Capsaicin cream, and other forms of capsaicin, provide relief for a variety of musculoskeletal conditions and arthritis.
History of Capsaicin and Uses
Capsaicin is derived from chili peppers. In pure capsaicin form, it irritates the skin, creating a burning sensation. In the wild, “capsaicin and several related compounds are called capsaicinoids and…(are probably) deterrents against certain mammals and fungi”. The pure capsaicin is hydrophobic, volatile, odorless, colorless, and has a “crystalline to waxy compound”. In 1898 Karl Micko was able to isolate pure capsaicin. It was synthesized in 1930 by Stephen F. Darling and Ernst Spath, and “similar substances” called capsaicinoids were isolated by Japanese chemists in 1961. Now, the most common forms of capsaicinoids are “capsaisin (69%), dihydrocapsaicin (22%) and nordihydrocapsaicin (7%), homocapsaicin (1%), and homodihydrocapsaicin (1%)”. Capsaicin causes burning when it contacts mucous membranes, so it is a food additive for “heat” or spice, in forms such as paprika or chili powder. The skin or eyes may burn, however, with exposure to high concentrations. Large amounts of ingestion can lead to vomiting, nausea, burning diarrhea, and abdominal pain. Cold milk (with caseins) can alleviate the burning sensation from ingestion. The heat level of food is measured with the “subjective Scoville scale”. Many people enjoy spicy foods, and it is not uncommon for some to have euphoric effects from capsaicin ingestion. Some “chiliheads” attribute this pleasurable sensation to an endorphin release. There are people who use capsaicin pills for weight loss, but “there has been a report of heart attack; this was thought to be due to excess sympathetic output”. That said, capsaicin may decrease appetite and food intake. Capsaicin is effective as a topical analgesic, in forms such as capsaicin cream, capsaicin ointment, dermal patches, and nasal sprays, which are all used to alleviate pain. The concentration for that purpose is generally .025% to .25%. Capsaicin is also used in pepper spray and to deter pests.1
What is Capsaicin Cream?
Capsaicin cream is one form of capsaicin that can be applied topically. It can provide some temporary relief for joint and muscle pains and aches in patients with backache, strains, sprains, and arthritis. Capsaicin cream is also helpful for patients with shingles who have “peripheral neuropathy such as post-herpetic neuralgia” (PHN). The capsaicin patch (Qutenza) is often prescribed patients with shingles.2 Topical forms of capsaicin work by “decreasing a certain natural substance in your body (substance P) that helps pass pain signals to the brain”. It can treat nerve pain. The capsaicin cream should only be used on the skin, and only as directed. Patients may experience a burning or stinging sensation, watery eyes, throat irritation, or coughing, so inhalation of medication residue should be avoided. Most people do not have such serious side effects; however a healthcare professional should be consulted if there is swelling or blistering or increases pain. Patients who are allergic to capsicum hot peppers, lidocaine, or other allergies should not use this product, and those with irritated or injured skin should discuss use with a healthcare professional. For those patients using the capsaicin patch, and who are about to have an MRI, it is important to inform the medical professionals since some of the patches “contain metals that can cause serious burns during an MRI”. Due to their similarities, patients should not “use medications containing zucapsaicin while using capsaicin.3 Individuals who are allergic to cayenne pepper are those more likely to be allergic to latex, kiwi, bananas, and chestnuts, as well. This can be a problem for people who ingest cayenne pepper capsules. An allergic reaction may include “breathing, chest pain, tightness in the throat or chest, a skin rash, hives, and itchy or swollen skin”, and it is a medical emergency. Excessive capsaicin consumption can lead to liver and kidney damage. Women who are breastfeeding should be aware that cayenne or any supplements with cayenne can trigger erythematous dermatitis, a skin condition, in babies. This condition causes skin peeling and scaling.4 The European Union has allowed the capsaicin patch to be used in non-diabetic patients with neuropathy, in those with PHN, and in patients with HIV polyneuropathy. In the US, the FDA only has approved the patch for PHN patients. The high-concentration capsaicin patch can last for 3 months, which is different from the low-concentration capsaicin cream.5
There are a variety of capsaicin cream brands available to patients. Some are creams, and others are in capsaicin ointment form. Brand names include Capsin, Icy Hot Arthritis Lotion, Zostrix, and Arthricare for Women.6 Sombra offers a gel for pain relief called Sombra Warm Therapy. It is meant to alleviate the aches and pains of joints and muscles in patients with bruises, sprains, strains, backaches, and arthritis. It has both warming and cooling ingredients, and it is an animal-free, USA-made product. One of the ingredients is capsicum anuum fruit extract.7 Pharmacies, such as Walgreens, also offer their own brands of arthritis pain relief creams, with a .1% concentration of capsaicin. Capsaicin cream is considered one of the natural remedies for arthritis.8
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