Gotu Kola Forms, TECA and Topical Use

Almost every argument about whether gotu kola “works” is really an argument about which gotu kola. A salad leaf in Colombo, a cup of infusion, a 500 mg capsule of milled dried herb, a 60 mg tablet of titrated triterpenic fraction and a Korean cica cream are five different products that happen to share a plant. Only one of them — the titrated fraction — is what the clinical trials studied.

This article is the practical one: what each form contains, what the standardised extract actually is, what doses appeared in the literature, how to read a label, and the two real safety issues — allergic contact dermatitis on the skin, and rare liver injury by mouth.

Table of Contents

1. The Forms, and What Each One Delivers
2. What TECA and TTFCA Actually Are
3. The Name Zoo
4. Does Oral Gotu Kola Get Absorbed?
5. Doses Used in the Trials
6. Topical Use in Practice
7. Leaf, Tea and Food Use
8. What a Good Label Looks Like
9. Contact Dermatitis: the Best-Documented Adverse Effect
10. The Liver Reports, in Detail
11. Pregnancy, Sedation and Interactions
12. Regulatory Status
13. Key Research Papers
14. Connections

The Forms, and What Each One Delivers

Read down that “Studied?” column and the practical implication is unavoidable. If you want the effect that was measured in a trial, you need the titrated extract. Everything else is either food, tradition, or an untested cosmetic dose.

What TECA and TTFCA Actually Are

The titrated extract is a purified fraction rather than a whole-plant extract. Its defining feature is a fixed ratio of the plant’s four active triterpenes, so that a milligram figure on a box means the same thing from batch to batch.

The classical composition is approximately 40% asiaticoside, with the remainder made up of the two free acids, asiatic acid and madecassic acid, in roughly equal share. Asiaticoside and madecassoside are glycosides — the triterpene core with sugars attached; asiatic and madecassic acid are the corresponding sugar-free cores.

Two abbreviations dominate the literature and they refer to the same kind of material:

• TECA — titrated extract of Centella asiatica. The term used in the French literature and by the plastic-surgery and dermatology papers.
• TTFCA — total triterpenic fraction of Centella asiatica. The term used throughout the Italian vascular literature.

You will also see “titrated extract”, “standardised to total triterpenes”, or a percentage-of-asiaticoside claim on supplement labels. Those are the phrases to look for. A product whose only quantitative claim is milligrams of herb tells you nothing about what you are taking.

The Name Zoo

The same plant travels under an unusual number of names, which is part of why its literature is hard to follow.

• Botanical: Centella asiatica (L.) Urban. Older literature uses Hydrocotyle asiatica, and older papers file it under Umbelliferae rather than the modern Apiaceae.
• Common: gotu kola, Indian pennywort, Asiatic pennywort, pegaga (Malay), ji xue cao 積雪草 (Chinese), mandukaparni and — contentiously — brahmi (Sanskrit/Hindi).
• Pharmaceutical: Madecassol, Centellase, Emdécassol and other regional brands of the titrated extract, formulated as ointment, powder, tablet and injection depending on the country and era.
• Cosmetic: “cica”, from cicatrisation (scar formation). An unregulated marketing term that signals nothing about dose.

The name that causes real harm is brahmi, because it is shared with Bacopa monnieri. That has its own article.

Does Oral Gotu Kola Get Absorbed?

This is a fair question for any large saponin, since molecules of that size and polarity often cross the gut wall badly.

Grimaldi and colleagues addressed it directly in 1990, developing an assay for asiatic acid and giving TTFCA to healthy volunteers as single and repeated doses. Asiatic acid was measurable in plasma, which establishes that the fraction is orally bioavailable to a useful degree. That is more than most botanicals can demonstrate, and it is one reason the venous trials are worth taking seriously at all — the drug demonstrably reached the circulation.

Bioavailability is nonetheless a recognised limitation. The 2022 wound-healing systematic review flagged it explicitly and suggested delivery systems such as nanoencapsulation as a research direction — which is a polite way of saying that getting enough triterpene to the target tissue remains an unsolved formulation problem.

Practical consequences: take oral gotu kola with food, which improves absorption of lipophilic compounds and reduces stomach upset, and split the daily dose the way the trials did rather than taking it all at once.

