Chili Pepper Compounds in the Management of Neuropathic Pain

Chili peppers are spicy fruits consumed worldwide. Capsaicin is the main compound contained in chili peppers responsible for the typical pungency. Many pharmacological properties have been attributed to capsaicin, and the analgesic property has been applied to the treatment of peripheral neuropathic pain. Capsaicin is an agonist of TRPV1 receptors. After initial pain and irritation of the skin for the stimulation of peripheral nerve endings, these become desensitized and irresponsive to further stimuli. This mechanism counteracts nociceptor dysfunction and hyperalgesia present in neuropathic pain and is dose dependent. The safest route of administration of capsaicin is the topical one. Creams and an 8% patch are safe and effective for peripheral neuropathic pain. HIV-related neuropathy and postherpetic neuralgia in adults are currently the main indications for the capsaicin patch. Future studies could enlarge the indications and the categories of patients to be treated.