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Chili peppers are famous for a lot of things, including their spicy kick. This spice sensation is caused by a chemical compound called capsaicin.

While known for causing a three-alarm fire in your mouth, capsaicin extract can also provide pain relief when applied to the skin. That’s because capsaicin has analgesic properties that help relieve pain.

When used topically, capsaicin may help control peripheral nerve pain as well as other types of muscle and joint pain. It works by releasing heat that gives comfort to patients with conditions like arthritis.

Capsaicin is available over the counter (OTC) and in prescription form. Here are the best capsaicin products and answers to your most burning questions about this natural wonder.

Capsaicin cream, gels, ointments, and patches are primarily used for relieving pain in conditions like arthritis, muscle pain or strains, joint pain, and diabetic neuropathy.

A 2021 review found that topical capsaicin is beneficial in treating chronic lower back pain, which is one of the most common reasons for visiting a doctor.

Prescription capsaicin patches work like other topicals but contain a higher concentration of capsaicin. According to a 2013 review, the capsaicin 8% prescription patch is used to manage neuropathic pain conditions in various patients.

Oral capsaicin supplements are sometimes used as part of a weight loss routine. A 2017 review found that a dietary capsaicin supplement benefits metabolic health, especially for weight loss in obese populations.

Capsaicin works by reducing substance P. This compound plays an important role in transmitting pain signals from nerve endings to your brain. It’s also involved in activating inflammatory substances in joints.

Ready to try a capsaicin product but not sure where to start? Here are some of the best capsaicin products you can buy online, in the store, or with a prescription.

Best prescription product

Qutenza

Most OTC products contain between 0.025% and 0.1% capsaicin. This amount can help temporarily relieve some minor pain, but if you need something stronger, your doctor may recommend a prescription patch called Qutenza.

Designed to treat neuropathic pain associated with postherpetic neuralgia and for neuropathic pain associated with diabetic peripheral neuropathy of the feet, Qutenza topical system is 8% capsaicin — a significantly higher amount than OTC products.

The capsaicin is delivered through a patch that your doctor applies to a specified area. The patch remains on the skin for 30 to 60 minutes, depending on what is being treated. Treatment with Qutenza can be repeated every three months.

Best capsaicin blend

Nervex

Nervex nerve pain relief cream is a topical OTC product that contains:

  • capsaicin
  • arnica
  • B12, B1, B5, and B6
  • D3
  • methylsulfonylmethane (MSM)
  • witch hazel

The company advertises the cream for anyone experiencing neuropathy and fibromyalgia pain, muscle spasms, and other daily minor pain. Nervex is odorless and appropriate to apply to your hands, feet, or other areas recommended by your doctor or another healthcare professional.

One downside is the label does not list the percentage of capsaicin. However, Nervex does not require a prescription, and you can purchase it in-store or online.

Best capsaicin gel

Capzasin Quick Relief Gel

Capzasin Quick Relief Gel is one of the most popular capsaicin gels on the market. Affordable and effective, Capzasin contains 0.025% capsaicin along with 10% menthol, which has a cooling sensation when applied to the skin. This combination may provide temporary relief for minor aches and pains.

One notable feature of this product is the sponge-top applicator that allows you to apply and massage the gel into the skin without getting it on your hands.

Capzasin gel does not require a prescription. It is available online and in stores.

Best oral supplement

NOW Cayenne 500 mg capsules, 100 count

If you’re looking to support digestive health, metabolism, and overall joint and muscle health, oral capsaicin products like NOW Cayenne are a great place to start.

Unlike topical capsaicin, which helps provide temporary and often fast pain relief, capsules take longer to work, but they provide potential benefits like digestive and metabolism support that topical capsaicin lacks.

NOW Cayenne contains 500 milligrams (mg) of cayenne pepper in the form of Capsicum annuum. It’s soy-free, vegan, and non-GMO. The recommended dosage is one capsule two to four times per day. NOW Cayenne does not require a prescription, and you can purchase it in-store or online.

