08/21/2026
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A recent randomised, double blind, placebo-controlled, parallel-group trial provides one of the stronger recent clinical evaluations of orally administered gotu kola (Centella asiatica) for skin ageing, although several limitations should be considered when interpreting its clinical significance. The study enrolled 112 Korean women aged 30 to 60 years with visible facial wrinkles and relatively dry skin. After exclusions, the per-protocol analysis included 53 participants receiving gotu kola and 52 receiving placebo. The intervention lasted 12 weeks and compliance exceeded 94%.
Participants received 200 mg daily of a spray-dried hydroethanolic extract of gotu kola leaves, taken as a single oral tablet 30 minutes after a meal. The extract was prepared using 70% ethanol and standardised to contain 7% asiaticoside (70 mg/g). Although the authors acknowledged the presence of other important triterpenes, including madecassoside, asiatic acid and madecassic acid, their concentrations were not reported. The publication did not provide the extraction yield or drug-to-extract ratio, so the equivalent amount of starting dried leaf material cannot be determined. However, typical hydroethanolic extraction results suggest that 200 mg of extract could correspond to approximately 0.8 to 1.3 g of starting leaf.
After 12 weeks, participants receiving the gotu kola experienced statistically significant improvements in several objective wrinkle parameters compared with placebo. Average wrinkle depth decreased by 11.1%, largest wrinkle depth by 14.4%, maximum wrinkle depth by 13.3%, total wrinkle volume by 13.7%, and surface roughness by 10.4%. Skin barrier function also improved, as demonstrated by a significant reduction in cheek transepidermal water loss, indicating enhanced barrier integrity. Cheek skin hydration increased significantly relative to placebo, although improvements at other body sites were smaller and inconsistent.
Statistically significant improvements were also observed in skin elasticity and skin brightness, but these changes were very small, approximately 0.7%, making their clinical relevance uncertain. The intervention was well tolerated, with no serious adverse events reported, and liver function, renal markers and haematological parameters remained within normal limits throughout the study.
The study has several notable strengths. It employed a rigorous randomised, double blind, placebo-controlled design, which was adequately powered for its primary endpoint, achieved high compliance with low dropout rates, and relied on objective instrumental assessments, rather than the subjective cosmetic evaluations that are mostly used in such trials.
However, important limitations temper confidence in the findings. The study was funded and conducted by the manufacturer of the commercial extract, introducing the possibility of sponsorship bias. The primary analysis was conducted on a per-protocol rather than an intention-to-treat basis, which may overestimate treatment effects. Apart from the wrinkle measurements, most statistically significant improvements were numerically small.
While no one should confuse an oral herbal extract with injectable cosmetic procedures, these findings do tempt one to describe gotu kola as "Botox in a bottle"—a tongue-in-cheek nickname from a colleague that is now reflected in its measurable ability to soften wrinkles naturally. The dose used in the trial was relatively low, implying that even better results might be obtained from prescribing normal doses of this herb.
For more information see: https://pubmed.ncbi.nlm.nih.gov/42196964/
