Centella Asiatica Scar Creams

centella asiaitca

centella asiatica

Centella Asiatica is a mildly antibacterial, anti-viral, anti-inflammatory herb indigenous to south and south east Asia. The plant grows in swampy areas in India, Sri Lanka, Indonesia, Malaysia, Iran, northern Australia,  Melanesia, and New Guinea.

The herb has been used for ages for its medicinal qualities in both traditional Chinese medicine and traditional Indian (Ayurvedic) medicine as well. It is also known as Gotu Kola, Asiatic or Indian Pennywort, Rau má in Vietnam and Saraswathi Plant” in India.

(photo by suatu ketika | Creative Commons)

Ascribed benefits of its culinary and medicinal use are stimulation of overall health, rejuvenation, boosting the nervous system and increasing concentration. Some extracts have been used traditionally to treat leprosy. In Thailand it is used as a detoxifying agent to aid treatment of opium addicts.

A popular folklore tale from Sri Lanka speaks of a prominent king from the 10th century AD named Aruna Withane who claimed that Gotu Kola provided him with energy and stamina to satisfy his 50-woman harem.  Source: Wikipedia




Centella Asiatica Scar Creams
Several studies show Centella asiatica’s ability to improve wound healing. Some aspects of the chemical compounds in this herb seem to aid scar treatment as well. More specific; the main substances; asiatic acid, asiaticoside and brahminoside seem to stimulate type 1 collagen production which leads to less prominent scars.

Also inflammation, which is a major factor in (abnormal) scar creation, is reduced. Apart from this, the process of myofibroblast production, which boosts wound healing by contracting the edges of the wound, is decreased. It is theorized that residue myofibroblasts are the reason for hypertrophic and keloid scar development.



Madecassol
A segment of the chemicals in the Asiatic acid are also described as madecassol. This madecassol has shown to be an effective treatment of keloid scars. (E1-Hefnawi H: Treatment of keloids with asiaticoside. Dermatologica 125:387, 1962)

Another scientist found that when taken orally madecassol turned out to be “an active scar improver with few side effects”.  His conclusion was that although more extensive study on its true mechanism of action and long-term safety needs to be done, it is promising regarding effective treatment of keloids. (Bosse JP: Clinical study of a new anti-keloid agent. Ann Plast Surg 3:13, 1979)

Landes reported about his 20 years of experience with madecassol ointment. He reported to use madecassol as additional treatment after cosmetic surgery. (Landes E: Konservative Therapie yon Narben und Falten. Z Hautkr 62:805, 1987)


No Side Effects
Studies as well as anecdotal reports have not shown any side effects of the topical application of Centella asiatica extract.  Because the plant and its three main chemical substances (terpenoids) are weak sensitizers skin irritations are considered unlikely, and have not been reported.


Centella Asiatica based Scar Creams
A well known scar cream is Alpha Centella cream. This product is used by some physicians, especially in Asia, to prevent and treat scars. The cream has two main ingredients.  Apart from the aforementioned three extracts of C. asiatica it also has extracts of the Bulbine frutescens plant in it. This herb possesses moisturizing and antibacterial properties and its action is sometimes compared with Aloe Vera (as is C. asiatica).

A newcomer on the market is Scartini serum with main ingredients Centella asiatica and lychee extract. As far as I know, this is the first cream with this centella asiatica (Gotu Kola) ingredient on the American consumer market, which could be promising. How much of the Centella asiatica ingredient is present in the product is unclear. Also the dermal benefits of lychee extract are not convincing when examining available research.


Conclusion
The positive effects of C. asiatica in wound healing are convincing (documented to aid wound healing in a large number of scientific reports) Also evidence for the improvement of, especially, keloid scar appearance is available but more research has to be done. Key effects appear to be speeding scar maturity, anti-inflammatory action and the decrease of excessive scar tissue (myofibroblast production). 

Or as this study abstract on New Innovations in Scar Management puts it:

“Centella asiatica has been documented to aid wound healing in a large number of scientific reports. The most beneficial effect appears to be the stimulation of maturation of the scar by the production of type I collagen and the resulting decrease in the inflammatory reaction and myofibroblast production.”
That’s why this report mentions Centella asiatica together with effective measures such as; pressure therapy, hydration, and silicone sheeting.

Since there do not seem to be any really effective scar ointments (except for the prescription cream Imiquimod (brand name Aldara) and silicone gel creams) Gotu Kolu based scar creams might be a worthy contribution to the effective scar products pool.

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