Gotu Kola: What the Research Says About Veins, Skin, and Brain

Among all the ancient medicinal plants, few carry as broad a reputation as Gotu Kola, a small creeping plant with fan-shaped leaves that grows in humid areas of Asia, scientifically known as Centella asiatica. In Ayurvedic and Chinese medicine, it has been considered for centuries a plant of longevity, for wound healing and sharpening the mind, and in Ayurveda it is sometimes called "Brahmi," a name associated with mental clarity.

In the modern supplement era, Gotu Kola has returned to fashion from three completely different angles: as a cream and serum for the skin, as a supplement for vein and leg health, and as a herbal "nootropic" for memory and mood. The question is whether science supports any of these angles, all of them, or none. The answer, as we will see, is that Gotu Kola is a rare example of a plant where the evidence is relatively strong precisely in the less glamorous areas, and weak in the area where it is most marketed. In this article, we will separate facts from hype and explain why we rated Gotu Kola yellow.

What is Gotu Kola?

Gotu Kola (Centasia asiatica) is a herbaceous creeping plant from the Apiaceae family, and despite its name, it has no connection to the kola nut or caffeine. Here is what is important to understand about it:

• The active components are triterpenes. The main group of active substances in the plant are pentacyclic triterpenes, primarily asiaticoside, madecassoside, asiatic acid, and madecassic acid. These are the components responsible for most of the studied effects.
• It promotes collagen production. In laboratory and animal studies, the triterpenes stimulate fibroblasts to produce type 1 and 3 collagen, strengthen connective tissue, and accelerate wound closure. This is the biological basis for its use for skin and scars.
• It has antioxidant and anti-inflammatory activity. The triterpenes reduce oxidative stress and inflammatory mediators in cellular models, contributing to both the effect on the skin and the effect on blood vessels.
• It improves microcirculation. One of the most documented properties is strengthening the vein and capillary wall and reducing capillary permeability, hence the effect on leg edema.

Gotu Kola is sold in various forms: capsules and powder of the plant extract for oral intake, as well as creams, gels, and serums for topical application on the skin (in Korean cosmetics it is known as "cica"). Quality extracts are usually standardized to a fixed percentage of triterpenes. It is important to distinguish between these two routes of use, because the evidence for topical application on a scar differs from the evidence for internal intake, and we will discuss both separately.

The Connection to Veins and Skin: The Mechanism

To understand why Gotu Kola works specifically in the areas where it does, one needs to know two central mechanisms that recur throughout the research.

First mechanism, strengthening the connective tissue of the blood vessel wall. Chronic venous insufficiency is a condition where the valves in the leg veins weaken, blood tends to pool, pressure in the capillaries rises, and fluid leaks into the tissue, causing edema. The triterpenes of Gotu Kola strengthen the connective tissue layer (collagen) in the vein wall and reduce capillary permeability, thereby decreasing the leak and the edema. A well-known standardized preparation of the plant, referred to in research as TTFCA (Total Triterpenic Fraction of Centella asiatica), has been studied precisely in this context.

Second mechanism, accelerating collagen production in wound and scar healing. The same triterpenes that strengthen the vein wall also stimulate skin fibroblasts to produce collagen and promote the formation of new blood vessels (angiogenesis) in the injured tissue. Asiaticoside has been shown to accelerate wound closure, and madecassoside reduces inflammation and balances the scar formation process, which may lead to a softer and less prominent scar. This is why Gotu Kola is a common ingredient in scar creams and in skin care "cica."

These two mechanisms share a common denominator: they relate to connective tissue and microcirculation. In contrast, the proposed effect on the brain, through antioxidant activity, support of the nerve growth factor BDNF, and an effect on acetylcholine, is documented mainly in rodents and in vitro, and the transition from this to proven cognitive benefit in humans is precisely the weak point, as we will see in the evidence section.

