Wound Healing and Scar Management
This is where centella has its deepest evidence base. Multiple RCTs and systematic reviews confirm it accelerates wound closure, improves scar quality and supports re-epithelialization. The active compounds asiaticoside and madecassoside work by activating the TGF-beta/Smad pathway. That pathway drives collagen deposition and extracellular matrix synthesis.
It has also been included in clinical recommendations for post-laser scar management. A study using 0.05% ECa 233 gel after laser resurfacing for acne scars showed significant improvement in erythema and wound appearance.
Centella cream applied to split-thickness skin graft donor sites was assessed using the Vancouver Scar Scale at 4, 8 and 12 weeks. Asiaticoside and madecassoside together induced collagen synthesis, fibroblast proliferation and improved scar outcomes versus placebo.
A PRISMA systematic review across four clinical trials found centella asiatica enhanced wound healing through improved angiogenesis, wound contraction, granulation and re-epithelialization. Improvements were documented in erythema scores, healing time and wound appearance.