Cayenne, also known as red pepper, was first introduced to the world outside the Americas by the Caribbean Indians, who gave some to Christopher 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 ingredient in cayenne that makes it hot. Even though cayenne tastes hot, capsaicin actually helps lower body temperature, which is one of the reasons that people in hot climates like to eat so much of it. Capsaicin also contributes to many of cayenne's other medicinal properties to stimulate the cardiovascular system, improve digestion, relieve pain on the surface of the skin or in joints, act as an expectorant, and fight bacteria.

Cayenne lowers levels of cholesterol in the blood, which in turn helps lower blood pressure. It also prevents blood in your arteries from clotting. These properties help prevent heart disease, such as atherosclerosis (hardening of the arteries).

Even though cayenne can sting your tongue, it is actually a powerful pain reliever. It initially stimulates, but then decreases the intensity of pain in the body. This makes it particularly effective for people with chronic pain, since it takes only a few days to see significant results. Those who suffer from shingles, pain from diabetes, postmastectomy pain, and other postsurgical pain may especially benefit from several different cayenne or capsaicin creams that are available. The capsaicin in cayenne may not only relieve the pain of osteoarthritis and rheumatoid arthritis, but may also help reduce the swelling from these conditions when used as a rub.

Cayenne improves digestion by stimulating production of digestive juices in the stomach and by fighting bacteria that could cause infection. Its antibacterial power also fights diarrhea caused by infection. As an expectorant, it thins mucus and helps move it out of the lungs. Because it also strengthens lung tissue, it is helpful for those with emphysema.

Cayenne is a shrub that grows in subtropical and tropical climates. Its fruit grows into long pods that turn red, orange, or yellow when they are ripe. The fruit is eaten raw or cooked, or is dried and powdered into the spice that has been used for centuries in food and medicines.

Capsaicin is the most active ingredient in cayenne. In addition to the uses described above, capsaicin has antioxidant properties, which may protect your cells from damage.

Cayenne may be taken by eating raw or cooked red pepper. Dried red pepper is available powdered, and may be added to food, stirred into juice, tea, or milk, or taken in capsule form. It also comes in creams for external use (should contain at least 0.025% capsaicin).

Because cayenne is so good for your heart, adding it regularly to food or taking it in capsule form can help prevent heart disease. Although it is spicy, it actually aids digestion and is not irritating to most ulcers. It is powerful even in small doses, so it is best not to take more than you would eat with food.

For improved digestion and prevention of heart disease, capsaicin may be taken in capsules (30 to 120 mg, three times daily). You can make an infusion (a tea) by adding 1/4 to 1/2 tsp of powder to a cup of boiling water and drinking it.

As a pain reliever, cayenne powder or cream can help relieve toothache, shingles, arthritis, psoriasis, and other kinds of chronic pain. Although it may cause some initial burning or itching, this should go away quickly. Because cayenne works by first stimulating and then decreasing the intensity of pain in the body, your pain may increase slightly at first, but then should diminish greatly over the next few days.

When applied to the skin, capsaicin cream (0.025 to 0.075% capsaicin) may be applied directly to the affected area up to four times a day.

Keep cayenne away from your eyes, and wash your hands thoroughly after use. Because cayenne does not dissolve easily in water, use vinegar to remove it. Capsaicin cream may cause skin irritation in some people. Test it on a small area of your skin before extended use. If it causes irritation, discontinue use. It may cause stomach irritation, but does not worsen duodenal ulcers. Do not use it for children under age 2. It is safe for use during pregnancy. It is not known if the spicy compounds are transferred through breast-feeding.

Using capsaicin cream on the skin may increase the risk of cough associated with angiotensin-converting enzyme (ACE) inhibitors, medications used to regulate blood pressure. If you use capsaicin cream while on these medications and you develop a cough, discontinue use of the cream.

In one clinical trial, capsaicin reduced aspirin-induced irritation and damage to the stomach. If you are on chronic aspirin therapy, consult with your health care provider before using capsaicin.

Regular use of cayenne may increase the absorption of theophylline, a medication used to treat asthma, thereby increasing the risk of toxicity associated with this medication. You should not use cayenne if you are taking theophylline except on the advice of your health care provider.

Boone CW, Kelloff GJ, Malone WE. Identification of candidate cancer chemopreventive agents and their evaluation in animal models and human clinical trials: a review. Cancer Res. 1990;50:2–9.

Bouraoui A, Toumi A, Mustapha HB, et al. Effects of capsicum fruit on theophylline absorption and bioavailability in rabbits. Drug-Nutrient Interact. 1988;5:345–350.

Chevallier A. The Encyclopedia of Medicinal Plants. London, England: DK Publishing Inc; 1996.

Cliff MA, Green B. Sensitization and desensitization to capsaicin and menthol in the oral cavity: interactions and individual differences. Physiol Behav. 1996;59(3):487–494.

Duke J. The Green Pharmacy. Emmaus, Pa: Rodale Press; 1997.

Hakas JF Jr. Topical capsaicin induces cough in patient receiving ACE inhibitor. Ann Allergy. 1990;65:322.

Hot peppers and substance P. Lancet. 1983;I:1198. Editorial.

Gruenwald J, Brendler T, Jaenicke C et al, eds. PDR for Herbal Medicines. Montvale, NJ: Medical Economics Company; 1998.

Heinerman J. Heinerman's Encyclopedia of Fruits, Vegetables and Herbs. Englewood Cliffs, NJ: Prentice Hall; 1988.

Kong YO, Kin CS, Kim ND, et al. Effect of capsicum components on liver microsomal cytochrome P-450 in rat [in Chinese]. Saeng Hakhoe Chi. 1979;10(1):17–22.

Kowalchik C, Hylton W, eds. Rodale's Illustrated Encyclopedia of Herbs. Emmaus, Pa: Rodale Press; 1987.

Locock RA. Capsicum. Can Pharm J. 1985;517–519.

Munn, S.E., et al. The effect of topical capsaicin on substance P immunoreactivity: A clinical trial and immuno-hisochemical analysis [letter]. Acta Derm Venereol (Stockh). 1997;77:158–159.

Murray M. The Healing Power of Herbs. Rocklin, Calif: Prima Publishing; 1995.

Newall C, et al. Herbal Medicines. London, England: Pharmaceutical Press; 1996.

Tandan R, et al. Topical capsaicin in painful diabetic neuropathy. Controlled study with long-term follow-up. Diabetes Care. 1992;15:8–14.

Tyler V. The Honest Herbal. New York, NY: Pharmaceutical Products Press; 1993.

Visudhiphan S, et al. The relationship between high fibrinolytic activity and daily capsicum ingestion in Thais. Am J Clin Nutr. 1982;35:1452–1458.

Vogl T. Treatment of hunan hand. N Engl J Med. 1982;306:178.

Yeoh KG, et al. Chili protects against aspirin-induced gastroduodenal mucosal injury in humans. Dig Dis Sci. 1995;40:580–583.