Doses Used in the Trials

Three warnings about this table. The 12 g startle dose was a one-off supervised experimental dose and is not a model for anything you should take. The cognition doses come from studies whose pooled result was null, so they are “what was tried”, not “what is recommended”. And a dose of titrated fraction is not interchangeable with the same number of milligrams of anything else — 120 mg of TTFCA is not 120 mg of dried leaf.

Topical Use in Practice

Topical is where gotu kola is most used and where the risk–benefit is most favourable: systemic exposure is minimal, so the liver concern essentially disappears, and the indication — skin and scars — is the one the evidence best supports.

Prescription-style products

TECA ointments and powders have been sold as medicines in France, Korea, Japan and parts of southern Europe for decades, for wounds and hypertrophic scars. Where available they contain a declared concentration of the titrated extract, which is what makes them different from a cosmetic.

Cosmetic cica products

Since around 2015 Centella asiatica has become one of the most-used botanical actives in skincare, typically as extract or isolated madecassoside, sold for redness, barrier repair and post-procedure skin. Points to hold onto:

• Concentration is almost never declared. An ingredient listed near the end of an INCI list may be present at a fraction of a percent.
• “Cica” is a marketing word, not a standard. It guarantees nothing.
• The soothing effect people report is plausible on the anti-inflammatory mechanism, and largely untested at cosmetic doses.
• The base matters as much as the active. Much of the benefit of any barrier cream comes from occlusion and humectants, which the placebo arms of trials also provided.

How to use it sensibly

1. Patch-test first. Apply a small amount to the inner forearm daily for five to seven days before using it on the face or on a large area. Allergic contact dermatitis to this plant is well documented and builds over days rather than appearing immediately.
2. Closed wounds only. Scar products are for fully healed skin. Open, deep, infected or non-healing wounds need clinical care, not a botanical cream.
3. Be patient and realistic. Scar remodelling runs over a year or more. Nothing visible happens in a fortnight.
4. Combine with what works. For a new surgical scar, silicone gel or sheeting plus strict sun protection have the best evidence. Add Centella to those rather than instead.
5. Stop if it stings, itches or reddens over successive days. That is the pattern of sensitisation, not of “it’s working”.

Leaf, Tea and Food Use

In Sri Lanka, southern India, Thailand, Malaysia and Indonesia gotu kola is an ordinary vegetable — shredded raw into gotu kola sambol with coconut and lime, blended into cooling green drinks, or cooked into porridge and soups. Culinary quantities have a long, unremarkable history of use.

Two honest caveats. First, food use is not evidence of medicinal effect: nobody has shown that a bowl of sambol does anything measurable to a vein or a scar, and the triterpene dose is far below the studied range. Second, food use is reassuring about ordinary safety at ordinary amounts — which is not the same as safety of a concentrated extract taken daily for months.

Tea deserves a specific note: triterpene saponins are not very water-soluble, so a hot-water infusion extracts them poorly. A gotu kola tea is a pleasant, mild, essentially food-level preparation. Treat it as such.

What a Good Label Looks Like

1. Centella asiatica printed in full. Not just “brahmi”, not just “gotu kola”.
2. Plant part: aerial parts / herb. That is what the pharmacopoeial material and the EMA monograph cover.
3. A standardisation figure — percentage of total triterpenes or asiaticoside, or the words “titrated extract”. Without one, you cannot connect the product to any trial.
4. Milligrams of extract, plus the extract ratio (for example 10:1). “1000 mg of gotu kola” with no further detail is a marketing number.
5. Third-party testing for identity, heavy metals and microbial contamination. Gotu kola grows in wet ground and standing water and can accumulate contaminants from its growing site — identity and purity testing matters more here than for a cultivated dry-land herb.
6. No proprietary “brahmi complex”. Blends make attribution impossible and usually under-dose every component.

Contact Dermatitis: the Best-Documented Adverse Effect

If gotu kola has one well-established harm, this is it, and it belongs to the topical products that most people consider harmless.

The case literature is consistent and spans three decades. Danese and colleagues reported allergic contact dermatitis to Centella asiatica extract in Contact Dermatitis in 1994. Bilbao and colleagues followed in 1995 with a case involving a combination product. Gomes and colleagues reported further cases in 2010. And in 2024 Özkaya and Toprak described two patients in Turkey sensitised to Centella asiatica extract alongside fragrance allergens — showing that the arrival of mass-market cica cosmetics has not made the problem go away. Even the 1979 Madecassol scar report listed allergic reaction as one of only two adverse effects it observed.

