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Calendula

Scientific Name(s): Calendula officinalis L.
Common Name(s): Calendola, Calendula, Garden marigold, Gold bloom, Goudsbloem, Holligold, Maravilla, Marigold, Marybud, Marygold, Nagotki, Neven, Pot marigold, Ringelblume, Souci

Medically reviewed by Drugs.com. Last updated on Apr 22, 2024.

Clinical Overview

Use

Limited clinical studies have focused on use of calendula in wound healing, including radiation-induced dermatitis, venous leg ulceration, and burns/acute wounds. Antioxidant, anti-inflammatory, and antimicrobial effects, including in periodontal disease, are also documented. However, quality clinical trial data are lacking to recommend calendula for any indication.

Dosing

Commercial topical preparations are available. Various topical dosage forms and preparations have been evaluated in clinical studies; however, data are lacking regarding specific strengths/concentrations used, and trials are associated with methodological limitations, making dosing recommendations difficult. See specific indications in Uses and Pharmacology section.

Contraindications

Contraindications have not been identified.

Pregnancy/Lactation

Avoid use. Information regarding safety and efficacy in pregnancy and lactation is lacking. A study in rats demonstrated a reduction in maternal weight gain when calendula was administered during pregnancy.

Interactions

None well documented.

Adverse Reactions

Allergic reactions, contact sensitization, and one case of anaphylaxis have been reported.

Toxicology

No data.

Scientific Family

Botany

Calendula has almost worldwide distribution but is believed to be native to Egypt. Numerous varieties of the species exist, differing primarily in flower shape and color. Calendula grows to about 0.7 m in height, and the wild form has small, bright yellow-orange flowers that bloom from May to October. The ligulate florets of the plant have been used medicinally. Calendula should not be confused with other members of the marigold family.Hamburger 2003, USDA 2007

History

Calendula has been grown in European gardens since the 12th century. Tinctures and extracts of the florets were used topically to promote wound healing and reduce inflammationCarvalho 2018 and were used systemically to reduce fever, control dysmenorrhea, and treat cancer. The plant is listed in the German Commission E Monographs for its wound healing and anti-inflammatory actions.Hamburger 2003

Calendula has traditionally been used as a mouthwash to treat oral sores, consumed for its antispasmodic effects, and used topically for skin conditions. Traditional use of the plant for ophthalmological conditions has also been described.Calvo 2016, Duke 2002 The dried petals have been used as a seasoning and to adulterate saffron.Duke 1985 The pungent odor of the marigold has been used as an effective pesticide. Marigolds are often interspersed among plants in vegetable gardens to repel insects.Lewis 1977

Chemistry

The calendula plant contains a number of oleanolic acid glycosides.Kasprzyk 1973 Flavonol and triterpene glycosides have been isolated from C. officinalis via high-pressure liquid chromatography.D'Ambrosio 2015, Pietta 1992, Ukiya 2006 Calendulin (also known as bassorin), a mucilage found in the plant, contains sterols and fatty acids, including calendic acid.Badami 1965, Chisholm 1967, Szakiel 1989 The plant also contains triterpenoid in free and ester forms,Auguścińska 1982, Neukirch 2004, Neukirch 2005 tocopherols,Janiszowska 1982 mucilage, and a volatile oil.Hamburger 2003 Enzymatic activity of calendula extracts has been described.Chudnicka 2005 The carotenoid pigments have been used as coloring agents in cosmetics, and the volatile oil has been used in perfumes.Hamburger 2003, Kishimoto 2005, Tyler 1987

Uses and Pharmacology

Despite the history of calendula use and detailed studies of its chemistry, few robust clinical studies have been published.

Anti-inflammatory effects

Animal data

Triterpenoid-containing extracts of calendula have demonstrated anti-inflammatory activity in chemically induced inflammation in mice.Neukirch 2005, Ukiya 2006 Calendula extracts alleviated signs of chronic conjunctivitis and other chronic ocular inflammatory conditions in ratsMarinchev 1971; the extracts also had a systemic anti-inflammatory effect. In a study of dogs with experimentally induced ulcerative colitis, a calendula 40% solution was associated with statistically significant healing of the mucosa at 30 and 45 days after induction.Mehrabani 2011

Clinical data

A case report describes use of calendula tincture in a 52-year-old woman with chronic anal fissures for which nonpharmacological, pharmacological, and surgical options had failed. Following surgery, the patient's fissures had returned, and she began using a calendula tincture applied to the area 3 times daily with a cotton ball for 4.5 months. She reported improvement in pain with no rectal bleeding.Naseer 2012

