String of dried red peppersby James Hubbard, M.D., M.P.H.

Around here it’s not unusual to see a string of dried peppers hanging on a wall for decoration. These people are preppers and probably don’t know it. Many would be surprised of the pain-relief power packed in each those little pods.

Capsaicin is the chemical that makes the pepper hot. It’s concentrated in that pepper placenta—the light-colored material that keeps the seeds stuck together. Diluted into a cream or spray, the capsaicin can do wonders for certain types of pain. In a disaster setting, when no other pain medicine is available, you could make your own. But be very careful. You’d need gloves, a mask, and airtight goggles. Undiluted capsaicin is beyond hot. More on recipes later.

When I have to give a painful shot, I often kid that at least it’ll take your mind off the pain you came in for. I know, lame on my part, but that’s actually the way I used to think the capsaicin worked. It masked the underlying problem. Now I know it works in far more wondrous ways than that.

How Capsaicin Fights Pain

I don’t have to tell you that if you rub a hot pepper on the skin, it burns. The capsaicin in the pepper triggers the release of chemicals along nerves that relay pain signals back to the brain. So far, pretty obvious. But what’s different about the capsaicin is it gets those chemicals to fire so much and so often that the chemical becomes depleted. No chemical, no pain.

So the first two things you should know about using capsaicin are:

  1. It’s going to really burn the first few times you put it on.
  2. It takes a day or two, sometimes more, before it depletes the chemical and begins to relieve your underlying pain.

Capsaicin’s Best Pain Targets

Even if you do have access to oral medicine, capsaicin may be worth the effort for what it works on the best, nerve pain and cluster headaches. These pains usually don’t respond well to the normal array of over-the-counter pain relievers.

  • Postherpetic neuralgia. It’s pretty rare, but some people continue to have nerve pain, called postherpetic neuralgia, for months or years after an outbreak of shingles. Don’t use capsaicin on the initial rash outbreak. It’s typical to have pain in that area for several weeks after shingles, but if it’s months, this may be worth try.
  • Diabetic neuropathy. Diabetes can wreak havoc on your smallest blood vessels and nerves. One symptom is a pain or tingling in the feet, especially at night. Capsaicin is worth a try.
  • Osteoarthritis. Capsaicin can relieve some of the joint aching. It doesn’t do much for rheumatoid arthritis, just osteo.
  • Cluster headache. This is a rare variety of migraine. The headache is one-sided and severe, often accompanied by a watery eye on that side. As the name implies it comes in clusters. You’re headache-free, and wham, out of the blue they hit you, one after the other, for weeks, months. The diluted capsaicin goes in the same nostril as the side of the headache. It may take a few days to work, whereas one-hundred percent oxygen may work much faster.

With all of these problems you need to see a doctor to rule out other causes, and prescription treatments can be more effective. But if you’re in a bind, and there’s no doctor on hand, capsaicin certainly is worth a try.

How to Get Capsaicin

Zostrix is a reliable brand. Of course you can make capsaicin cream. The problem is getting the strength correct so you can tolerate it. Here’s one link that tells how to make it with habanero powder and sunflower or canola oil. (I haven’t tested the recipe.) If you have others, please share.

Don’t try to smear the capsaicin on directly from the pepper. It’s way, way too strong. And don’t apply any cream to areas with cracked skin. Wash your hands immediately after applying. You don’t want to take the chance some could get into your eyes. Talk about burning.

Photo by James Stewart.