How to recognise it

• Timing: allergic contact dermatitis develops over 24–72 hours after exposure, not within minutes. A product that stings instantly is more likely to be causing irritation than allergy.
• Appearance: itchy redness, small bumps or vesicles, sometimes weeping, confined at first to where the product was applied and later spreading past those edges.
• Course: it recurs and worsens with each re-exposure. Sensitisation is permanent — once allergic, always allergic.
• Confirmation: patch testing by a dermatologist can identify the specific allergen, which matters because it may be the Centella extract or the fragrance, preservative or other botanical in the same jar.

The practical rule: patch-test at home before committing a Centella product to your face or to healing skin, and if a reaction develops, stop everything containing it and get patch-tested properly rather than working through brands by trial and error.

The Liver Reports, in Detail

Oral gotu kola has a rare but genuine association with liver injury, and the key report deserves to be described precisely rather than waved at.

Jorge and Jorge, gastroenterologists in Mendoza, Argentina, published three cases in 2005. Three women, aged 61, 52 and 49, developed jaundice after taking Centella asiatica for 30, 20 and 60 days respectively. Their laboratory findings:

• ALT 1193, 1694 and 324 U/L — the first two are dozens of times the upper limit of normal.
• Alkaline phosphatase 503, 472 and 484 U/L.
• Bilirubin 4.23, 19.89 and 3.9 mg/dL.
• The first patient also had anti-smooth-muscle antibody at 1:160 and anti-mitochondrial antibody at 1:320, suggesting an immune-mediated component.

Liver biopsies showed granulomatous hepatitis with marked necrosis and apoptosis in the first patient, chronic hepatitis with cirrhotic transformation and intense necroinflammatory activity in the second, and granulomatous hepatitis in the third. All three improved after stopping the herb, with ursodeoxycholic acid 10 mg/kg/day.

The decisive detail: the first patient took Centella asiatica again and the liver damage recurred. A positive rechallenge is the strongest form of causality evidence in drug-induced liver injury — it is the closest thing to an experiment that clinical practice ever produces. The second patient had also taken the herb a year earlier, consistent with prior sensitisation.

What this does and does not mean

• It is rare. Three cases against very widespread use. Most people take gotu kola without any liver effect, and the trials — including a twelve-month one — reported no such problem.
• It is real. Rechallenge plus biopsy plus recovery on withdrawal is about as solid as a case series gets.
• Duration is the pattern. All three were on continuous daily oral use for weeks. This is the strongest argument for time-limited courses with breaks, which also happens to be traditional practice.
• It applies to oral use. Topical products do not deliver meaningful systemic exposure.

Stop and seek medical care for unexplained fatigue, loss of appetite, nausea, right-upper-abdominal discomfort, dark urine, pale stools, itching, or yellowing of the skin or eyes. Avoid oral gotu kola altogether if you have liver disease, and be cautious if you drink heavily or take other hepatotoxic medication. Anyone using it for more than a few weeks could reasonably ask for liver enzymes to be checked.

Pregnancy, Sedation and Interactions

• Pregnancy and breastfeeding — avoid oral use. Safety has not been established and there is no reason to take the risk. The striae creams tested in pregnancy were topical and used under trial supervision; clear any product with your maternity team.
• Sedatives, alcohol and anaesthesia. Gotu kola may add to sedation. Use caution with benzodiazepines, sleep medication, opioids and alcohol, and stop it roughly two weeks before planned surgery.
• Liver-metabolised medication. Given the hepatotoxicity reports, combining long-term oral gotu kola with other drugs that stress the liver is a poor idea. Tell your prescriber you are taking it.
• Diabetes and lipid medication. There are suggestions of effects on glucose and lipids. If you take medication for either, monitor and mention it.
• Allergy: carrot family, not daisy family. Warnings about ragweed, marigold and chrysanthemum are copied from Asteraceae herbs and do not apply. Centella asiatica is Apiaceae — carrot, celery, parsley, fennel.
• Photosensitivity. Sometimes claimed on the basis of the Apiaceae family association with furocoumarins. It is not well documented for this species specifically, but sun protection on treated skin is sensible advice for scar care regardless.

Regulatory Status

The European Medicines Agency’s Committee on Herbal Medicinal Products has finalised its assessment of Centellae asiaticae herba and adopted a European Union herbal monograph, most recently revised in 2022. The therapeutic area the EMA files it under is worth noting: skin disorders and minor wounds. Not cognition. Not memory. The European regulator’s own classification matches where the evidence actually is.