Antimicrobial effects

In vitro data

In vitro studies report antibacterial, antiviral, and antifungal properties of calendula extracts.De Tommasi 1990, Dumenil 1980, Efstratiou 2012, Iauk 2003, Mertenat 2020, Tresch 2019, Ukiya 2006 In a study of isolates from infected eyes and contact lens cases, extracts of calendula flowers reduced bacterial biofilm formation.El-Ganiny 2017 In ethnobotanical interviews conducted in Navarra, C. officinalis was one of several plants cited for use in ophthalmological problems, prompting a review of literature to confirm such applications; 2 pharmacological studies were identified, one determining, by high-performance liquid chromatography, the content of several bioactive compounds in C. officinalis that could be beneficial in treating inflammatory eye disorder, and one evaluating in vitro cytotoxicity and wound healing efficacy of calendula-loaded solid lipid nanoparticles on the conjunctival epithelium cell line WKD.Calvo 2016

Clinical data

In a randomized study of 80 women with bacterial vaginosis, a methanol extract of calendula flowers made into a cream reportedly demonstrated clinical equivalence to metronidazole cream. The final strength of the calendula cream was not described, and only symptoms were evaluated, with no laboratory cultures reported.Pazhohideh 2018

In a randomized controlled trial, 150 women with vaginal candidiasis received a methanol 1% extract of calendula flowers as a cream or a clotrimazole 1% cream each night for 7 nights. Calendula extract was reportedly less effective (as determined by mycology) at 10 to 15 days but performed better than clotrimazole at 30 to 35 days postintervention.Saffari 2017 Topical calendula ointment has been compared to olive oil, aloe extract, and bentonite in the management of diaper dermatitis in several studies. Calendula was found to be as effective as olive oil and aloe cream, but inferior to bentonite. However, these findings are largely based on parent-assessed symptoms; no tests for mycology were reported.Mahmoudi 2015, Panahi 2012, Sharifi-Heris 2018

Antioxidant effects

Animal data

In animal models, calendula demonstrated protective effects against induced hepatotoxicity and nephrotoxicity, possibly via antioxidant activity.Kaur 2016, Preethi 2009, Rusu 2005, Verma 2016 In rats, a calendula solution was cardioprotective for reperfusion injury through stimulation of left ventricular pressure and aortic flow, and through reduction in myocardial infarct size (41.45%±2% in the control group vs 20.5%±1.61% in the treatment group). Tumor necrosis factor alpha levels were also reduced in calendula-treated rats.Ray 2010 In a murine model, C. officinalis extract given twice daily 1 hour before cigarette exposure conferred some protection against cell injury. Specifically, rats treated with calendula had reduced levels of malondialdehyde and protein carbonyl content in their lungs and brain, compared with increased levels for those exposed to cigarette smoke only.Ozkol 2012

Burns/Wound healing

Animal and in vitro data

Calendula extracts have been used topically to promote wound healing, and experiments in rats consistently report a measurable effect.Carvalho 2018, Givol 2019

Mechanisms by which calendula extracts may promote wound healing have been studied in vitro and histologically in animal studies. Possible mechanisms include increased glycoprotein, nucleoprotein, and collagen metabolism at the wound site; inhibition of collagenase; stimulation of epithelialization; and anti-inflammatory effects.Aro 2015, Dinda 2016, Hormozi 2019, Millán 2016, Nicolaus 2017, Okuma 2015, Preethi 2009 Calendula may enhance blood flow to the affected area,Naseer 2012, Parente 2011 and antioxidant activity has been demonstrated.Chandran 2008, Mishra 2012

Clinical data

Burn/Wound healing

In an older (1992) randomized, controlled, open clinical study in patients with partial and full thickness burns, no differences in burn healing or complication incidence were observed between those receiving topical calendula extract ointment and those receiving chemical debridement standard care and ointment base. The authors note that fewer adverse effects and decreased pain occurred with calendula compared with control.Givol 2019

In a study of primiparous women who underwent an episiotomy (N=111), calendula ointment applied every 8 hours to the perineal area was associated with improvements in redness, edema, approximation, and ecchymosis compared with control (standard treatment with povidone-iodine washes).Eghdampour 2013, Givol 2019 A study of 72 women with cesarean wounds reported improved healing rates with calendula ointment versus usual hospital care.Jahdi 2018 However, not all trial details were reported, making attribution of the positive findings to calendula difficult.

