Cayenne, also known as red pepper, was first introduced to the world by the Caribbean Indians, who gave it to Columbus. Since then its popularity has spread, and it has become an important spice particularly in Cajun and Creole cooking, and in the cuisines of southeast Asia, China, southern Italy, and Mexico. Capsaicin is the most important ingredient in cayenne and gives it its spiciness. Although spiciness is associated with heat, capsaicin stimulates a section of the hypothalamus which effectively lowers body temperature. Natives of subtropical and tropical climates consume it regularly because it helps them tolerate the heat. As well as being an important spice in many ethnic cuisines, cayenne has many important medicinal properties, including supporting and stimulating the cardiovascular system, acting as a long-lasting topical analgesic, improving digestion, and acting as an expectorant, antioxidant, and antibacterial. Cayenne is very beneficial for the cardiovascular system. A study done on natives of Thailand, who ingest cayenne every day in their meals, shows that they have much lower rates of cardiovascular disease than Americans. Cayenne lowers levels of blood cholesterol. It helps prevent blood clots as well. These properties greatly reduce the likelihood of developing atherosclerosis.

The capsaicin in cayenne has very powerful analgesic properties when applied topically. It works primarily by decreasing pain transmitters in the body, making it an excellent solution for the pain caused by postherpetic neuralgia, diabetic neuropathy, toothache and trigeminal neuralgia, postmastectomy and other surgical trauma or stump pain, headaches, psoriasis, and osteoarthritis and rheumatoid arthritis. Capsaicin also reduces inflammation in joint tissues, which aggravates arthritic conditions. Use of capsaicin-laced taffy to relieve mouth pain from chemotherapy and radiation has been very effective.

Cayenne stimulates saliva and stomach secretions which promotes digestion. Its antibacterial power also fights infection in the gastrointestinal tract and can relieve infectious diarrhea. As an expectorant, it thins mucus and helps move it out of the respiratory tract, making it helpful for emphysema. Its strong antioxidants also protect lung tissue from cellular damage.

Shrubby, tropical perennial. Can grow up to two feet. Branches and stems are hardwood and angular. Flowers bloom in pairs or clusters, greenish or yellowish-white. Leaves broad, elliptical, puffy, wrinkled. Fruit pendulous, podlike, shiny, red, orange, and yellow when ripe. Flowers in summer. Indigenous to Mexico and Central America, but now grows in subtropical and tropical zones of Europe, Asia, Africa, and North America.

• Seeds
• Fruit

Capsaicin (0.1% to 1.5%), carotenoids, vitamins A and C, flavonoids, volatile oil, steroidal saponins (capsidicins—in seeds only).

Fruit eaten raw or cooked. Fruit dried and powdered. Powder can be added to foods, stirred into juice, tea, or milk, or taken in capsule form. Capsaicin cream: Zostrix, Axsain, Capzasin-P (should contain at least 0.025% capsaicin).

Traditional: antioxidant, expectorant, antihypertensive, topical analgesic, stomachic, carminative, gastrointestinal stimulant, rubefacient, antibacterial, circulatory stimulant, diaphoretic, used to strengthen integrity of veins, capillaries, and arteries. Historically used to treat ulcers.

Clinical applications: emphysema, high blood pressure, rheumatoid arthritis, osteoarthritis, carpal tunnel syndrome, fever, cluster headaches, migraine, shingles, indigestion, artherosclerosis, psoriasis, flatulent dyspepsia

Can also be used topically with caution for the following: postherpetic neuralgia, trigeminal neuralgia, postmastectomy pain, mouth pain from chemotherapy or radiation, diabetic neuropathy, psoriasis

Capsaicin is the most important pharmacological ingredient in cayenne. Cayenne contains high levels of vitamin C and A, and its carotene molecules act as an antioxidant. Cayenne supports and stimulates the cardiovascular system in several ways. It helps prevent atherosclerosis by lowering blood cholesterol and triglyceride levels, which reduces blood pressure as well. It also increases fecal excretions of free cholesterol, preventing absorption of cholesterol. It has an anti-aggregation effect on platelets and increases fibrinolytic activity.

Cayenne contains six pain-relieving compounds and seven anti-inflammatory ones, the most important of which is capsaicin. It also contains salicylates which are similar to salicin, the herbal equivalent of aspirin. Capsaicin inhibits pain by causing an initial increase in substance P and then a depletion of it in the sensory nerves. Because of the initial stimulation of substance P, it takes several days for the pain release to become effective, but it is very helpful for chronic pain sufferers. The depletion of substance P is also thought to decrease inflammation in joint tissues affected by osteoarthritis and rheumatoid arthritis. Because cayenne is a rubefacient, it helps to increase blood flow to painful joints or cold extremities, and reduces the scaling and redness of psoriasis, although it may cause some initial burning and itching.

The capsaicin in cayenne stimulates the cooling center of the hypothalamus, which decreases body temperature. Its salicylate content and stimulation of sweat glands help reduce fever as well.

The gastric and duodenal mucosae have capsaicin-sensitive areas which respond to stimulation from capsaicin by increasing mucosal blood flow and vascular permeability, inhibiting gastric mobility and activating duodenal motility. This aids digestion and protects against acid- and drug-induced ulcers.

As an external analgesic, apply capsaicin cream (0.025% to 0.075% capsaicin) directly to affected area up to qid. Also used as tincture (1:5): 1 ml tid.

Cayenne pepper is generally regarded as safe in the United States. Topical applications may cause temporary burning sensation or redness, but this should subside without complication. Keep cayenne away from eyes, as the capsaicinoids are a strong irritant to mucosal membranes. Chronic overuse of capsaicin can be toxic.

Wash hands well after use and avoid touching the eyes. Not very soluble in water, so use vinegar to remove it best. Cream may cause skin irritation in some people. Test on small area of skin before extended use. If causes irritation, discontinue use. May cause gastrointestinal irritation, although does not influence duodenal ulcers. Do not use for children under age 2. Safe for use during pregnancy. It is not known if the spicy compounds are transferred through breast-feeding.

A case of cough induced by topical capsaicin cream (0.075%) has been reported in a patient taking an ACE inhibitor (Hakas 1990). A 53-year-old female patient applied capsaicin cream to her lower extremities for the treatment of peripheral neuropathy secondary to diabetes. She had been maintained on an ACE inhibitor for several years without experiencing cough as a side effect prior to the introduction of the capsaicin. The cough was temporally related to application of the capsaicin cream.

In a clinical trial involving 18 healthy volunteers, capsaicin reduced gastric mucosal damage induced by aspirin (Yeoh et al. 1995). Endoscdopic examination revealed that oral administration of 20 g of chili (equivalent to 9.65 mg capsaicin) 30 minutes prior to ingesting aspirin (600 mg) reduced gastric mucosal lesions.

Cayenne enhanced theophylline absorption and bioavailability when administered orally to rabbits (Bouraoui et al. 1988). High or regular use of cayenne may increase the risk of theophylline toxicity, although this has not been tested in humans.

On U.S. FDA list of herbs generally regarded as safe. FDA approval of capsaicin creams, Zostrix and Axsain, for chronic pain.

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