Table of ContentsView AllTable of ContentsUsesSide EffectsPrecautionsDosageToxicityInteractionsHow to StoreSimilar SupplementsFrequently Asked QuestionsSources & What to Look For
Table of ContentsView All
View All
Table of Contents
Uses
Side Effects
Precautions
Dosage
Toxicity
Interactions
How to Store
Similar Supplements
Frequently Asked Questions
Sources & What to Look For
Comfrey cream is used to treat back pain, knee osteoarthritis, ankle sprains, bruises, and other injuries. It combines ingredients like oils or water and glyceryl stearate withSymphytum officinale(comfrey) extracts. Comfrey is an herb in theBoraginaceaefamily and has small purple flowers. It’s found in Europe, Asia, and North America.
In the United States, the Food and Drug Administration (FDA) does not regulate supplements the way it regulates prescription drugs. That means some supplement products may not contain what the label says. Whenchoosing a supplement, look for independently tested products and consult a healthcare provider, registered dietitian nutritionist (RD or RDN), or pharmacist.
Verywell / Anastasia Tretiak
Supplement Facts
Uses of Comfrey Cream
Comfrey has been used medicinally for at least 2,000 years for various conditions, includingbone fractures,ulcers, andgout.
Researchers have investigated the effects of comfrey cream on several health conditions. However, further, well-designed studies are needed. Here’s a look at research on comfrey cream for back pain, osteoarthritis, and ankle sprains.
Back Pain
One study of 379 patients with acute upper-or low-back pain used a topical combination of 35% comfrey root extract plus 1.2% methyl nicotinate versus a single preparation of methyl nicotinate orplacebocream. The dosage was a 12 cm layer of cream three times daily for five days. The combination that included the comfrey root demonstrated superiority to the two other treatment arms resulting in a reduction in pain for the majority of patients.
Further study is needed to confirm these results.
Osteoarthritis
Comfrey cream may help treatknee osteoarthritis, according to a Cochrane review of topical herbal therapies.The review included one study of 220 people with knee osteoarthritis, a degenerative wear-and-tear joint condition. The participants were assigned three weeks of treatment with 2 g of either comfrey ointment or a placebo three times a day. Those who used the comfrey ointment experienced improvements in pain, mobility, and quality of life.
Research exploring a variety of topical herbal therapies for treating osteoarthritis have also found comfrey to be among those effective when applied topically.
Ankle Sprains
Research has shown that comfrey cream may be helpful in the treatment ofankle sprains.
One study followed 142 patients with ankle sprains. One group used a cream with comfrey root fluid extract on the ankle while the others received a placebo. After eight days, the group that used the cream had significantly less pain than those who used the placebo.
Additional Uses
Comfrey has also been used for the following conditions:
There is currently not enough evidence to recommend comfrey cream for any of these uses.
What Are the Side Effects of Comfrey Cream?
Using a supplement like comfrey may have potential side effects. These side effects may be common or severe.
Common Side Effects
A review of 26 clinical trials concluded that mild skin reactions were the most common side effects of comfrey creams used in the studies.
Severe Side Effects
Comfrey containsPAs, substances that can cause significant damage, including:
Since these toxic substances can be absorbed through the skin, there’s concern about the safety of comfrey cream applied topically. It’s typically only used in small amounts for a very short period.
Expertssuggest not using comfrey cream for longer than 10 days in a row. Using it no more than four to six weeks a year as a general guideline would be best.
If you’re considering using the cream, consult your healthcare provider first. You and your healthcare provider should weigh the pros and cons and use it only under their supervision.
Don’t use comfrey products if you have or are at risk of having liver disease, cancer, or are taking any medication that affects the liver since it may increase the risk of liver toxicity.
Comfrey is not recommended for children under 3 years old, as it’s not been studied in that population.
Comfrey shouldn’t be used in any form during pregnancy or nursing due to the risk of liver damage to infants.
Recap
Dosage: How Much Comfrey Cream Should I Use?
Always speak with a healthcare provider before taking a supplement to ensure that the supplement and dosage are appropriate for your individual needs.
There is no daily recommended allowance for comfrey, sold in creams, ointments, gels, and salves. The following applications have been used in research:
What Happens If I Use Too Much Comfrey Cream?
Using large amounts of comfrey cream or using it for extended periods of time increases the risk of side effects like liver toxicity.
Because of the risk of liver toxicity, comfrey cream shouldn’t be used with other medicines that may also causeliver damage.
