I think this is masochism. Food doesn’t leave any external marks so these people go with food.

I used to live in West Africa, where everything is spicy. Grilled scotch bonnet peppers are a garnish in restaurants. It’s sink or swim. Thai restaurants make their “mild” Thai mild, swimming in peppers.

At some point you cross a point of tolerance where the lovely flavors of hot peppers open up to you. Orange bonnets and habaneros are wonderfully delicious. Zingy with a fruity chili flavor that is unlike other milder peppers. 10/10 my favorite. But only something one can taste once you learn to tolerate capsicum exposure.