Centella asiatica is a small, creeping herb in the parsley family that has been used in traditional medicine across Asia for centuries and is now one of the most studied botanical ingredients in skincare and supplement research. Known commonly as gotu kola, it grows in tropical wetlands and produces kidney-shaped leaves packed with a distinctive group of plant compounds called triterpenes. Its documented benefits range from wound healing and skin repair to potential brain-protective effects, though the strength of evidence varies sharply depending on the condition in question, and a handful of safety concerns deserve attention.
The Compounds That Make It Work
The therapeutic activity of Centella asiatica traces back to four main triterpene compounds: asiaticoside, madecassoside, asiatic acid, and madecassic acid.1Discover Plants. Centella asiatica and its bioactive compounds: a comprehensive approach to managing hyperglycemia and associated disorders These four molecules are the stars of nearly every pharmacological study on the plant, and they show up repeatedly when researchers isolate which fraction of a Centella extract is actually doing something useful. The plant also contains flavonoids like quercetin and kaempferol, along with phenolic acids and phytosterols, but the triterpenes dominate the conversation because they are present in relatively high concentrations and have the most direct links to measurable biological effects.2Phytomedicine Plus. Centella asiatica: Secondary metabolites, biological activities and biomass sources
One detail that matters for anyone taking Centella orally: when you swallow a supplement, the two glycoside forms (asiaticoside and madecassoside) are poorly absorbed on their own. Your gut bacteria break them down into their respective acid forms (asiatic acid and madecassic acid), which are the versions that actually reach your bloodstream in meaningful amounts.3Scientific Reports. Pharmacokinetics and metabolomics investigation of an orally modified formula of standardized Centella asiatica extract in healthy volunteers This means the bioavailability of an oral Centella product depends heavily on its formulation and on your individual gut microbiome, which partly explains why people report wildly different experiences with the same product.
Wound Healing and Tissue Repair
This is the area where Centella asiatica has its deepest roots and some of its best evidence. The plant’s triterpenes encourage fibroblasts, the cells responsible for building connective tissue, to multiply and produce more collagen.4PubMed Central. Centella asiatica and Its Metabolite Asiatic Acid: Wound Healing Effects and Therapeutic Potential At the same time, they dial down inflammation and provide antioxidant protection, creating a more favorable environment for tissue to rebuild.5PubMed Central. Topical Application of Centella asiatica in Wound Healing: Recent Insights into Mechanisms and Clinical Efficacy In practical terms, Centella preparations have been used topically on surgical wounds, burns, and chronic skin injuries, often to speed up closure and reduce scarring.
The scar reduction angle has drawn particular clinical interest. A randomized, controlled, double-blind trial tested a Centella-based cream against a placebo on post-surgical scars and found that the treatment group had reduced pigmentation scores at 8 and 12 weeks and an improved overall scar assessment score between weeks 4 and 12.6PubMed Central. A Prospective Randomized, Controlled, Double-Blind Trial of the Efficacy Using Centella Cream for Scar Improvement The improvements were real but modest, so this is not a miracle scar eraser. It is more useful as a complementary tool alongside standard wound care than as a standalone fix.
Skin Health Beyond Wounds
If you have encountered Centella asiatica anywhere in the past five years, it was probably in a skincare product. The plant has become a staple in Korean beauty (K-beauty) formulations, often marketed under the shorthand “cica.” The evidence for its topical skin benefits goes beyond marketing hype, though the effect sizes tend to be incremental rather than transformative.
