The Effectiveness of Topical Capsaicin for Management of Cannabinoid Hyperemesis Syndrome: A Literature Review

Background: In people with chronic use of cannabis, Cannabinoid Hyperemesis Syndrome (CHS) is an illness associated with symptoms of cyclic vomiting, nausea, and abdominal pain. Conventional antiemetic medications frequently offer very modest relief. Topical capsaicin works by activating the transient receptor potential vanilloid 1 (TRPV1) in response to high temperatures and substance P regulation. This leads to pain relief by depleting substance P over time. Capsaicin has recently drawn interest since it mimics heat exposure from hot showers, which has been shown to reduce symptoms. This study was performed to investigate the effect of topical Capsaicin in treating CHS. Methods: We searched PubMed, Embase, and Scopus and selected nine articles that were performed between 2013 and 2024, including clinical trials, case reports, and case series that evaluated capsaicin use in patients with CHS. Information about Caspacicin dosage, formulation, and adverse effects was studied. Results: A total of 196 patients from nine selected studies were included. We found that applying 0.025%–0.1% capsaicin cream to the abdomen or thorax consistently resulted in rapid symptom alleviation (within 30–90 minutes). Capsaicin found to be better than conventional antiemetics in terms of symptom recurrence and time to resolution. Localized burning was the most frequent side effect, and no major adverse effects were observed in any of the studies. The effectiveness of Capsaicin was seen whether or not cannabis was stopped. Conclusion: We found that topical Capsaicin is a safe, quick-acting, and affordable supplement for traditional antiemetics in CHS. Its symptom-relief characteristics and convenience of usage make it particularly helpful in emergency situations. To develop conclusive treatment procedures and maximize the use of Capsaicin as a first-line treatment for CHS, more randomized trials are required.