Ask the doctor: How does hot pepper cream work to relieve pain?
We don't know exactly how capsaicin works, but it's thought to stimulate the release of substance P, a chemical that helps transmit pain signals from sensory nerve fibers to the brain. After several applications of capsaicin, local stores of substance P (and possibly other chemical pain messengers) become depleted, and the nerve fibers in that area transmit fewer pain signals.
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