Formulations containing about 5% Centella extract improved skin hydration and reduced water loss from the skin’s surface in human testing, while also showing anti-inflammatory properties.7PubMed Central. Moisturizing and Antiinflammatory Properties of Cosmetic Formulations Containing Centella asiatica Extract For anti-aging, the extract inhibits enzymes that break down collagen, elastin, and hyaluronic acid, three structural components whose degradation leads to wrinkles and sagging.8PubMed. Matrix metalloproteinase, hyaluronidase and elastase inhibitory potential of standardized extract of Centella asiatica UV exposure accelerates this enzyme activity, and animal research has shown that Centella extract counteracts several markers of sun-induced skin aging, including wrinkle formation, collagen loss, and breakdown of the skin’s moisture barrier.9PubMed Central. Oral Centella asiatica Extract Attenuates UVB-Induced Skin Photoaging via Antioxidant, Anti-Inflammatory, and Extracellular Matrix-Preserving Effects in Hairless Mice
Stretch marks are another common target. A small study of postpartum women found that most participants who received Centella powder had noticeably faded stretch marks.10KESANS : International Journal of Health and Science. Effect of Centella Asiatica Powder (gotu kola) Against Stretch Marks in Postpartum Mothers Combining topical Centella with fractional CO2 laser treatment also reduced stretch mark severity and improved quality of life in a clinical trial.11PubMed Central. Effectiveness of Fractional CO2 Laser and Topical Centella asiatica Combination Therapy in Striae Distensae (Stretch Marks) These are promising results, but both studies were small, so the extent to which Centella alone drives stretch mark improvement versus acting as a helpful addition to other treatments remains an open question.
Vascular Health and Chronic Venous Insufficiency
One of the better-established clinical uses of Centella asiatica, and one less well known outside Europe, is in managing chronic venous insufficiency, the condition where blood pools in your leg veins, causing swelling, heaviness, and skin changes. A systematic review pooling data from multiple studies found that Centella extracts, specifically the total triterpenic fraction known as TTFCA, improved several microcirculation markers including oxygen and carbon dioxide exchange through the skin, the rate of ankle swelling, and the response of small blood vessels.12PubMed Central. A Systematic Review of the Efficacy of Centella asiatica for Improvement of the Signs and Symptoms of Chronic Venous Insufficiency
TTFCA appears to work by strengthening the vein wall and protecting the inner lining of blood vessels from damage caused by chronic high pressure. It has shown benefits in both venous insufficiency and in the small-vessel damage that occurs in conditions like diabetes.13Angiology. Total Triterpenic Fraction of Centella asiatica in Chronic Venous Insufficiency and in High-Perfusion Microangiopathy In parts of Europe, standardized Centella extracts have been used as a complementary treatment for venous problems for decades. This remains one of the few areas where Centella’s clinical track record includes reasonable-quality human trials rather than just cell and animal studies.
Brain Health and Cognitive Function
Traditional medicine systems have long used gotu kola as a “brain tonic,” and modern preclinical research has started to sketch out why. In mouse models of Alzheimer’s disease, a water extract of Centella asiatica improved memory in a dose-dependent manner. The cognitive gains were linked to increased antioxidant signaling and reduced markers of oxidative stress in the hippocampus and prefrontal cortex, brain regions critical for memory and decision-making, rather than to any reduction in amyloid plaques themselves.14PubMed Central. Centella Asiatica Improves Memory and Promotes Antioxidative Signaling in 5XFAD Mice Separately, a compound isolated from Centella called araliadiol protected neuronal cells and reversed drug-induced cognitive impairment in mice.15PubMed. The protective effect of Centella asiatica and its constituent, araliadiol on neuronal cell damage and cognitive impairment
These results are interesting, but they are heavily weighted toward animal models. The jump from a mouse hippocampus to a human brain struggling with age-related decline is enormous, and large-scale human trials on cognitive outcomes are still lacking. A handful of small clinical studies have hinted at benefits for attention and working memory in healthy adults, but none has been definitive enough to recommend Centella as a standalone nootropic. For now, the brain health story is “biologically plausible and worth watching,” not “clinically proven.”
Anxiety and Mood
A small clinical study looked at Centella asiatica as a treatment for generalized anxiety disorder and found that it reduced anxiety-related symptoms, stress, and accompanying depression while improving cognitive function and willingness to adjust to situations.16PubMed. A clinical study on the management of generalized anxiety disorder with Centella asiatica The effects were noted as being statistically meaningful, and the researchers suggested Centella could become a useful anxiolytic agent.
This is encouraging, but the caveat is the usual one for herbal anxiolytic research: the study was small, and the field has not produced the kind of large, multi-site trials that would put Centella on equal footing with established treatments. If you are dealing with mild, situational anxiety and want to explore a botanical option alongside lifestyle approaches, Centella is a reasonable candidate to discuss with a healthcare provider. For moderate-to-severe anxiety disorders, it does not yet have enough human evidence to stand alone.
