Pepper spray, or Oleoresin Capsicum (OC), uses a highly concentrated oil-based extract from chili peppers to cause immediate, intense irritation to the eyes, skin, and respiratory system. The active ingredient, capsaicin, is hydrophobic, making effective decontamination challenging since it does not mix well with water. Immediate and correct action is necessary to minimize the duration of incapacitation and discomfort.
Immediate Actions After Exposure
The first priority upon exposure is to immediately move out of the contaminated area and into a location with fresh air, ideally facing into an upwind breeze to help clear the respiratory passages. While the urge is powerful, it is important to resist rubbing the affected areas, especially the eyes. Rubbing physically drives the capsaicin oil deeper into the skin and eyes, intensifying the pain and prolonging the effects, and also spreads the irritant to previously unaffected skin.
Focusing on controlled breathing can help manage the intense respiratory irritation that often accompanies exposure. Taking slow, deliberate breaths, rather than short, rapid gasps, can prevent the hyperventilation that may occur due to panic and throat constriction. Any contaminated clothing should be removed as quickly as possible and sealed in a plastic bag to prevent re-exposure.
If contact lenses are worn, they must be removed immediately using clean hands or with the assistance of an uncontaminated person. Contacts can trap the OC residue directly against the cornea, and they should be discarded rather than cleaned. Removing clothing by cutting it off, instead of pulling it over the head, will prevent dragging the irritant across the face and eyes again.
Decontamination and Symptom Relief
The core of treatment involves flushing the eyes and skin continuously with cool water or a sterile saline solution for at least 15 to 20 minutes. This prolonged irrigation is necessary to physically wash away the oil particles and dilute the remaining irritant. The stream of water should flow from the inner corner of the eye outward to avoid spreading the OC to the tear duct or the other eye.
Since capsaicin is an oil, water alone is often insufficient for skin decontamination, necessitating a cleansing agent that can break down the oil. Gently wash the skin with a non-oil-based soap, such as dish soap or baby shampoo, to emulsify the sticky capsaicin residue. It is important to use cool water during this process because hot water causes pores to open, which allows the OC to penetrate the skin more deeply, increasing the burning sensation.
After washing, avoid applying any lotions, creams, or petroleum-based products like Vaseline to the affected areas. These substances can trap the OC against the skin, reactivating the burning sensation. Symptom relief can be aided by using a fan to cool the skin or applying a cool, damp compress to the facial area.
While the most intense pain typically subsides within 20 to 30 minutes, some residual discomfort and irritation can persist for several hours. Continuing to blink rapidly during and after flushing encourages tear production, which helps the eyes clear themselves of the irritant.
When to Get Medical Help
Although most effects from pepper spray are temporary and resolve with thorough decontamination, there are situations that require professional medical attention. Individuals with pre-existing respiratory conditions, such as asthma or chronic obstructive pulmonary disease (COPD), face a higher risk of severe complications. Any indication of severe or worsening breathing difficulties, persistent wheezing, or chest pain warrants immediate medical evaluation, as the spray can cause significant airway inflammation.
If eye pain, blurred vision, or intense light sensitivity does not show significant improvement after 45 to 60 minutes of continuous flushing and decontamination, seek medical care. Prolonged or forceful exposure can potentially lead to physical trauma, such as corneal abrasion, which requires specialized treatment.
Physical signs of injury, including blistering, chemical burns, or cyanosis—a bluish discoloration of the skin indicating low oxygen levels—are also strong indicators for emergency medical intervention. These reactions suggest a localized injury beyond the temporary irritant effect. Any individual who has been sprayed at point-blank range should also be examined by a healthcare professional.