Health Care Professional Information

Scientific Name
Calendula officinalis
Common Name

Gold-bloom, Marigold, Marybud, Pot Marigold

Clinical Summary

Extracted from the flower of the marigold plant, calendula is used topically for wound healing (1). Major constituents of the leaves and stems of the plant include lutein and beta-carotene (2). Extracts from calendula demonstrated anti-inflammatory properties (3), which may improve wound healing (4), and antibacterial, antiparasitic (5), anti-HIV (6), cytotoxic and anti-tumor effects (9) (10) both in vitro and in vivo. Further, studies done in mice indicate hepato-, reno- (14), photo- (15), and cardioprotective (16) properties.

An herbal formulation containing calendula was found effective in reducing earache in children with acute otitis media (7) (8).
Topical application of a calendula cream was shown safe and effective in infants as well for treating diaper dermatitis (21).
Preliminary data support use of topical calendula for prophylaxis of acute dermatitis during radiation therapy (11) (13); and a mouthwash containing calendula against chemotherapy-induced stomatitis (17).  More research is needed.
 

Purported Uses
  • Conjunctivitis
  • Eczema
  • GI disorders
  • Inflammation
  • Menstrual cramps
  • Menstrual disorder
  • Radiation therapy side effects
  • Spasms
  • Varicose veins
Constituents
  • Flavonoids
  • Polysaccharides
  • Triterpenoids (oleanolic acid)
  • Volatile Oils
    (3) (5) (14)
Mechanism of Action

The triterpenoids from calendula have been shown to have anti-inflammatory (3) and anti-HIV (6)effects, and a calendula extract suppressed cell fusion, which may inhibit early events in the HIV replication cycle (6). The most active triterpenoid is a monoester of faradiol (1). Calendula also exhibits hepato- and reno-protective effects which are likely due to its antioxidant activity (14). The photoprotective effect of topical gel formulations of calendula is thought to be associated with an improvement in collagen synthesis in the sub-epidermal connective tissue (15). Calendula also affords cardioprotection which involves modulating the antioxidant and anti-inflammatory pathways by activation of Akt (a serine/threonine protein kinase) and Bcl2 (a protein that regulates apoptosis) and down regulation of tumor necrosis factor (TNF alpha) (16). In another study, calendula was shown to inhibit human gingival fibroblast-mediated degradation of collagen and matrix metalloprotease (MMP-2) activity (18).
In a recent study, the essential oil from calendula flowers was shown to have sun protection activity (19) Application of a cream containing essential oil of calendula prevented UV-B-induced alterations in the skin in a study of rats (20). Calendula extract also accelerated healing of experimentally-induced thermal burns in rats by increasing collagen-hydroxyproline and hexosamine, bio-indicators of wound healing(4).

Contraindications

Calendula should be avoided during pregnancy and lactation because safety data are lacking (1).

Adverse Reactions

Calendula is known to cause allergic reactions (1) (12).

Literature Summary and Critique

Pommier P, 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;22:1447-53.
Two hundred fifty-four patients who underwent surgery for breast cancer were randomized to receive either calendula or trolamine, a routine treatment for topical application during postoperative radiation therapy. Occurrence of grade 2 or higher acute dermatitis was significantly lower in patients who used calendula compared to those who used trolamine.
Due to differences in texture, color, and smell, the trial was single-blinded. Well-designed studies are needed to confirm the beneficial effects of calendula.

