In recent years, online challenges involving extremely spicy foods and hot chili peppers have gained popularity. Although most individuals experience an intense burning sensation, some may develop gastrointestinal symptoms and severe allergic reactions in rare cases. The French Agency for Food, Environmental and Occupational Health & Safety (ANSES) has issued a warning, particularly for adolescents.

The trend of filming individuals eating extremely spicy foods gained popularity after the US television series Hot Ones and later spread to France, particularly among adolescents. Some retailers have also begun specializing in chili-based sauces and related products to capitalize on the trend. What might otherwise seem like a harmless challenge has been associated with cases of food poisoning, including fatal cases, prompting health authorities to issue warnings.

The main culprit is capsaicin, or 8-methyl-N-vanillyl-6-nonenamide, a naturally occurring compound in chili peppers (Capsicum species) that produces a characteristic burning sensation and spicy taste. Capsaicin concentrations vary widely among chili varieties. The heat intensity of spicy food is measured using the Scoville scale and expressed in Scoville heat units (SHU). The scale was named after pharmacologist Wilbur Scoville, who developed it in 1912 while working at Parke-Davis in Detroit.

Capsaicin activates receptors in the nervous system that signal a change in temperature in the brain, producing a burning sensation in the mouth without an actual increase in temperature. At higher doses, it can cause pain in the digestive tract. The burning sensation may extend from the mouth to the esophagus and stomach and may be accompanied by nausea, vomiting, diarrhea, and burning or irritation during bowel movements. Systemic effects including elevated blood pressure, palpitations, and loss of consciousness can also occur.

Exposure is not limited to ingestion. Skin contact with spicy products can cause erythema, whereas exposure to the eyes can result in irritation, excessive tears, blepharospasm, or keratitis.

Spicy Chip Challenges

Tolerance to capsaicin varies significantly from person to person. Children and individuals with digestive or cardiovascular conditions may be particularly susceptible to these effects, which may occasionally be severe.

In 2023, a 14-year-old US adolescent with mild cardiac malformation died of cardiopulmonary arrest after consuming an extremely spicy potato chip. The challenge, known as the “One Chip Challenge,” involved eating an extremely spicy chip without drinking or eating anything else for as long as possible while recording the reaction for online sharing.

One of the peppers used in the chip was the Carolina Reaper, considered one of the world’s hottest peppers, with a heat intensity of 1.8 million-2.2 million SHU. By comparison, ordinary Tabasco sauce contains approximately 2500-5000 SHU, according to ANSES.

France has also been affected by the trend. Between 2021 and 2025, 124 individuals who developed symptoms after consuming spicy food or spicy dishes contacted a poison control center. More than one third (39%) became ill while taking part in a challenge. In 34 cases, multiple individuals were affected, including two incidents involving groups of 12 and 10 middle school students.

Adolescents aged 10-15 years accounted for 65% of individuals who took part in a challenge. Spicy chips were used in 83% of these cases. The remaining cases involved chili peppers consumed alone or spicy products such as Tabasco sauce, chili oil, harissa — Jewish Tabasco or Sriracha — spicy ketchup, or green curry, according to ANSES.

Among individuals who received medical care, the most common symptoms were pain, including epigastric pain in 35%, oropharyngeal pain in 20%, and abdominal pain in 17%. Oral irritation occurred in 17% and vomiting in 10%. Individuals could experience more than 1 symptom.

Most cases were mild. One case was moderately severe. A 28-year-old woman with a history of allergies developed angioedema affecting the face and throat and a dry cough after eating spicy potato chips as part of a challenge. Her symptoms resolved after emergency treatment with antihistamines and corticosteroids, according to ANSES.

Regulations

Following several EU alerts that resulted in recalls of products containing excessively high levels of capsaicin or products with incorrect labeling, the European Food Safety Authority is assessing the acute and chronic risks to human health associated with capsaicin consumption, with a focus on acute effects. The assessment is expected to be completed by the end of 2027.

While regulatory measures are pending, ANSES recommends several precautions. Individuals should check product labels for capsaicin content and look for terms such as “super spicy,” “ultra hot,” or “extreme” as indicators of high capsaicin levels. Extreme challenges should be avoided because what begins as a game can become a medical emergency.

What to Do

• Milk, yogurt, ice cream, or a small amount of cooking oil may help relieve the burning sensation. Bread, potatoes, and rice may also provide some relief.
• Avoid water and carbonated drinks because capsaicin does not dissolve in water.
• Seek emergency medical help if you develop swelling or difficulty breathing because these may indicate a serious allergic reaction.
• If symptoms persist or worsen, contact a local poison control center, or seek medical care.

This story was translated from Medscape’s French edition.