The Current Evidence

Study 1: Gotu Kola and Chronic Venous Insufficiency, Systematic Review by Chong and Aziz 2013

This is the strongest summary evidence on venous use. In 2013, Chong and Aziz from the University of Malaya published a systematic review in the journal Evidence-Based Complementary and Alternative Medicine, which gathered controlled trials examining Gotu Kola for improving the signs and symptoms of chronic venous insufficiency.

The finding was positive in its direction: Gotu Kola improved parameters of microcirculation and venous symptoms such as edema, heaviness, and leg pain. However, the authors themselves emphasized caution: most of the included studies were small, with insufficient methodological reporting and unclear risk of bias. The fair conclusion is that there is a relatively consistent positive signal here, but not proof at a high level of certainty. This is one of the main reasons for the yellow rating.

Study 2: TTFCA and Leg Edema, Controlled Trial by De Sanctis and Colleagues 2001

An example of a representative single trial in the venous field. In 2001, De Sanctis, Belcaro, and their colleagues published in the journal Angiology a prospective, placebo-controlled, randomized trial examining different doses of the triterpenic extract TTFCA (60 mg and 120 mg per day) in patients with venous hypertension and edema.

The results showed a significant reduction in edema (ankle volume) and capillary permeability in the treatment groups compared to placebo, with a dose-dependent effect. This finding aligns with the mechanism of strengthening the blood vessel wall and reducing leakage. As with most studies in the field, this involves a relatively small sample and a specific standardized preparation, so the result is promising but requires confirmation in larger trials.

Study 3: Gotu Kola, Cognition, and Mood, Meta-analysis by Puttarak and Colleagues 2017

Here, precisely, the picture reverses. In 2017, Puttarak and colleagues published in the journal Scientific Reports a systematic review and meta-analysis of 11 controlled trials, examining the effect of Gotu Kola on cognitive function and mood.

The finding was sobering: No significant difference was found between Gotu Kola and placebo in any of the cognitive function domains examined. The only effect identified was modest and related to mood, a certain increase in alertness and a decrease in anger about an hour after intake, a short-term effect and not a lasting memory improvement. In other words, although Gotu Kola is marketed mainly as a plant for memory and the brain, it is precisely there that the human evidence is the weakest. This is an important reminder of the gap between traditional reputation and what controlled trials show.

Study 4: Topical Application for Wound and Scar Healing

In the skin field, recent reviews of clinical and preclinical studies indicate benefit. A review published in 2024 in the journal Pharmaceutics concluded that topical application of Gotu Kola extract accelerates wound closure, promotes tissue regeneration, and minimizes scar formation, with a favorable safety profile.

Some studies examined creams containing Gotu Kola for improving the appearance of scars after surgery and showed improvement in scar elasticity and appearance. Here too, the evidence consists of relatively small studies, but they are consistent with the mechanism of promoting collagen production. Note that the relatively strong evidence here pertains to topical application on the skin, and not necessarily to taking capsules for skin beauty.

What About Anxiety, Diabetes, and Aging?

Beyond the three main areas, Gotu Kola has been examined in several other contexts, although the evidence there is thinner. A number of small studies have examined a possible effect on anxiety and mood, some in the context of generalized anxiety disorder, and showed an encouraging signal, but these involve small samples and variable methodological quality, so it is not yet possible to recommend it as a treatment for anxiety.

Other areas examined in early studies include a possible effect on microcirculation in diabetic patients (diabetic microangiopathy) and on general vascular health, based on the same mechanism of strengthening the blood vessel wall. The bottom line repeats itself across all areas: Gotu Kola is a plant with real and interesting mechanisms, but outside of veins and skin, the evidence is preliminary. Expectations should remain realistic.

Should You Start Taking Gotu Kola?

