morning for 4 to 8 hours. Additionally, a 0.05% capsaicin cream applied three times a day for 21 days decreases back pain by 58% compared to a placebo. A study found that capsaicin combined with diclofenac modestly reduces back pain, with comparable effects when used alone. These results encourage the use of capsaicin as a therapeutic option for back pain.

Posologie

Cutaneous route

0.05 %

patch, cream

Itching, Psoriasis
✪✪✪✪✪

Clinical studies have shown that capsaicin-based creams are effective in treating various skin conditions, including psoriasis accompanied by itching. The application of a cream containing 0.025% capsaicin four times a day for six weeks resulted in a significant improvement in psoriasis severity scores and notable itch reduction compared to a placebo. The effects of capsaicin in reducing itching are also observed in the treatment of aquagenic pruritus and anal pruritus. Patients treating with capsaicin creams reported significant itch relief, often with an initial burning sensation that diminishes over time. Studies suggest that capsaicin reduces itching by depleting neuropeptides from cutaneous nerve fibers, disrupting itch signal transmission. Capsaicin has also shown beneficial effects against severe nodular prurigo and other inflammatory skin diseases, providing itch relief under continuous treatment. However, symptoms may reappear after stopping treatment, suggesting a potential need for continuous application to maintain benefits.

Posologie

Cutaneous route

0.025 %

patch, cream

Arthritis, Osteoarthritis
✪✪✪✪✪

The effectiveness of capsaicin in the treatment of joint pain, particularly osteoarthritis, is well documented by several clinical studies. The use of creams containing 0.025% to 0.075% capsaicin has proven to be temporarily effective in relieving chronic pain associated with conditions such as osteoarthritis and rheumatoid arthritis. Randomized controlled trials show that topical application of capsaicin can significantly reduce pain in patients suffering from knee or hand osteoarthritis. For example, one study involved 70 patients with osteoarthritis who received a 0.025% capsaicin cream for four weeks. The results indicated a significant reduction in pain measured by visual analog scales (VAS) and improvement according to the global assessment by physicians, with efficacy superior to placebo for osteoarthritis (p = 0.033) and rheumatoid arthritis (p = 0.003). Additionally, a meta-analysis of studies showed that 0.075% capsaicin is beneficial for treating musculoskeletal pain with a notable relative benefit compared to placebo. Moreover, another study on 113 patients with osteoarthritis observed that the application of 0.025% capsaicin on affected areas for 12 weeks led to a greater reduction in pain severity compared to placebo, with significant results starting from the fourth week and maintained until the twelfth week. These results suggest that capsaicin, used topically, offers an effective and well-tolerated treatment option for pain related to osteoarthritis, justifying its inclusion among the treatments recommended by bodies such as the American College of Rheumatology, while noting certain restrictions regarding its use for hip osteoarthritis due to the depth of the joint under the skin surface.

Posologie

Topical route

0.025 - 0.075 %

patch, cream

Obesity
✪✪✪✪✪

Capsicum, commonly used in the form of chili pepper, is being studied for its potential effects on weight management. Recent research, including an extensive meta-analysis, highlights the potential role of capsaicinoids, extracted from chili, in reducing energy intake. Systematic analysis of various studies suggests that prior ingestion of capsaicinoids may decrease calorie intake by 74 kcal per meal. This finding underscores their potential in weight management strategies, particularly for those seeking to naturally reduce their caloric intake. It is important to note that to achieve these beneficial effects, a minimum of 2 mg of capsaicinoids is required. In a clinical trial, daily intake of capsinoids at 3 mg twice a day, 30 minutes before meals for 12 weeks, reduced abdominal fat by approximately 1%, without significant reduction in total weight. Furthermore, another study on overweight individuals showed that a specific chili extract at 200 mg, combined with fenugreek dietary fibers for sustained release, administered at a level of 4 mg of capsaicinoids per day for 28 days, reduced body weight and BMI by about 2%, without impacting blood pressure.

Posologie

Oral route

2 - 6 mg

standardized extract

Sports performance, Muscle pain
✪✪✪✪✪

The use of capsaicin by athletes to enhance athletic performance shows varied results according to clinical studies. Capsaicin activates TRPV1 receptors in skeletal muscles, thus promoting calcium release and enhancing muscle contraction strength. This could also reduce oxidative costs of muscle contraction and increase free fatty acid levels induced by epinephrine in plasma. A meta-analysis of several small clinical studies indicates that the consumption of capsaicin before exercise can improve muscle endurance, but not aerobic endurance, compared to a placebo. Doses generally vary around 12 mg. However, these studies have methodological limitations, such as small sample sizes and short study durations, which affect the reliability of the results.

Posologie

Oral, topical route

12 - 26 mg

cream, standardized extract

Fibromyalgia
✪✪✪✪✪

Preliminary clinical research indicates that applying a cream containing 0.025% capsaicin, the active component of capsicum, four times a day on tender points for 4 weeks reduces localized tenderness in patients with fibromyalgia. Another study showed that applying a 0.075% capsaicin cream three times a day for 6 weeks, in addition to standard treatment, increased the pain threshold compared to standard treatment alone. However, capsaicin does not appear to reduce overall pain or improve physical function in these patients. The long-term effects of capsaicin on fibromyalgia-related pain remain uncertain.

Posologie

Topical route

patch, cream