Side Effects of Topical Capsaicin

Capsaicin—the active ingredient in chili peppers—is sometimes used to help relieve certain types of pain. When applied to the skin (topically), capsaicin temporarily blocks the way your body interprets pain messages.

Research suggests that capsaicin may relieve pain for a variety of arthritis and musculoskeletal-related conditions, including muscle strains and sprains, fibromyalgia, headaches,  joint pain, and diabetic neuropathy.

Some studies have also indicated that using capsaicin could help improve symptoms of psoriasis and relieve nerve damage pain from conditions like shingles and HIV.

It’s important to understand how to properly use capsaicin and what to expect because it does have the potential to provoke side effects that are both common and rare. For most people, after application, capsaicin prompts a tingling, warming or cooling sensation that appears to initially irritate the area before it relieves the pain.

In general, it’s a good idea to check with your healthcare provider before starting any form of capsaicin to make sure it’s appropriate for your specific condition.

Forms of Capsaicin

Capsaicin for topical use comes in two main forms: 

• Cream, ointment, gel, or lotion
• Skin (transdermal) patch

Capsaicin cream is what's usually recommended for most types of pain relief. It’s available over-the-counter in strengths from 0.025% to 0.1% and is applied to the area where the pain is felt, generally up to four times per day.

Experts suggest using it for three to four weeks, then evaluating whether it’s working for your condition. When using this form of capsaicin, make sure to wash your hands thoroughly after use, and keep it away from your eyes, nose and mouth.

Capsaicin patches have much higher levels of the ingredient than the cream version (8%). This form of capsaicin is only available from a healthcare provider's office, and is typically recommended for longer-term conditions, such as diabetic neuropathy (nerve damage associated with diabetes) or postherpetic neuralgia (chronic pain post shingles).

Patch application must be done at your healthcare provider's office usually with local sedation, due to the initial pain and burning sensation that comes with the stronger dose. The capsaicin patch may help relieve pain for up to three months. During that time, you don’t have to do anything special except avoid touching the patch while it’s on your skin.

Common Side Effects of Capsaicin

There are several common side effects that many people experience when using topical capsaicin. Remember that some level of irritation, sensation, stinging, or pain when using capsaicin is to be expected, especially when you first start using it. This is expected to subside after anywhere from a few days to a few weeks.

Here's what you might experience:

• Redness
• Soreness
• Dryness
• Stinging/burning
• Itching
• Low levels of pain

Keep in mind that the areas you treat may be sensitive to heat (like hot water, direct sunlight, and sweating) for a few days after application.

Severe Side Effects of Capsaicin

Capsaicin can cause some rare, more serious side effects in some people.

The capsaicin patch has the potential to cause side effects that could affect your heart—including a slow or fast heart rate and a change in blood pressure. That’s why it’s important to let your healthcare provider know if you have a history of heart disease or high blood pressure.

In addition, if capsaicin cream is inhaled during or after the application process, coughing, sneezing, watery eyes, sore throat, and difficulty breathing can happen as a result.

If capsaicin cream is ingested in moderate amounts, it can cause nausea, vomiting, abdominal pain, and burning diarrhea. Seek medical attention immediately if you notice any of these more severe side effects.

Precautions and Contraindications

If you're pregnant or breastfeeding, experts recommend checking with your healthcare provider before using any form of capsaicin medication.

It is not recommended to use capsaicin cream or patch on or near the breast area if you are breastfeeding. Studies have shown that exposure to the product could affect the baby if there's direct contact with areas of the skin that have been treated.

When to See a Healthcare Provider

Like any medication, capsaicin can cause an allergic or adverse reaction in some people.

Stop using capsaicin and notify your healthcare provider immediately if you experience severe pain (beyond the initial burning/stinging sensation), blistering, hives, swelling in your throat, chest tightness, and trouble breathing while using any form of capsaicin.

Remember that higher doses of capsaicin may result in additional, or more severe, side effects. Experts recommend starting to use lower doses of capsaicin products in smaller amounts before building up a tolerance for larger quantities.

Definitely stop using it and check with your healthcare provider if your condition gets worse, or if it doesn't show any signs of improvement after a few weeks of consistent use.

A Word From Verywell

While capsaicin cream may not be right for everyone, it does help some people manage pain in conjunction with standard medical treatment, and there are risks and benefits to both formulations. The cream form does require regular applications, takes some time to build up in your system, and has common side effects that many people experience.

On the other hand, the higher-concentration patch doesn't require repeated daily applications, but it can cause significant burning and pain in the initial days after it is applied.

If you're considering trying any form of topical capsaicin for pain relief, speak to your healthcare provider or another healthcare professional to discuss whether it's appropriate for your specific condition, and for more details on what to expect.