Lithospermum erythrorhizon

botanical
Take on an empty stomach

What is it

Lithospermum erythrorhizon (zi cao, red gromwell) is a perennial herb native to East Asia. Its purplish-red root is used in Chinese medicine for inflammatory skin conditions, burns, and detoxification.

Evidence for 2 uses

AI-assisted evidence assessment — talk to your doctor before relying on any single supplement.

Wound healing / skin conditions (topical)

Limited

Topical shikonin preparations have shown benefit in small studies of burns and dermatitis.

Anti-inflammatory / anticancer (preclinical)

Mixed

Preclinical evidence only.

How it works

The root contains naphthoquinone pigments, primarily shikonin and its derivatives. Shikonin has shown anti-inflammatory, antimicrobial, anticancer, and wound-healing activity in preclinical studies. Mechanisms include inhibition of NF-kB, induction of apoptosis in cancer cells, and modulation of immune cell function. Shikonin-based ointments are used topically for skin conditions, with some clinical evidence for burn healing and dermatitis. Oral use is more limited and may carry hepatotoxicity concerns at higher doses.

Dosage

Topical: as directed in commercial preparations. Oral traditional Chinese medicine: 3-9 g of dried root per day in decoction.

When and how to take it

Topical: per product instructions. Oral: between meals if used.

2 commercial forms

Shikonin-containing ointment (zi cao gao)

Topical.

Traditional Chinese topical preparation.

Dried root extract (oral)

Variable.

Used in TCM decoctions.

Safety

Topical use is well tolerated. Oral use may cause hepatotoxicity at higher doses; pyrrolizidine-alkaloid contamination is a theoretical concern in some boraginaceous plants (though L. erythrorhizon is generally considered low-PA).

Who should be cautious

Avoid in pregnancy and breastfeeding. Caution in liver disease.

Interactions

Theoretical interactions with hepatotoxic medications.

Frequently asked questions

Is zi cao safe to take orally?⌄

Topical use is well-established; oral use carries some hepatotoxicity concerns.

What is shikonin?⌄

The main pigment in Lithospermum erythrorhizon root, responsible for color and most biological activity.

References

  • Lithospermum erythrorhizon on Wikidata — Wikidata link
  • Lithospermum erythrorhizon on NIH DSLD (US supplement label database) — NIH Dietary Supplement Label Database link
  • Research on Lithospermum erythrorhizon (PubMed search) — PubMed link

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Evidence-based·How we grade evidence

Disclaimer: These statements have not been evaluated by the FDA. This page is educational, not a substitute for personalized medical advice. Evidence grades are AI-assisted assessments — talk to your doctor before starting any new supplement, especially if you’re pregnant, breastfeeding, on medications, or managing a chronic condition.