Gut Protection
A lesser-known line of research has explored Centella’s ability to protect the stomach lining from damage. Animal studies have consistently shown that Centella extract shields the gastric mucosa against injury caused by anti-inflammatory drugs and alcohol, two common sources of stomach irritation.17PubMed. Centella asiatica Leaf Extract Protects Against Indomethacin-Induced Gastric Mucosal Injury in Rats The protection appears to come from multiple angles: reducing lipid damage in tissue, boosting mucus production, and dampening inflammatory signals.
In one study, the highest dose tested reduced alcohol-induced stomach ulcers by nearly 99%, preserved the stomach’s tissue architecture, and activated protective antioxidant pathways.18Galen Medical Journal. Protective Effect of Aqueous Centella asiatica Extract on Ethanol-Induced Gastric Mucosal Injury These are rat studies, and there is no guarantee the effect translates cleanly to humans. Still, the consistency of the gastroprotective findings across multiple labs and damage models is notable and suggests a legitimate biological activity worth pursuing in clinical trials.
Oral Health
Centella asiatica has also turned up in dental research, partly because its collagen-boosting and anti-inflammatory properties apply to gum tissue as much as to skin. A randomized clinical trial in patients with diabetes, a group especially prone to gum disease, found that a Centella-based mouthwash significantly reduced gingival and periodontal inflammation over the follow-up period.19Journal of King Saud University – Science. Evaluating the efficacy of Centella asiatica on enhancement of oral health status in hyperglycemic patients – A randomized clinical trial Separately, research has shown that Centella extract stimulates collagen production in gum fibroblast cultures in a dose-dependent way, which could help explain how it reduces visible signs of gum inflammation.20Journal of Korean Academy of Oral Health. Comparative effects of aqueous single-phase and oil-water two-phase mouthrinses containing bamboo salt, magnolia bark and Centella asiatica extracts on reducing gingivitis: a randomized clinical trial
This is a niche application, but for people who are already interested in Centella for other reasons, it is worth knowing that the same mechanisms that help your skin may also benefit your gums.
Side Effects and Safety Concerns
Centella asiatica is generally well tolerated, but “generally” is doing meaningful work in that sentence. There are a few real risks that deserve attention rather than a handwave.
The most common adverse reaction with topical use is allergic contact dermatitis. Although Centella is considered a weak sensitizer, cases have been documented in the dermatology literature going back decades.21PubMed. Allergic contact dermatitis due to Centella asiatica: a new case22PubMed. Allergic contact dermatitis due to Centella asiatica extract If you are using a “cica” cream or serum for the first time, patch testing on a small area of skin before slathering it across your face is a sensible precaution, especially if you have a history of contact allergies to botanical ingredients.
More worrying is the liver issue. A case report documented three women who developed jaundice after taking Centella orally for periods ranging from 20 to 60 days. Their liver enzyme levels were sharply elevated, in one case reaching nearly 1,700 U/L for ALT, well beyond normal range.23PubMed. Hepatotoxicity associated with the ingestion of Centella asiatica These are rare events, and millions of people consume gotu kola without liver problems, but the cases serve as a warning that prolonged oral use at high doses is not risk-free. If you are taking Centella supplements daily, periodic liver function monitoring is reasonable, and you should not take it alongside other supplements or medications known to stress the liver.
Drug Interactions to Watch For
Centella asiatica extracts have been shown to inhibit two liver enzymes, CYP3A4 and CYP2D6, that are responsible for metabolizing a wide range of prescription drugs.24PubMed. Investigation of CYP3A4 and CYP2D6 Interactions of Withania somnifera and Centella asiatica in Human Liver Microsomes CYP3A4 alone handles roughly half of all commonly prescribed medications. If Centella slows down these enzymes in a living person the way it does in a test tube, the result would be higher-than-expected blood levels of whatever drug you are also taking, potentially pushing a safe dose into a problematic one.
The flavonoids quercetin and kaempferol appear to be the primary culprits behind the CYP3A4 inhibition. This is worth keeping in mind if you take medications like certain statins, calcium channel blockers, immunosuppressants, or antifungals, which are all processed through CYP3A4. The interaction data comes from lab experiments using liver cell preparations rather than from human pharmacokinetic studies, so the real-world significance is not yet confirmed. But the effect was potent enough in vitro that co-administration of alcoholic Centella extracts with CYP3A4- or CYP2D6-dependent drugs warrants caution and a conversation with your pharmacist.