Elsewhere:

• France, Korea, Japan and parts of southern Europe: titrated-extract products have been licensed medicines for wounds and scars for decades.
• United States: a dietary supplement. Not approved as a drug, not reviewed for efficacy before sale, and not required to contain what the label says beyond general manufacturing rules.
• Cosmetics generally: Centella asiatica extract and madecassoside are permitted cosmetic ingredients with no efficacy requirement whatsoever.

Key Research Papers

1. James JT, Dubery IA. Pentacyclic triterpenoids from the medicinal herb, Centella asiatica (L.) Urban. Molecules. 2009;14(10):3922–3941. The reference account of the four triterpenes, their variability between growing sites, and how extracts are standardised.
2. Grimaldi R, De Ponti F, D’Angelo L, Caravaggi M, Guidi G, Lecchini S, et al. Pharmacokinetics of the total triterpenic fraction of Centella asiatica after single and multiple administrations to healthy volunteers. A new assay for asiatic acid. Journal of Ethnopharmacology. 1990;28(2):235–241. Establishes oral bioavailability.
3. Brinkhaus B, Lindner M, Schuppan D, Hahn EG. Chemical, pharmacological and clinical profile of the East Asian medical plant Centella asiatica. Phytomedicine. 2000;7(5):427–448. The classic overview of preparations and their clinical use.
4. Sun B, Wu L, Wu Y, Zhang C, Qin L, Hayashi M, et al. Therapeutic potential of Centella asiatica and its triterpenes: a review. Frontiers in Pharmacology. 2020;11:568032.
5. Bylka W, Znajdek-Awiżeń P, Studzińska-Sroka E, Brzezińska M. Centella asiatica in cosmetology. Postępy Dermatologii i Alergologii. 2013;30(1):46–49. The review behind the cosmetic use of the extract.
6. Bylka W, Znajdek-Awiżeń P, Studzińska-Sroka E, Dańczak-Pazdrowska A, Brzezińska M. Centella asiatica in dermatology: an overview. Phytotherapy Research. 2014;28(8):1117–1124.
7. Arribas-López E, Zand N, Ojo O, Snowden MJ, Kochhar T. A systematic review of the effect of Centella asiatica on wound healing. International Journal of Environmental Research and Public Health. 2022;19(6):3266. Flags bioavailability as the limiting factor.
8. Jorge OA, Jorge AD. Hepatotoxicity associated with the ingestion of Centella asiatica. Revista Española de Enfermedades Digestivas. 2005;97(2):115–124. Three cases with biopsies and one positive rechallenge.
9. Danese P, Carnevali C, Bertazzoni MG. Allergic contact dermatitis due to Centella asiatica extract. Contact Dermatitis. 1994;31(3):201.
10. Bilbao I, Aguirre A, Zabala R, González R, Ratón J, Diaz Pérez JL. Allergic contact dermatitis from butoxyethyl nicotinic acid and Centella asiatica extract. Contact Dermatitis. 1995;33(6):435–436.
11. Gomes J, Pereira T, Vilarinho C, Duarte ML, Brito C. Contact dermatitis due to Centella asiatica. Contact Dermatitis. 2010;62(1):54–55.
12. Özkaya E, Toprak İD. Allergic contact dermatitis from Centella asiatica extract and fragrance allergens: report of two patients from Turkey. Contact Dermatitis. 2024;91(1):85–87. The problem in the cica era.
13. Bossé JP, Papillon J, Frenette G, Dansereau J, Cadotte M, Le Lorier J. Clinical study of a new antikeloid agent. Annals of Plastic Surgery. 1979;3(1):13–21. Madecassol; notes mild gastric intolerance and allergic reaction as the observed adverse effects.

Live PubMed Searches

1. Titrated extract of Centella asiatica (TECA)
2. Asiatic acid pharmacokinetics and bioavailability
3. Centella asiatica contact dermatitis and patch testing
4. Herb-induced liver injury from supplements
5. Standardisation and asiaticoside content of Centella products
6. Madecassoside in cosmetic formulation

Connections

• All Herbs
• Gotu Kola Benefits (hub)
• Gotu Kola (main page)
• Wound Healing and Scars
• Venous Insufficiency and Circulation
• Cognition, Anxiety and the Brahmi Confusion
• Bacopa Monnieri
• Calendula
• Comfrey
• Dermatology

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