FAMILY MEDICINE® COLUMN
By John C. Wolf, D.O.
Associate Professor of Family Medicine®
Ohio University College of Osteopathic Medicine

READER'S HOT PEPPERS ARE TOO HOT TO HANDLE

Question: I was making a spicy salsa that uses hot peppers the other day. I've made this before without any problems. This year, though, after several hours of chopping peppers, my hands began to burn like they were on fire. I washed them immediately, but that didn't change the pain. They have burned for more than a day now. I've tried every lotion and cream in our medicine cabinet without any relief. My doctor didn't even have anything to help me. Why did I have trouble this year when I haven't in the past, and how long will this burning last?

Answer: Your skin is the largest, and arguably the most important, organ of your body. It protects you from the outside environment while at the same time keeping you informed about your surroundings. Normally the skin sensors of the hands only note the temperature, surface texture and moisture content of hot peppers when they are handled. Other sensors, like those that detect smell, can inform you as you prepare salsa or another spicy dish that the peppers in it will add that special "zing."

The chemical responsible for the "hot" in hot peppers is called capsaicin. Unfortunately, if your skin is exposed to large amounts of capsaicin, it can cause severe burning and discomfort like you've experienced! Paradoxically, you may have seen products with capsaicin advertised as arthritis treatments. Surprisingly these products actually are of some benefit. This is because in small amounts administered over a period of time, capsaicin has the ability to block transmission from pain nerves.

The skin covering the palms of the hands is quite thick. Most of this thickness is made up of the dead and dried cells in the outermost layer of skin. These cells form a tough protective coating that has no nerve endings. Capsaicin from peppers can be absorbed through this thick and tough skin, but it takes quite a lot of the substance and a fairly long time to penetrate deep enough to reach the nerve endings. Once the capsaicin does, though, the burning sensation begins. And a word of precaution, thinner skin can be penetrated more quickly, as my patient who was picking peppers and then urinated in the hidden corner of the garden can tell you.

There is no antidote for the burning pain that capsaicin causes. Once you have had sufficient exposure to cause pain, only strong pain medication will give relief. No topical ointment or cream will make much difference. The pain will subside over a period of a few days with larger exposure taking a bit longer that smaller ones.

Chopping or handling a pepper or two for a single dish is usually no problem if one is careful to avoid rubbing his or her eyes or touching other sensitive skin areas. Usual soap and water washing will remove the capsaicin from the skin without trouble. Cooking tasks that require repeated handling of hot peppers should be done with gloves.

Last year's salsa production was probably done with fewer peppers or spread out over a greater period of time with more hand washing in-between. That is why you experienced no problems in 1996 but did in 1997. And in case you are wondering, it is perfectly safe to eat hot peppers. The digestive tract is lined with cells that differ from those of the skin and are not injured by the peppers and their component capsaicin.

Family Medicine® is a weekly column. To submit questions, write to John C. Wolf, D.O., Ohio University College of Osteopathic Medicine, Grosvenor Hall, Athens, Ohio 45701.