Contamination and Product Quality
A less obvious risk with Centella asiatica has nothing to do with the plant’s own chemistry and everything to do with where it grew. Because Centella thrives in wet, marshy soils, it readily absorbs heavy metals from contaminated ground. A study of Centella plants growing in various locations across Peninsular Malaysia found elevated levels of cadmium, copper, lead, zinc, and nickel. The estimated daily intake of lead from plants harvested at polluted sites was high enough to raise toxicity concerns, leading researchers to recommend against daily consumption of Centella from those areas.25PubMed. Effects of metal-contaminated soils on the accumulation of heavy metals in gotu kola (Centella asiatica) and the potential health risks: a study in Peninsular Malaysia
This is relevant even if you do not live in Malaysia. Centella supplements are a global product, and the raw plant material can come from anywhere. Without standardization for both active compounds and contaminants, you have no guarantee that what you are buying is clean. Look for products from manufacturers that provide certificates of analysis including heavy metal testing. Standardized extracts that list the triterpene content (typically expressed as a percentage of asiaticoside, madecassoside, or total triterpenes) at least indicate that someone measured what was in the product. Whole-herb powders from unknown sources carry more uncertainty.
Topical Versus Oral Use
The choice between applying Centella to your skin and swallowing it as a supplement depends on what you are trying to achieve. For wound healing, scar management, moisturizing, and anti-aging, topical application makes intuitive sense and has the most direct evidence. The active compounds land where you want them, and you avoid the bioavailability challenges of oral dosing. Most “cica” serums, creams, and sheet masks deliver the triterpenes directly to skin cells.
Oral use makes more sense for systemic benefits like venous insufficiency, cognitive support, or gut protection, where you need the compounds circulating through your bloodstream or reaching your digestive tract. As noted earlier, the glycoside forms undergo conversion in the gut, so standardized extracts in capsule or tablet form tend to be more reliable than teas or raw leaf preparations, which deliver unpredictable concentrations. Many clinical trials that showed positive results used standardized extract doses in the range of 30 to 180 mg of total triterpenic fraction per day, though these numbers vary across studies and conditions.
Some emerging research has even explored oral Centella as a “nutricosmetic,” the idea being that swallowing the extract protects skin from the inside by reducing systemic inflammation and oxidative stress. An animal study found that oral Centella extract reduced wrinkle formation, improved skin elasticity, and preserved moisture-barrier lipids in mice exposed to UV radiation.9PubMed Central. Oral Centella asiatica Extract Attenuates UVB-Induced Skin Photoaging via Antioxidant, Anti-Inflammatory, and Extracellular Matrix-Preserving Effects in Hairless Mice Whether this translates meaningfully to humans drinking a Centella supplement and getting visibly better skin is still an open question, but it points to a plausible mechanism that goes beyond what topical creams can do alone.
Traditional Use and How It Shaped Modern Research
Centella asiatica has been documented in traditional medicine systems for a remarkably long time. In Chinese medicine, it was recorded as early as the Eastern Han Dynasty, and it appears in the Ayurvedic, Unani, and traditional Southeast Asian pharmacopeias as well. Traditional uses ranged from wound treatment and fever reduction to mental clarity and longevity, essentially a general-purpose healing plant.
What is interesting is how closely modern research has followed these traditional leads. The wound-healing and cognitive applications that dominate today’s scientific literature are exactly what traditional practitioners used the plant for centuries ago. This does not validate every folk claim, but it does mean that the research pipeline was pointed in a promising direction from the start. Clinical applications that have been explored more recently include chronic kidney diseases, radiation-induced skin damage, and precancerous lesions, expanding the plant’s therapeutic profile well beyond its historical uses.26World Journal of Traditional Chinese Medicine. Phytochemistry, Pharmacology, and Clinical Applications of Centella asiatica (L.) Urban Most of these newer applications remain in early stages, but they illustrate how a plant with a broad traditional reputation can generate a surprisingly wide research agenda when modern tools are brought to bear on it.