Centella asiatica (cica) in skincare: wound healing, barrier repair, and what the evidence shows

Centella asiatica — marketed as "cica" — has moved from traditional Asian wound care to global skincare staple. The traditional use has legitimate science behind it; the marketing has grown well beyond it. Here's what centella actually does.

What centella asiatica is

Centella asiatica (gotu kola) is a small herbaceous plant native to tropical Asia, widely used in Ayurvedic and traditional Chinese medicine for wound healing, skin conditions, and cognitive function for thousands of years. It is the "cica" in K-beauty (from "cicatrice" — French for scar/healing).

Key active compounds isolated from centella:

| Compound | Type | Primary activity |
|---|---|---|
| Asiaticoside | Triterpene glycoside | Collagen synthesis; wound healing |
| Madecassoside | Triterpene glycoside | Anti-inflammatory; collagen synthesis |
| Asiatic acid | Free triterpene acid | Fibroblast stimulation; wound healing |
| Madecassic acid | Free triterpene acid | Anti-inflammatory |
| Brahmoside / brahminoside | Minor glycosides | Anti-anxiety (primarily oral) |

The glycosides (asiaticoside, madecassoside) are prodrugs — they're hydrolyzed in the skin to their corresponding free acids (asiatic acid, madecassic acid), which are the biologically active forms.

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How centella asiatica works

Collagen synthesis and wound healing

Asiatic acid and madecassic acid stimulate fibroblast proliferation and collagen synthesis through multiple pathways:
Upregulation of transforming growth factor-β (TGF-β), a key collagen synthesis regulator
Increased procollagen type I and III production
Enhanced fibroblast migration to wound sites

Rosen et al. (1967, Journal of the Society of Cosmetic Chemists) — an early study of topical centella for wound healing established the foundational collagen synthesis evidence. Subsequent studies confirmed this mechanism in human skin models.

Lu et al. (2012, Journal of Ethnopharmacology) — demonstrated that madecassoside significantly promoted wound closure and collagen synthesis in both in vitro and in vivo models.

Anti-inflammatory activity

Madecassoside specifically inhibits NF-κB activation — the master transcription factor regulating pro-inflammatory cytokines (TNF-α, IL-1β, IL-6). This is the same pathway targeted by many anti-inflammatory drugs, confirming centella's mechanism is genuinely anti-inflammatory rather than just soothing.

Clinical implication: For inflammatory skin conditions — acne, rosacea, eczema, post-procedure redness — centella's anti-inflammatory mechanism provides real relief rather than just surface cooling.

Antioxidant activity

Centella's triterpenes and flavonoids provide antioxidant activity via free radical scavenging — protecting against UV-induced and environmental oxidative stress.

Barrier function support

Asiaticoside promotes ceramide synthesis and has been shown to improve TEWL (transepidermal water loss) in compromised skin. This barrier-supportive effect explains why cica products are effective for post-procedure skin (laser, microneedling, chemical peel recovery) and atopic dermatitis.

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Clinical evidence

Wound healing and scars

Shukla et al. (1999, Journal of Ethnopharmacology) — controlled study of topical asiaticoside in wound healing found accelerated wound closure and collagen synthesis compared to control.

MEDERMA and centella-containing scar treatments have a body of clinical evidence for keloid and hypertrophic scar improvement, though the quality is variable.

Atopic dermatitis and barrier repair

Kimura et al. (2006) — an RCT of centella extract cream for mild atopic dermatitis found significant improvement in itch, dryness, and skin hydration vs. vehicle. The ceramide-synthesis and anti-inflammatory effects appear to drive this benefit.

Post-procedure recovery

Multiple smaller studies and strong clinical experience support centella products for post-procedure recovery (laser, microneedling, peels) — reducing redness, supporting barrier repair, and potentially accelerating wound healing. This use is now standard in many Korean dermatology practices.

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Centella vs. other skin-calming ingredients

| Ingredient | Primary mechanism | Evidence level | Best use case |
|---|---|---|---|
| Centella asiatica | Collagen synthesis + NF-κB anti-inflammatory | Good | Wound healing, barrier repair, acne calm |
| Allantoin | Cell proliferation; wound healing | Good | Soothing, moisturizing |
| Oat (avenanthramides) | NF-κB inhibition; histamine reduction | Strong (FDA OTC) | Atopic dermatitis, itch |
| Aloe vera (acemannan) | Macrophage activation; wound healing | Good (burns) | Sunburn, mild wounds |
| Panthenol (vitamin B5) | Keratinocyte proliferation; TEWL | Strong | Barrier repair, wound healing |

Centella's collagen synthesis + anti-inflammatory combination is most analogous to panthenol — both support wound healing and barrier repair through fibroblast-mediated pathways.

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What "cica" means on product labels

The marketing term "cica" encompasses products that may contain:
Full centella asiatica extract (standardized or unstandardized)
Isolated asiaticoside alone
Isolated madecassoside alone
Combinations of the triterpenes
Centella leaf water / extract in varying concentrations

Quality indicators:
Look for "Centella asiatica extract" or specific triterpenes (asiaticoside, madecassoside) listed high in the ingredient list
"Centella asiatica" as ingredient #15 in a formula is likely too low-concentration to be biologically meaningful
Products listing standardized % (e.g., "standardized to 40% total triterpenes") provide clearer dosing information
CICA®-branded ingredients (used in some Korean pharmaceutical-grade products) are standardized

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How to use centella asiatica

For barrier repair and daily calming:
Cream, serum, or moisturizer format
AM and/or PM — no photosensitivity
Apply after cleansing and water-based serums, before or as the moisturizer step

For post-procedure recovery:
Apply 24–48 hours after procedures (laser, microneedling, chemical peel) once the skin is no longer open/weeping
Use generously; reapply throughout the day
Continue for 1–2 weeks post-procedure for maximum barrier support

For acne-prone skin:
Centella's anti-inflammatory effect addresses post-acne redness without irritating active lesions
Lightweight gel or fluid formats preferred over heavy occlusive creams for acne-prone skin

For sensitive or rosacea-prone skin:
Centella + niacinamide is one of the strongest evidence-backed combinations for barrier repair + anti-inflammatory support
Minimal irritation risk — one of the safest actives for reactive skin

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