Calendula (Calendula officinalis L.)

Category

Herbs & Supplements

Synonyms

Allo-ocimene, Asteraceae (family), bride of the sun, bull flower, butterwort, Calendula arvensis L., Calendula micrantha, Calendula officinalis, calendula flower, calendula herb, calendulae flos, calendulae herba, Caltha officinalis, calypso orange florensis, cis-tagetone, claveton (Spanish), Compositae (family), cowbloom, death-flower, dihydro tagetone, drunkard gold, Fiesta Gitana Gelb, fior d'ogni (Italian), flaminquillo (Spanish), fleurs de tous les mois (French), gauche-fer (French), gold bloom, goldblume (German), golden flower of Mary, goulans, gouls, holligold, holygold, husband's dial, kingscup, Laser Activated Calendula Extract (LACE), limonene, lutein, maravilla, marybud, marigold, marigold dye, marigold flowers, may orange florensis, marygold, mejorana (Spanish), methyl chavicol, patuletin, patulitrin, piperitenone, piperitone, poet's marigold, pot marigold, publican and sinner, Ringelblume (German), ruddles, Scotch marigold, shining herb, solsequia, souci (French), souci des champs (French), souci des jardins (French), summer's bride, sun's bride, T. florida Sweet, Tagetes lucida (Asteraceae), Tagetes maxima, Tagetes patula (Asteraceae), T. schiedeana, water dragon, yolk of egg.

Note: Calendula or marigold should not be confused with the common garden or French marigold (Tagetes), African marigold (T. erecta), or Inca marigold (T. minuta).

Background

Calendula, also known as marigold, has been widely used on the skin to treat minor wounds, skin infections, burns, bee stings, sunburn, warts, and cancer. Most scientific evidence regarding its effectiveness as a wound-healing agent is based on animal and laboratory study, while human research is virtually lacking.

One study in breast cancer patients receiving radiation therapy suggests that calendula ointment may be helpful in preventing skin dermatitis (irritation, redness, and pain).

Evidence

DISCLAIMER: These uses have been tested in humans or animals. Safety and effectiveness have not always been proven. Some of these conditions are potentially serious, and should be evaluated by a qualified healthcare provider.

Radiation skin protection: A study in women receiving radiation therapy to the breast for breast cancer reports that calendula ointment applied to the skin at least twice daily during treatment reduces severe dermatitis (skin irritation, redness, pain). However, this study cannot be considered conclusive due to limitations of its design. Based on this evidence, this approach may be considered in patients who experience radiation dermatitis that cannot be controlled with other therapies.
Grade: B

Ear infection: Calendula has been studied for reducing pain caused by ear infections. Some human studies suggest that calendula may possess mild anesthetic (pain-relieving) properties equal to those of similar non-herbal eardrop preparations. Further studies are needed before a recommendation can be made in this area.
Grade: C

Skin inflammation: Limited animal research suggests that calendula extracts may reduce inflammation when applied to the skin. Human studies are lacking in this area.
Grade: C

Venous leg ulcers: Calendula has been suggested as a possible treatment for venous leg ulcers. Further study is warranted.
Grade: C

Wound and burn healing: Calendula is commonly used on the skin to treat minor skin wounds. Reliable human research is necessary before a firm conclusion can be drawn.
Grade: C

Tradition

WARNING: DISCLAIMER: The below uses are based on tradition, scientific theories, or limited research. They often have not been thoroughly tested in humans, and safety and effectiveness have not always been proven. Some of these conditions are potentially serious, and should be evaluated by a qualified healthcare provider. There may be other proposed uses that are not listed below.
Abscesses, acne, anemia, anti-inflammatory, antioxidant, antiviral, anxiety, appetite stimulant, atherosclerosis (clogged arteries), athlete's foot, bacterial infections, benign prostatic hypertrophy, bladder irritation, blood purification, blood vessel clots, bowel irritation, bruises, cancer, cholera, circulation problems, conjunctivitis, constipation, contact dermatitis, cosmetic, cough, cramps, detoxification (purging agent), diabetes, diaper rash, diaphoresis (sweating), diarrhea, dizziness, diuretic, dystrophic nervous disturbances, eczema, edema, epididymitis, eye inflammation, fatigue, fever, frostbite, fungal infections, gastrointestinal inflammation, gastrointestinal tract disorders, gingivitis, gout, gum disease prevention, headache, heart disease, hemorrhoids, herpes keratitis, herpes simplex virus infections, high cholesterol, HIV, immune system stimulant, immunomodulation, indigestion, influenza, insomnia, jaundice, kidney or bladder stones, liver cancer, liver dysfunction, liver-gallbladder function stimulator, menstrual period abnormalities, metabolic disorders, migraine, mouth and throat infections, mosquito repellant, muscle spasms, muscle wasting, nausea, nervous disorders (iatrogenic disability), nervous system disorders, nosebleed, oral hygiene (oral cavity irrigation), pain, parasite infection, prostatitis, ringing in the ears, skin cancer, sore throat, spleen disorders, syphilis, toothache, tuberculosis, ulcerative colitis, ulcers (peptic ulcer disease), urinary retention, uterus problems, varicose veins, venous disorders (phlebitis, thrombophlebitis), vitamin deficiencies (lutein or beta-carotene), warts, yeast infections.

