What does the research show about centella asiatica?

Centella asiatica

A meta-analysis of 11 trials found no difference from placebo in any area of cognition, with small gains in alertness. Small trials report less ankle swelling in venous hypertension and shallower wrinkles in one oral skin trial. A 40-person trial found a reduced startle response. Case reports describe liver injury, including granulomatous hepatitis in three women.

Add to Bio HackChecked 2026-11-09

Status: Dietary supplement in the US. Not FDA-approved for any condition.
Also called: gotu kola, Indian pennywort, asiaticoside, madecassoside, asiatic acid, TTFCA, total triterpenic fraction of Centella asiatica, cica
Taken for: venous insufficiency, leg swelling, swelling, edema, skin aging, wrinkles, wound healing, memory, cognition, anxiety, mood

Strong several reviews agree · Moderate one review or consistent trials · Limited one or a few small studies · Untested no study in people, listed with what it rests on

Shown to help3

LimitedOne small trial found a single 12 g dose lowered the startle reflex in 40 healthy adults, with no change in self-rated mood.
LimitedOne small trial found 60 mg twice a day for 8 weeks lowered ankle swelling in 40 patients with severe venous hypertension.
LimitedOne trial found 200 mg a day for 12 weeks gave small changes in skin elasticity, brightness and hydration against placebo in 112 Korean women.

Reported risks1

LimitedCase reports: three women developed hepatitis with jaundice after 20 to 60 days of centella, improving after stopping. In one, it returned when she took it again.

What people take it for, and what was found

Shown to help3

Limited

Anxiety and mood

One small trial found a single 12 g dose lowered the startle reflex in 40 healthy adults, with no change in self-rated mood.

The numbers and sources

Effect: In 40 healthy adults, a single 12 g dose lowered the peak acoustic startle response at 30 and 60 minutes against placebo. Self-rated mood, heart rate and blood pressure did not change [2]. Pooled trials found higher alertness and lower anger scores [1].
Population: 40 healthy adults [2]. Adults in RCTs [1].
Sources: [2], [1]
Caveats: The startle trial measured a reflex in healthy people, not anxiety symptoms in people with an anxiety disorder [2].

Limited

Venous insufficiency and ankle swelling

One small trial found 60 mg twice a day for 8 weeks lowered ankle swelling in 40 patients with severe venous hypertension.

The numbers and sources

Effect: In 40 patients with severe venous hypertension, ankle swelling and skin hardening, the total triterpenic fraction at 60 mg twice a day for 8 weeks lowered the rate of ankle swelling and resting skin blood flow (p < 0.05), with no change on placebo [3]. A Cochrane review of phlebotonics included 2 Centella trials, and its abstract reports results only for all phlebotonics together [4].
Population: 40 patients with venous hypertension and microangiopathy [3].
Sources: [3], [4]
Caveats: One small trial with results given as p values. The Cochrane authors note that findings for single phlebotonics are limited by small numbers [4].

LimitedStudied in women

Skin aging

One trial found 200 mg a day for 12 weeks gave small changes in skin elasticity, brightness and hydration against placebo in 112 Korean women.

The numbers and sources

Effect: In 112 Korean women, 200 mg a day for 12 weeks reduced average wrinkle depth by 11.1% from baseline. Skin elasticity and brightness differed from placebo (p < 0.05), but the changes were small: 0.7% for elasticity and brightness and 2.7% for hydration [5].
Population: 112 middle-aged women in Korea [5].
Sources: [5]
Caveats: Wrinkle results are reported against baseline. The analysis used only participants who completed the protocol [5].

Not shown to help2

Moderate

Memory and cognition

Not shown to change any area of cognitive function against placebo in adults across 11 trials. Alertness rose and anger fell an hour after a dose.

The numbers and sources

Effect: Across 5 RCTs of Centella alone and 6 of products containing it, no domain of cognitive function differed from placebo. Alertness scores rose (SMD 0.71, 95% CI 0.01 to 1.41) and anger scores fell 1 hour after a dose (SMD -0.81, 95% CI -1.51 to -0.09) [1].
Population: Adults in 11 RCTs [1].
Sources: [1]
Caveats: Doses, plant preparations and standardization varied between trials [1].