Dosage (Inside MSKCC Only)
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References
  1. Barnes J, Anderson LA, Phillipson JD. Herbal Medicines. London: Pharmaceutical Press; 2002.
  2. Bako E, Deli J, Toth G. HPLC study on the carotenoid composition of Calendula products. J Biochem Biophys Methods. Oct-Nov 2002;53(1-3):241-250.
  3. Akihisa T, Yasukawa K, Oinuma H, et al. Triterpene alcohols from the flowers of compositae and their anti-inflammatory effects. Phytochemistry. Dec 1996;43(6):1255-1260.
  4. Chandran PK, Kuttan R. Effect of Calendula officinalis Flower Extract on Acute Phase Proteins, Antioxidant Defense Mechanism and Granuloma Formation During Thermal Burns. J Clin Biochem Nutr. Sep 2008;43(2):58-64.
  5. Szakiel A, Ruszkowski D, Grudniak A, et al. Antibacterial and Antiparasitic Activity of Oleanolic Acid and its Glycosides isolated from Marigold (Calendula officinalis).Planta Med. Nov 2008;74(14):1709-1715.
  6. Kalvatchev Z, Walder R, Garzaro D. Anti-HIV activity of extracts from Calendula officinalis flowers. Biomed Pharmacother. 1997;51(4):176-180.
  7. Sarrell EM, Cohen HA, Kahan E. Naturopathic treatment for ear pain in children. Pediatrics. May 2003;111(5 Pt 1):e574-579.
  8. 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. Jul 2001;155(7):796-799.
  9. Boucaud-Maitre Y, Algernon O, Raynaud J. Cytotoxic and antitumoral activity of Calendula officinalis extracts. Pharmazie. Mar 1988;43(3):220-221.
  10. Ukiya M, Akihisa T, Yasukawa K, et al. Anti-inflammatory, anti-tumor-promoting, and cytotoxic activities of constituents of marigold (Calendula officinalis) flowers. J Nat Prod. Dec 2006;69(12):1692-1696.
  11. 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. Apr 15 2004;22(8):1447-1453.
  12. Reider N, Komericki P, Hausen BM, et al. The seamy side of natural medicines: contact sensitization to arnica (Arnica montana L.) and marigold (Calendula officinalis L.). Contact Dermatitis. 2001 Nov;45(5):269-72.
  13. Kassab S, Cummings M, Berkovitz S, et al. Homeopathic medicines for adverse effects of cancer treatments. Cochrane Database Syst Rev. 2009 Apr 15;(2):CD004845. Review.
  14. Preethi KC, Kuttan R. Hepato and reno protective action of Calendula officinalis L. flower extract. Indian J Exp Biol. 2009 Mar;47(3):163-8.
  15. Fonseca YM, Catini CD, Vicentini FT, et al.  Efficacy of marigold extract-loaded formulations against UV-induced oxidative stress. J Pharm Sci. 2011 Jun;100(6):2182-93.
  16. Ray D, Mukherjee S, Falchi M, Bertelli A, Das DK. Amelioration of myocardial ischemic reperfusion injury with Calendula officinalis.  Curr Pharm Biotechnol. 2010 Dec;11(8):849-54.
  17. Oberbaum M, Yaniv I, Ben-Gal Y, et al.  A randomized, controlled clinical trial of the homeopathic medication TRAUMEEL S in the treatment of chemotherapy-induced stomatitis in children undergoing stem cell transplantation. Cancer. 2001 Aug 1;92(3):684-90.
  18. Saini P, Al-Shibani N, Sun J, et al. Effects of Calendula officinalis on human gingival fibroblasts. Homeopathy. 2012 Apr;101(2):92-8.
  19. Mishra A, Mishra A, Chattopadhyay P. Assessment of In vitro Sun Protection Factor of Calendula Officinalis L. (Asteraceae) Essential Oil Formulation. J Young Pharm. 2012 Jan;4(1):17-21.
  20. Mishra AK, Mishra A, Verma A, Chattopadhyay P. Effects of Calendula Essential Oil-Based Cream on Biochemical Parameters of Skin of Albino Rats against Ultraviolet B Radiation. Sci Pharm. 2012 Sep;80(3):669-83.
  21. Panahi Y, Sharif MR, Sharif A, et al. A randomized comparative trial on the therapeutic efficacy of topical aloe vera and Calendula officinalis on diaper dermatitis in children. Scientific World Journal. 2012;2012:810234.

Consumer Information

How It Works

Bottom Line: Topical application of calendula may reduce painful swelling and irritation associated with radiation therapy. It has not been shown to treat cancer.

Naturally occurring chemicals derived from the marigold plant have been shown to reduce inflammation in laboratory studies. These chemicals, which are called triterpenoids, also inhibit HIV virus and some tumors. When applied to the skin, extracts of calendula help to heal wounds and inflammation after radiation therapy. More research is needed.

Purported Uses
  • To heal burns and scalds
    Laboratory and animal studies show that calendula, when applied to the skin, has anti-inflammatory properties, and reduces burn tissue injury in animals. However, studies have not been undertaken to determine if this corresponds to faster healing of burns and scalds. Also, clinical studies in humans have not been performed.
  • To treat painful menstruation
    No scientific evidence supports this use.
  • To prevent skin inflammation
    Calendula ointment applied to the skin reduced painful swelling and irritation associated with radiation therapy in breast cancer patients.
  • To treat spasms
    No scientific evidence supports this use.
  • To treat varicose veins
    This claim is not backed by scientific data.
Research Evidence

Radiation Therapy Associated Dermatitis
Two hundred fifty-four breast cancer patients undergoing radiation therapy participated in a trial of Calendula to see if it would reduce skin inflammation due to radiation therapy. The patients were randomly assigned to receive a topical ointment containing either Calendula or trolamine. Trolamine is a standard treatment for skin inflammation. Subjects who used calendula had fewer cases of severe skin inflammation. Because the texture, color, and smell of the two ointments were quite different, patients knew which treatment they were receiving but researchers did not know which treatment they had received. This study suggests that calendula ointment may be used as a preventive treatment for skin inflammation due to radiation therapy.

Do Not Take If
  • You are allergic to plants in the Asteraceae/Compositae family.
  • You are pregnant or lactating because safety data are lacking.
Side Effects
  • Calendula can cause allergic reactions.
E-mail your questions and comments to aboutherbs@mskcc.org.