This is precisely why we rated Gotu Kola yellow. On one hand, there is real and relatively consistent benefit in defined areas; on the other hand, the evidence is based on small studies, some popular claims (memory) are unsupported, and there are safety issues to be aware of. Here are the considerations:

• The benefit is focused, not general. The best evidence is for chronic venous insufficiency and leg edema (internal intake of a standardized extract) and for scar healing (topical application). For memory and cognition, a large meta-analysis found no significant benefit.
• Caution with the liver in long-term use. There are rare case reports of liver injury (hepatotoxicity) following long-term use of high doses. This is rare, but anyone taking the plant for a long time should take breaks and consider monitoring, and certainly avoid combining it with other supplements or medications that burden the liver.
• Pregnancy and breastfeeding, avoid. There are not enough safety data, and Gotu Kola has even been traditionally associated with undesirable effects in pregnancy. Pregnant or breastfeeding women should avoid it.
• Drowsiness and fatigue. Some people report feeling drowsy, so caution is advised when combining with sedatives, sleeping pills, or alcohol.

Additionally, there are groups that need a doctor's approval before taking it. Those scheduled for surgery should stop the plant in advance due to the possible effect on drowsiness and the liver, and those taking diabetes medications, liver medications, or sedatives should consult a doctor or pharmacist. As always: a "natural" plant is not synonymous with "safe for everyone at any dose."

What to Take Away from the Research?

1. Match expectations to the right area. If the goal is heavy legs, swelling, or a feeling of mild venous insufficiency, Gotu Kola (standardized extract) is a reasonable candidate to discuss with a doctor. If the goal is memory enhancement, the evidence simply isn't there.
2. For scars, prefer topical application. A cream or gel with Gotu Kola on a relatively new scar is better supported by research than swallowing capsules for skin beauty.
3. Choose a standardized, quality extract. Look for a product that states a fixed percentage of total triterpenes (TTFCA or similar), as this is the preparation that was actually studied.
4. Avoid if pregnant or breastfeeding, and be cautious with the liver. Do not take long-term at a high dose without breaks, and consult if you have liver disease or are on regular medication.
5. Don't neglect the basics. For vein health, movement, weight loss, compression stockings, and leg elevation have a much greater effect than any supplement.

For those who want to try Gotu Kola from a reliable source, you can purchase Gotu Kola on iHerb and choose a standardized extract from a reputable company. To check which supplements are truly suitable for your health goals, including skin health, according to your age and condition, you can use our personal supplement checker that rates each supplement based on the quality of evidence.

The Broader Perspective

Gotu Kola is a particularly interesting case study of the gap between traditional reputation and science. A plant that tradition sanctifies mainly as a plant for memory and mental clarity, reveals itself in controlled trials as effective in a completely different place: in strengthening connective tissue, in veins and skin. This is a reminder that centuries-old tradition can point to a plant of value, but only rigorous trials can tell us exactly what it is good for, and what it is not.

The practical lesson is twofold. First, Gotu Kola is an example that "a supplement works" is not a yes or no question, but a question of for what: the same plant can be promising for leg edema and a scar, and of no proven value for memory. Second, even in areas where the evidence is positive, it is based on small studies and specific standardized preparations, so caution and informed choice are important. Vein health, skin health, and longevity are built first and foremost from movement, nutrition, sleep, and maintaining a healthy weight, and Gotu Kola can be, at best and in the right area, a small and cautious contributor. And that is precisely the perspective we hold here: to rate each supplement according to what the science actually shows, when it is promising, and when it is best to remain cautious.

References:
Chong N.J., Aziz Z., A Systematic Review of the Efficacy of Centella asiatica for Improvement of the Signs and Symptoms of Chronic Venous Insufficiency, Evidence-Based Complementary and Alternative Medicine, 2013 (DOI: 10.1155/2013/627182)
Puttarak P. et al., Effects of Centella asiatica (L.) Urb. on cognitive function and mood related outcomes: A Systematic Review and Meta-analysis, Scientific Reports, 2017;7:10646 (DOI: 10.1038/s41598-017-09823-9)
Topical Application of Centella asiatica in Wound Healing: Recent Insights into Mechanisms and Clinical Efficacy, Pharmaceutics, 2024 (review on wound healing and scar improvement)