Chronic wounds

A group of researchers reports therapeutic benefit of C. officinalis hydroglycolic extract in studies of patients with ulcer.Buzzi 2016, Buzzi 2016, Buzzi 2016 One study suggested safety and efficacy of the extract in diabetic foot ulcer healing.Buzzi 2016 Another study in patients with venous leg ulcers showed would healing activity of topical C. officinalis extract to be superior to standard care.Buzzi 2016 In an observational cohort study, bioactive C. officinalis was considered a safe treatment that promotes healing of pressure ulcers.Buzzi 2016 However, these studies are associated with various methodological limitations.

In a small clinical study (N=32) evaluating the management/healing process of diabetic foot ulcers, patients were randomly distributed to receive control, low-level laser therapy, C. officinalis oil (5 mL), or low-level laser therapy with C. officinalis oil over 30 days. Low-level laser therapy, alone or in combination with C. officinalis, was effective in relieving pain and accelerating tissue repair in diabetic foot ulcers; C. officinalis alone was not more effective than usual care.Carvalho 2016 In a similar study evaluating effects of calendula 7.5% extract (treatment duration, 3 weeks) in patients with leg ulcers due to venous insufficiency (N=34), a significantly greater reduction in total ulcer surface area was observed in the calendula group than in the control (saline solution dressing) group (41.7% vs 14.5%; P<0.05).Givol 2019

Postradiation dermatitis

A single-blind, phase 3, randomized trial investigated the efficacy of a calendula ointment preparation in preventing grade 2 or higher radiation therapy–associated acute dermatitis in breast cancer patients receiving postoperative radiation therapy (N=254). Decreases in grade 2 or higher dermatitis and in pain were observed with calendula ointment compared with trolamine; however, application of the calendula preparation proved difficult for 30% of participants.Pommier 2004 A randomized, blinded, phase 3 trial evaluated the potential for calendula cream to reduce severe acute radiation skin reactions associated with adjuvant radiotherapy for breast cancer in 411 women. Patients received either calendula cream or an aqueous cream applied twice daily, starting on the day of initial radiotherapy and continuing until 2 weeks after the last radiotherapy session or until the acute radiation skin reaction healed. No statistically significant difference between treatment groups was observed with regard to acute radiation skin reactions (incidence of 23% with calendula vs 19% with the aqueous cream). In general, patients reported low levels of skin symptoms. The authors concluded that acute radiation skin reactions may be influenced more by treatment factors than by selection of skin products.Sharp 2013 In another clinical trial conducted in 51 patients with head and neck cancer, topical calendula was more effective than essential fatty acids for the prevention and treatment of radiodermatitis.Schneider 2015

Reviews of the literature evaluating C. officinalis use for treatment of radiation dermatitis note conflicting evidence and lack of consistency regarding the severity of dermatitis and the calendula preparations evaluated. Additional limitations include difficult application of topical products for this condition and the possibility that the vehicle itself is effective.Bolderston 2006, Kodiyan 2015, McQuestion 2006

Cancer

Animal and in vitro data

In vitro and animal studies suggest that chemical compounds extracted from C. officinalis flowers, root, and whole plant (including lupeol, lutein, and eugenol) have potential applications in treating certain human cancer cell lines via mechanisms such as induction of apoptosis and other antimetastatic effects.Behbahani 2014, Cruceriu 2018, Jiménez-Medina 2006, Preethi 2010, Ukiya 2006, Xuan 2019 Antioxidant activity has also been described.Abudunia 2017, Alnuqaydan 2015, Moradkhani 2015, Verma 2016 However, angiogenic activity due to induction of neovascularization has been reported with an ethanolic extract and dichloromethane and hexanoic fractions of calendula.Parente 2011

Extracts from related calendula species have also been shown to exert activity against human cancer cell lines.Abudunia 2017, Abutaha 2019

In a study of hamsters with 5-fluorouracil–induced oral mucositis, administration of C. officinalis gel reduced both microscopic and macroscopic mucositis scores.Tanideh 2013

Clinical data

Research reveals no clinical data regarding the use of calendula as a chemotherapeutic agent. With respect to the sequelae of radiation and chemotherapy such as oropharyngeal mucositis, superiority of calendula over comparator has been reported in several studies, while other trials report no difference over standard practice.Cruceriu 2018, Marucci 2017, Singh 2017

CNS effects

Animal data

In rodents with induced Huntington disease, an extract of C. officinalis flower attenuated reductions in body weight due to 3-nitropropionic acid; improved behavioral changes; increased locomotor counts; and improved memory performance, motor coordination, hind limb function, and grip strength.Shivasharan 2013 In another study of rodents with induced diabetes, an orally administered extract of aerial calendula plant parts improved learning and memory impairments associated with diabetes.Moradkhani 2015

Periodontal disease

Animal and in vitro data

In an in vitro study of human gingival fibroblasts, calendula completely inhibited collagen degradation and inhibited pro–matrix metalloproteinase-2 activity.Saini 2012

