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Bartoshuk became interested in capsaicin more than twenty years ago. Until recently, she says, they didn’t do any trials with capsaicin out of fear they would damage people. But the desire to help those who suffered from oral mucositis pain was greater than the fear, and a clinical trial was set up. “Our first test subject was a nurse with cancer who suffered from mouth lesions she developed during chemotherapy. When I first applied the capsaicin, my hand was shaking, and so was her tongue.” The nurse and many other test subjects proved that through desensitization of the mucous membrane, capsaicin has provided a substantial amount of pain relief for oral pain sufferers.
Yale medical student Wolffe Nadoolman made a good idea even better by suggesting that the capsaicin be packaged within a candy to make it more palatable. What they came up with was a taffy because it is soft and easily ingested without additional pain. While all of this information is very promising, Bartoshuk cautioned that many more in-depth clinical studies must be done before the FDA can approve the “cancer candy” as a treatment. “There are many areas of pain that I believe capsaicin can effectively help treat, from burn victims, to children who have suffered side effects from radiation or chemotherapy. We would like to develop products such as chile gummy bears or capsaicin popsicles in a suitable strength for kids.”
Heading Off The Pain
Cluster headaches are short-lived, but excruciating. In fact, Dr. Ninan T. Mathew, director of the Houston Headache Clinic once said in The Dallas Morning News that cluster headaches are the most severe form of head pain known to man. The pain, he says, is always isolated to one side of the head, and the attacks occur in groups or clusters, sometimes three or four times a day, and last from forty-five minutes to an hour. Sometimes the attacks will subside for months, or even years. Men comprise ninety percent of all sufferers, and Mathew says this phenomenon is probably related to testosterone levels. He has also found that the headaches can be precipitated by histamines, drinking alcohol, or taking or nitroglycerin, a heart medication.
Cluster headaches are not to be confused with migraine headaches, which last anywhere from two hours to two days, can cause nausea and vomiting, and affect mostly women. While nausea is not associated with cluster headaches, a person having an attack might experience one eyelid drooping and/or one nostril stopping up on the same side as the headache. Other symptoms can include watering and redness of both eyes and constricting pupils.
Enter capsaicin on a stick.
For the past four years Mathew has studied the effects of capsaicin on cluster headache pain. Patients use a cotton swab to apply a capsaicin cream such as Zostrix inside the nostril that is on the same side as the headache, and sometimes onto painful areas of the face. The first few treatments burn, but Mathew said the pain goes away after a few applications.
This treatment, however, does not necessarily provide instant relief. “It may work if applied immediately,” says Mathew, “but it’s more preventive than acute.” He says it takes about two weeks of daily application to deplete Substance P from the nerve that extends from the nostril to the head, which then renders it incapable of producing pain. This can keep headaches from recurring.
Additionally, a cluster headache study published in 1994 from the University La Sapienza, Rome, Italy, confirmed that capsaicin desensitizes nerves, and also found that it alters blood flow in the head, particularly when applied in the nostril on the same side as the headache. These results, too, found that this treatment helped prevent future attacks.
Although these results sound promising, Mathew cautions that more studies on larger groups of people need to be done before he can recommend capsaicin as a definite treatment for cluster headaches. “It’s an exciting idea that may not follow through,” he says. “But theoretically, it has merit.”
Breathing Easier
Some noses are more sensitive than others, particulary those suffering from rhinitis, an inflammation of the mucous membranes that line the nose. “When somebody with rhinitis is exposed to irritants, such as smoke, the nerves are stimulated and inflammation happens,” says Dr. Alvin Sanico, who works in the division of Clinical Immunology at the Johns Hopkins Asthma and Allergy Center in Baltimore. Chronic symptoms include any combination of nasal obstruction, nasal discharge, sneezing and facial pressure or pain.
For the past several years, doctors at the Asthma and Allergy Center have been studying the effects of capsaicin nasal spray on these symptoms, and while their results are not conclusive, they believe that further irritation leads to relief.
Initially the capsaicin nasal spray itself causes inflammation, sometimes accompanied by an onslaught of symptoms, but Sanico says that when the spray is administered repeatedly, this response diminishes. He says the capsaicin desensitizes these overactive nerves by depleting Substance P, and once the nerves calm down, the nasal passages clear. It is important to note, however, that people who are repeatedly given capsaicin nasal spray as part of these studies are also given lidocaine to ease the burning.
Capsaicin has also been studied as a way to relieve asthma symptoms.
“It can be said that rhinitis is to the nose as asthma is to the lungs,” says Sanico. “However, it would be a stretch to say that capsaicin can help asthma sufferers.”
Doctors at Papworth Hospital in Cambridge, England found that capsaicin caused the bronchial tubes of asthmatic patients to constrict, but they did not document the effect of repeated exposure.
Perhaps with repeated treatment, as in the rhinitis studies, this constriction might relax and breathing could become easier. More studies need to be done.
The answers, however, lie not only in the future, but also in the past. James A. Duke, Ph.D. has written books on ethnobotony and is recently retired from the United States Department of Agriculture as chief of the Germplasm Resources Laboratory in Washington, D.C. Some of his research was quoted in a 1994 edition of USA Today: “Asthma can be life-threatening, so I don’t encourage self-medication. But an attack in the jungle might be alleviated by an early Mexican Maya mixture, hot chocolate with hot pepper.”
While this may seem a simplistic remedy for a serious illness, capsaicin has since been found to have a potent effect in desensitizing nerves and killing pain. Doctors are now working to translate these capabilities into medicines that may one day allieviate the things that hurt your head.
Melissa T. Stock and Kellye Hunter are former editors of Chile Pepper Magazine and are currently working for Fiery Foods, the official magazine of the National Fiery Foods Show, and Sunbelt Shows. Along with Dave DeWitt, they are currently working on a book titled The Healing Powers of Peppers, to be published by Clarkson/Potter.
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