Dosing

Adults (over 18 years old)

For ear infections, the combination herbal product Otikon Otic® (which includes calendula) has been used in a dose of 5 drops placed in the affected ear three times daily. 5 drops of NHED® solution (which contains garlic [Allium sativum], Verbascum thapsus, Calendula flores, St. John's wort [Hypericum perfoliatum], lavender [Lavandula angustifolia], and vitamin E in olive oil) has been instilled into an affected ear three times daily.

According to two European expert panels, the German Commission E and the European Scientific Cooperative on Phytotherapy (ESCOP), a 2% to 5% ointment has been used. Preparations have been applied three to four times daily as needed.

A 1:1 tincture in 40% alcohol or a 1:5 tincture in 90% alcohol, diluted at least 1:3 with freshly boiled water, has been applied to the skin as a compress three to four times daily.

Children (under 18 years old)

There is currently not enough scientific evidence to recommend the use of calendula in children.

Safety

DISCLAIMER: Many complementary techniques are practiced by healthcare professionals with formal training, in accordance with the standards of national organizations. However, this is not universally the case, and adverse effects are possible. Due to limited research, in some cases only limited safety information is available.

Allergies

People with allergies to plants in the Aster/Compositae family, such as ragweed, chrysanthemums, marigolds, and daisies, are more likely to have an allergic reaction to calendula. There is one case of a severe allergic reaction (anaphylactic shock) after gargling with a calendula preparation.

Side Effects and Warnings

Aside from allergic reactions, few severe reactions have been found in published reports. In one small animal study, calendula was associated with a fatal reduction in blood glucose, accompanied by decreased serum lipids and protein. Skin (atopic dermatitis) and eye irritation have been reported.

Pregnancy and Breastfeeding

It is not clear if calendula is safe for use during pregnancy or breastfeeding. In animal studies, calendula has had effects on the uterus, and calendula has traditionally been thought to have harmful effects on sperm and to cause abortions. However, it is not clear if these effects occur with use of calendula on the skin.

Interactions

Interactions with Drugs

In early animal studies, high doses of calendula were reported to cause drowsiness. It is not clear if the use of calendula on the skin of humans has this effect. In theory, the use of calendula in combination with sedative drugs may lead to increased drowsiness. Examples include benzodiazepines such as lorazepam (Ativan®) or diazepam (Valium®), barbiturates such as phenobarbital, narcotics such as codeine, some antidepressants, and alcohol. Caution is advised while driving or operating machinery.

In early animal studies, high doses of calendula preparations were reported to lower blood pressure. It is not clear if the use of calendula on the skin of humans has this effect. In theory, the use of calendula in combination with drugs that lower blood pressure may lead to increased effects.

Calendula may also increase the effects of antispasmodics, which are drugs that help stop muscle spasms.

Use cautiously if taking drugs that can damage the liver or kidneys because calendula may increase the risk of organ damage.

Other possible interactions include increases in the activity of hypoglycemic (diabetic) medications or insulin, antifungal medications, or agents that decrease lipids and triglycerides (cholesterol-lowering drugs.)

Interactions with Herbs and Dietary Supplements

In early animal studies, high doses of calendula were reported to cause drowsiness. It is not clear if the use of calendula on the skin of humans has this effect. Use of calendula in combination with herbs or supplements that have possible sedative effects may lead to increased drowsiness. Caution is advised while driving or operating machinery.

In early animal studies, high doses of calendula preparations were reported to lower blood pressure. It is not clear if the use of calendula on the skin of humans has this effect. In theory, the use of calendula in combination with herbs that may lower blood pressure may lead to increased effects.

Other possible interactions include increases in the activity of hypoglycemic (diabetic) medications or insulin, antifungals, or agents that decrease lipids and triglycerides (cholesterol-lowering agents).