In studies of rodents with experimental periodontitis, calendula reduced oxidative stress, exerted anti-inflammatory effects (eg, on measures of tumor necrosis factor alpha and interleukin 1 beta), and reduced bone resorption via effects on osteoprotegerin.Alexandre 2018, Lima 2017

Clinical data

Limited case reports and a methodologically weak clinical trial report reductions in plaque and gingivitis with use of calendula-based mouthwashes.Khairnar 2013, Machado 2010

A small clinical trial (N=44) evaluated the effect of calendula tincture as a mouthwash for bone preservation after tooth extraction. The calendula group required less use of antibiotics and demonstrated favorable results for depth of alveolar bone upon radiological investigation.Uribe-Fentanes 2018

Dosing

Commercial topical preparations are available. Various topical dosage forms and preparations have been evaluated in clinical studies; however, data are lacking regarding specific strengths/concentrations used, and trials are associated with methodological limitations, making dosing recommendations difficult. An ointment containing calendula 7.5% extract was applied topically for 3 weeks in a study of patients with leg ulcers due to venous insufficiency.Givol 2019 A methanol 1% extract of calendula flowers as a cream was topically applied nightly for 7 days in a study of women with vaginal candidiasis.Saffari 2017

Traditionally, preparations have been made by steeping 5 to 10 mL of the herb in 240 mL (1 cup) of boiling water for 10 minutes and then gargled as a mouthwash for oral sores, consumed for antispasmodic effects, or applied topically for skin conditions.Awang 2009

Pregnancy / Lactation

Avoid use. Information regarding safety and efficacy in pregnancy and lactation is lacking. In a study in rats, a hydroalcoholic extract of C. officinalis did not demonstrate toxic effects on male fertility or during the early and midpregnancy periods in females. However, during the fetal period of pregnancy (ie, after the 10th week), a reduction in maternal weight gain was noted in rats receiving the extract.Silva 2009

Interactions

None well documented.

Adverse Reactions

Despite the widespread use of calendula preparations, there are few reports describing serious reactions.

Allergic reactions, contact sensitization, and one case of anaphylaxis with other members of the Asteraceae family have been described.Reider 2001, Wintzen 2003 In 2 clinical studies of patients with bacterial vaginosis or vaginal candidiasis, itching was reported more frequently with vaginally applied calendula cream than with comparator creams.Pazhohideh 2018, Saffari 2017

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Toxicology

The Cosmetic Ingredient Review Expert Panel concluded that C. officinalis extract, flower, flower extract, flower oil, and seed oil are safe for use in cosmetics.Andersen 2010 In a study of Wistar rats, 2,000 mg/kg given as 1 dose was not associated with any acute toxicity; calendula 50, 250, and 1,000 mg/kg/day for 90 days was assessed for toxicity in the subchronic toxicity arm of this study. Following 90 days of treatment, differences were noted in hemoglobin, erythrocytes, leukocytes, blood clotting time, AST, ALT, and alkaline phosphatase; differences were gender-specific in some cases. Slight abnormalities in the hepatic parenchyma were also noted.Lagarto 2011 Absence of toxicity was reported for topical application of the oil over 90 days in rodents.Mishra 2018 Saponin extracts of C. officinalis are not mutagenic.Elias 1990 The median lethal dose of calendula flower extract in rats was more than 4.64 g/kg.Andersen 2010

References

Disclaimer

This information relates to an herbal, vitamin, mineral or other dietary supplement. This product has not been reviewed by the FDA to determine whether it is safe or effective and is not subject to the quality standards and safety information collection standards that are applicable to most prescription drugs. This information should not be used to decide whether or not to take this product. This information does not endorse this product as safe, effective, or approved for treating any patient or health condition. This is only a brief summary of general information about this product. It does NOT include all information about the possible uses, directions, warnings, precautions, interactions, adverse effects, or risks that may apply to this product. This information is not specific medical advice and does not replace information you receive from your health care provider. You should talk with your health care provider for complete information about the risks and benefits of using this product.

This product may adversely interact with certain health and medical conditions, other prescription and over-the-counter drugs, foods, or other dietary supplements. This product may be unsafe when used before surgery or other medical procedures. It is important to fully inform your doctor about the herbal, vitamins, mineral or any other supplements you are taking before any kind of surgery or medical procedure. With the exception of certain products that are generally recognized as safe in normal quantities, including use of folic acid and prenatal vitamins during pregnancy, this product has not been sufficiently studied to determine whether it is safe to use during pregnancy or nursing or by persons younger than 2 years of age.

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