Best OTC patch

Salonpas Capsicum Patch

Whether you’re on the go, in a hurry, or just want to keep your hands clean, a peel-and-apply option for pain relief can deliver results quickly and with little effort on your part.

The Salonpas-Hot Capsicum patch is an OTC patch measuring 5.12 by 7.09 inches. It contains 0.025% capsaicin and provides temporary pain relief for muscle aches, strains, bruises, and minor arthritis.

Once applied, the patch lasts about 8 hours. For maximum pain relief, you can apply a new patch three to four times a day. You can purchase the Salonpas patch in-store or online. It does not require a prescription.

While generally considered safe when used in the correct dosage, capsaicin does come with some side effects. Topical capsaicin can cause the following issues:

  • burning sensation in the area applied
  • irritation, redness, or itching
  • respiratory problems like sneezing, coughing, and throat irritation

In more severe cases, topical capsaicin may cause eye irritation or pain. It can also cause pain, blistering, and swelling where it is applied.

Oral capsicum in the form of pills or capsules is also generally considered safe when taken as directed. Some side effects that may occur include upset stomach or irritation, sweating, or runny nose. Safety concerns arise if you take more than is recommended or for long periods of time.

When to contact a doctor

If you experience serious side effects or continue to have side effects after a few days, it’s time to call your doctor. Additionally, if you have an allergic reaction to topical or oral capsaicin, stop using it and seek emergency attention immediately.

Signs of an allergic reaction include:

  • difficulty breathing
  • swelling in your throat
  • hives
  • chest tightness
  • rash
  • itching

Talk with your doctor before using any capsicum product if you are pregnant or breastfeeding or have a chronic health condition.

You may also want to consult with a doctor if OTC capsaicin products are not effective and you need a stronger concentration. They can discuss a prescription-based patch that has a higher amount of capsaicin.

If you’re not a fan of capsaicin or you want to try a product that offers similar benefits, there are several alternatives to consider. While not an exhaustive list, the following ingredients are commonly found in topical products like ointments, creams, and gels used for aches and pains.

Is capsaicin good for you?

Capsaicin is a common ingredient found in many pain-relieving products. It’s also the zing that makes peppers and hot sauces spicy.

In addition to pain-relieving benefits, capsaicin can also increase the amount of heat your body produces, resulting in a higher calorie burn.

Another 2019 study found that regular chili pepper consumption as part of a Mediterranean diet is associated with a lower risk of total cardiovascular death.

What is the strongest capsaicin cream?

The strongest OTC capsaicin creams contain 0.1% capsaicin. Some of the more common high potency brands include Zostrix and several generic drugstore brands like Walgreens Capsaicin cream.

Where can I buy capsaicin cream?

You can purchase capsaicin cream online, at the drugstore, grocery store, or health food store — or ask your doctor about a prescription-strength capsaicin cream or patch.

When shopping, look for pain-relieving products for arthritis. Capsaicin is a common ingredient in OTC arthritis creams.

What foods have capsaicin?

Capsaicin packs a powerful punch, but it’s not abundant in many foods. The most common way to get capsaicin in your diet is in chili peppers, including habanero peppers, hot sauces, cayenne peppers, dried hot peppers, paprika, and certain spicy ketchups, according to a 2014 study.

Can capsaicin hurt you?

There’s not much evidence to support any major injury or negative effects from a balanced and moderate consumption of capsaicin.

The heat and discomfort you might feel with capsaicin is essentially a mind trick. It’s the result of your body considering the stimulus to be an actual burn. There’s no serious physical damage occurring to your cells.

Capsaicin is an extract from chili peppers. It can treat minor issues related to pain and sometimes aid in digestive health or weight loss.

You can find capsaicin in various formulas including creams, gels, capsules, or a patch. If you’re using capsaicin for pain relief, the best place to start is with a topical. However, if you’re looking for digestive or metabolic support, consider an oral supplement.

It’s important to follow the instructions on the label and do not use more than is recommended. If you experience any discomfort or unusual pain from capsaicin, stop using it. If it persists, call your doctor right away.