Limited

Wound healing

Limited evidence: a review found 4 wound healing trials, too few and varied to pool.

The numbers and sources

Effect: A systematic review found 4 clinical trials reporting on wound contraction, healing time, pain scores and wound appearance. The trials were too few and varied to pool [6].
Population: People with wounds in 4 trials [6].
Sources: [6]
Caveats: The abstract gives no effect sizes [6].

Doses studied

The venous trial used the total triterpenic fraction at 60 mg twice a day for 8 weeks [3]. The skin trial used 200 mg of extract a day for 12 weeks [5]. The startle trial used a single 12 g dose [2].

Risks

Reported risks1

Limited

Liver injury

Case reports: three women developed hepatitis with jaundice after 20 to 60 days of centella, improving after stopping. In one, it returned when she took it again.

The numbers and sources

Effect: Three women aged 61, 52 and 49 developed jaundice after taking Centella asiatica for 30, 20 and 60 days. ALT reached 1,193, 1,694 and 324 U/L. Biopsies showed granulomatous hepatitis in two and chronic hepatitis with cirrhotic change in one. All improved after stopping, and the first woman's liver injury returned when she took it again [7].
Population: Three case reports [7].
Sources: [7]
Caveats: Case reports cannot give a rate. The women also received ursodeoxycholic acid [7].

Checked, no increase found1

Limited

Adverse events in trials

Limited evidence: small, short trials reported no adverse effects and no serious adverse events.

The numbers and sources

Effect: None of the cognition trials reported adverse effects [1]. The skin trial reported no serious adverse events, and blood safety markers stayed in the normal range [5]. The venous trial observed no side effects [3].
Population: Adults in RCTs [1][5][3].
Sources: [1], [5], [3]
Caveats: Trials were small and short.

Claims tested and not found

That Centella asiatica improves memory or cognition. No cognitive domain differed from placebo across 11 trials [1].

Sources

Puttarak P, Dilokthornsakul P, Saokaew S, et al. Effects of Centella asiatica (L.) Urb. on cognitive function and mood related outcomes: A Systematic Review and Meta-analysis. Scientific Reports. 2017. https://doi.org/10.1038/s41598-017-09823-9
Bradwejn J, Zhou Y, Koszycki D, Shlik J. A double-blind, placebo-controlled study on the effects of Gotu Kola (Centella asiatica) on acoustic startle response in healthy subjects. Journal of Clinical Psychopharmacology. 2000. https://doi.org/10.1097/00004714-200012000-00015
Cesarone MR, Belcaro G, De Sanctis MT, et al. Effects of the total triterpenic fraction of Centella asiatica in venous hypertensive microangiopathy: a prospective, placebo-controlled, randomized trial. Angiology. 2001. https://doi.org/10.1177/000331970105202s04
Martinez-Zapata MJ, Vernooij RW, Simancas-Racines D, et al. Phlebotonics for venous insufficiency. Cochrane Database of Systematic Reviews. 2020. https://doi.org/10.1002/14651858.CD003229.pub4
Hur N, Seo Y, Bae J, et al. A Randomized, Double-Blind, Placebo-Controlled Trial Assessing the Effects of Oral Centella asiatica Extract on Skin Aging-Related Parameters in Middle-Aged Korean Women. Nutrients. 2026. https://doi.org/10.3390/nu18101505
Arribas-López E, Zand N, Ojo O, et al. A Systematic Review of the Effect of Centella asiatica on Wound Healing. International Journal of Environmental Research and Public Health. 2022. https://doi.org/10.3390/ijerph19063266
Jorge OA, Jorge AD. Hepatotoxicity associated with the ingestion of Centella asiatica. Revista Española de Enfermedades Digestivas. 2005. https://doi.org/10.4321/s1130-01082005000200006

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