Calendula may also increase the effects of herbs or supplements that help stop muscle spasms (called antispasmodics).

Use cautiously if taking herbs or supplements that can damage the liver or kidneys because calendula may increase the risk of organ damage.

Since the stem and leaves of calendula contain lutein and beta-carotene, a possible supplement interaction exists with products that contain these ingredients.

Attribution

This information is based on a systematic review of scientific literature, and was edited and peer-reviewed by contributors to the Natural Standard Research Collaboration (www.naturalstandard.com): Ethan Basch, MD, MPhil (Memorial Sloan-Kettering Cancer Center); Steve Bent, MD (University of California, San Francisco); Dawn Costa, BA, BS (Natural Standard Research Collaboration); Ivo Foppa, MD, ScD (University of South Carolina); Sadaf Haskmi, MD, MPH (Harvard School of Public Health); Jenna Hollenstein, MS, RD (Natural Standard Research Collaboration); David Kroll, PhD (Duke University); Michelle Mele, PharmD (Northeastern University); Philippe Szapary, MD (University of Pennsylvania); Shaina Tanguay-Colucci, BS (Natural Standard Research Collaboration); Catherine Ulbricht, PharmD (Massachusetts General Hospital); Mamta Vora, PharmD (Northeastern University); Wendy Weissner, BA (Natural Standard Research Collaboration); Sophanna Yong, PharmD (Massachusetts College of Pharmacy and Health Sciences).

Bibliography

DISCLAIMER: Natural Standard developed the above evidence-based information based on a thorough systematic review of the available scientific articles. For comprehensive information about alternative and complementary therapies on the professional level, go to www.naturalstandard.com. Selected references are listed below.

Anonymous. Final report on the safety assessment of Calendula officinalis extract and Calendula officinalis. Int J Toxicol 2001;20 Suppl 2:13-20.

Basch E, Bent S, Foppa I, et al. Marigold (Calendula officinalis L.): an evidence-based systematic review by the Natural Standard Research Collaboration. J Herb Pharmacother 2006;6(3-4):135-59.

Cordova CA, Siqueira IR, Netto CA, et al. Protective properties of butanolic extract of the Calendula officinalis L. (marigold) against lipid peroxidation of rat liver microsomes and action as free radical scavenger. Redox Rep 2002;7(2):95-102.

De Tommasi N, Conti C, Stein ML, et al. Structure and in vitro antiviral activity of triterpenoid saponins from Calendula arvensis. Planta Med 1991;57(3):250-253.

Duran V, Matic M, Jovanovc M, et al. Results of the clinical examination of an ointment with marigold (Calendula officinalis) extract in the treatment of venous leg ulcers. Int J Tissue React 2005;27(3):101-6.

Fuchs SM, Schliemann-Willers S, Fischer TW, et al. Protective effects of different marigold (Calendula officinalis L.) and rosemary cream preparations against sodium-lauryl-sulfate-induced irritant contact dermatitis. Skin Pharmacol Physiol 2005;18(4):195-200.

Hamburger M, Adler S, Baumann D, et al. Preparative purification of the major anti-inflammatory triterpenoid esters from Marigold (Calendula officinalis). Fitoterapia 2003;74(4):328-338.

Kalvatchev Z, Walder R, Garzaro D. Anti-HIV activity of extracts from Calendula officinalis flowers. Biomed Pharmacother 1997;51(4):176-180.

Lavagna SM, Secci D, Chimenti P, et al. Efficacy of Hypericum and Calendula oils in the epithelial reconstruction of surgical wounds in childbirth with caesarean section. Farmaco 2001;56(5-7):451-453.

Lievre M, Marichy J, Baux S, et al. Controlled study of three ointments for the local management of 2nd and 3rd degree burns. Clin Trials Meta-analysis 1992;28:9-12.

McQuestion M. Evidence-based skin care management in radiation therapy. Semin Oncol Nurs 2006 Aug;22(3):163-73.

Pommier P, Gomez F, Sunyach MP, et al. Phase III randomized trial of Calendula officinalis compared with trolamine for the prevention of acute dermatitis during irradiation for breast cancer. J Clin Oncol 2004;22(8):1447-1453.

Sarrell EM, Mandelberg A, Cohen HA. Efficacy of naturopathic extracts in the management of ear pain associated with acute otitis media. Arch Pediatr Adolesc Med 2001;155(7):796-799.

Remember, keep this and all other medicines out of the reach of children, never share your medicines with others, and use this medication only for the indication prescribed.