From the Guidelines
The use of capsaicin from chili in topical ointments for wound healing is not recommended due to the lack of high-quality evidence supporting its effectiveness and potential risks. Based on the most recent and highest quality study, 1, which is a 2024 guideline on interventions to enhance healing of foot ulcers in people with diabetes, it is recommended to avoid using any dressing based or topical applications impregnated with herbal remedies, including capsaicin, for the purpose of wound healing in diabetes-related foot ulcers. The rationale behind this recommendation is that the available evidence on the use of topical herbal or traditional medicinal preparations, including capsaicin, is of low certainty and does not demonstrate a significant benefit in wound healing outcomes. Some key points to consider when evaluating the use of capsaicin in wound healing include:
- The potential benefits of capsaicin, such as promoting tissue repair and reducing pain, are not supported by high-quality evidence in the context of wound healing.
- The use of capsaicin may be associated with adverse effects, such as burning sensation, which may be uncomfortable for patients.
- The current guidelines recommend against the use of topical antiseptic or antimicrobial dressings, including those containing capsaicin, for wound healing of diabetes-related foot ulcers 1.
- The principles of care for chronic diabetic foot ulcers emphasize the importance of treating associated infections, revascularization, offloading, and wound-bed management, but do not support the use of capsaicin 1. Overall, while capsaicin may have potential benefits in certain contexts, the current evidence does not support its use in wound healing, and 1 provides the strongest and most recent guidance on this topic.
From the FDA Drug Label
Warnings For external use only Read all warnings and directions before use. Test first on small area of skin. Do not use • On wounds or damaged skin. • If you are allergic to capsicum or chili peppers.
The role of capsaicin from chili in topical ointments for wound healing is contraindicated, as it should not be used on wounds or damaged skin 2.
From the Research
Role of Capsaicin in Topical Ointments for Wound Healing
- Capsaicin, a major component of chili peppers, has been found to exhibit anti-inflammatory properties through various pathways, including neurogenic inflammation and nociception pathways 3.
- The use of capsaicin in wound healing has been shown to improve the healing process by suppressing the inflammatory response and ameliorating the repair process 3.
- In an in vitro cell model and an in vivo animal model, capsaicin was found to increase cell migration and decrease interleukin 6 (IL-6) expression, as well as reduce the density of polymorphonuclear neutrophils and monocytes/macrophages in wounds 3.
- Capsaicin-treated wounds also showed higher densities of CD31-positive capillaries and collagen deposition at the late phase of wound healing, indicating improved wound healing 3.
Comparison with Other Topical Agents
- Other topical agents, such as curcumin, have also been studied for their wound healing properties, with curcumin showing promise in reducing persistent chronic inflammation and promoting wound healing 4.
- Topical antimicrobial agents, such as those used in burn wound care, have been found to be effective in preventing infection and promoting wound healing, with the development of effective topical antimicrobial agents being a major advance in burn patient care 5.
- However, the use of capsaicin in topical ointments for wound healing is a relatively new area of research, and further studies are needed to fully understand its effects and potential applications 3.
Mechanism of Action
- The mechanism of action of capsaicin in wound healing is thought to involve the suppression of the inflammatory response, which is a critical component of the wound healing process 3.
- Capsaicin has been shown to reduce the expression of pro-inflammatory cytokines, such as IL-6, and increase the expression of anti-inflammatory cytokines, promoting a more favorable wound healing environment 3.
- Further research is needed to fully elucidate the molecular mechanisms underlying the effects of capsaicin on wound healing 3.