The most common over-the-counter medication that can be toxic to the liver is Tylenol (acetaminophen). Other prescription medicines that may harm the liver include:
Some supplements may also harm the liver, including:
It is essential to carefully read a supplement’s ingredients list and nutrition facts panel to learn which ingredients are in the product and how much of each ingredient is included. Please review this supplement label with your healthcare provider to discuss potential interactions with foods, other supplements, and medications.
How to Store Comfrey Cream
Store comfrey cream according to package instructions, typically at room temperature (between 68 and 77 degrees F) and out of reach of children and pets. Discard after a year or according to labeling.
Other herbal supplements that may have benefits for back pain include:
Some other supplements that may be useful for osteoarthritis are:
Frequently Asked QuestionsBack pain is often treated with medication such as over-the-counter pain relievers.Other alternative therapies may help to ease the pain. Undergoingmassageor taking upyogamay help alleviate pain and help people with back or joint problems function more easily.Acupuncturehas also shown solid evidence of benefit for back pain.And topical capsaicin cream may help to relieve pain temporarily.The plant leaves have a lower concentration of PAs than the roots. For this reason, some topical products are advertised as made from comfrey leaves, but it’s safest to choose a PA-free product.Although topical comfrey has been used for this indication, there’s little evidence that it helps and can pose a big risk for nursing babies. If your healthcare provider recommends it, make sure to use it on intact skin for a small amount of time, and be careful that infants do not ingest it.
Back pain is often treated with medication such as over-the-counter pain relievers.Other alternative therapies may help to ease the pain. Undergoingmassageor taking upyogamay help alleviate pain and help people with back or joint problems function more easily.Acupuncturehas also shown solid evidence of benefit for back pain.And topical capsaicin cream may help to relieve pain temporarily.
Back pain is often treated with medication such as over-the-counter pain relievers.
Other alternative therapies may help to ease the pain. Undergoingmassageor taking upyogamay help alleviate pain and help people with back or joint problems function more easily.
Acupuncturehas also shown solid evidence of benefit for back pain.
And topical capsaicin cream may help to relieve pain temporarily.
The plant leaves have a lower concentration of PAs than the roots. For this reason, some topical products are advertised as made from comfrey leaves, but it’s safest to choose a PA-free product.
Although topical comfrey has been used for this indication, there’s little evidence that it helps and can pose a big risk for nursing babies. If your healthcare provider recommends it, make sure to use it on intact skin for a small amount of time, and be careful that infants do not ingest it.
Sources of Comfrey & What to Look For
Food Sources of Comfrey
Some people ingest comfrey roots or leaves or use them in teas. This is not recommended due to the presence of chemicals that can cause organ damage and cancer.
Comfrey Supplements
For topical comfrey cream, look for products labeled as free of pyrrolizidine alkaloids.These have a lower risk of serious side effects like liver damage.
Summary
Comfrey cream, a topical herbal product, is thought to reduce inflammation and pain when applied to the skin. Researchers have found it does seem to reduce pain in some conditions, including back pain, osteoarthritis, and ankle sprains.
20 SourcesVerywell Health uses only high-quality sources, including peer-reviewed studies, to support the facts within our articles. Read oureditorial processto learn more about how we fact-check and keep our content accurate, reliable, and trustworthy.Salehi B, Sharopov F, Boyunegmez Tumer T, et al.Symphytumspecies: a comprehensive review on chemical composition, food applications and phytopharmacology.Molecules. 2019;24(12):2272. doi:10.3390/molecules24122272Avila C, Breakspear I, Hawrelak J, Salmond S, Evans S.A systematic review and quality assessment of case reports of adverse events for borage (Borago officinalis), coltsfoot (Tussilago farfara) and comfrey (Symphytum officinale).Fitoterapia. 2020;142:104519. doi:10.1016/j.fitote.2020.104519National Library of Medicine, National Institutes of Health.Comfrey.Drugs and Lactation Database, National Library of Medicine.Comfrey.Dubey A.Possibility and scope of transdermal comfrey multipurpose nano patch: for the treatment of broken bones, wounds and external ulcers.Pharm Pharmacol Int J. 2017;5(1):4. doi:10.15406/ppij.2017.05.00106Pabst H, Schaefer A, Staiger C, Junker-Samek M, Predel HG.Combination of comfrey root extract plus methyl nicotinate in patients with conditions of acute upper or low back pain: a multicentre randomised controlled trial.Phytother Res. 2013;27(6):811-817. doi:10.1002/ptr.4790Cameron M, Chrubasik S.Topical herbal therapies for treating osteoarthritis.Cochrane Database Syst Rev. 2013;5(5):CD010538. doi:10.1002/14651858.CD010538Adeneye AA.Subchronic and chronic toxicities of african medicinal plants. In:Toxicological Survey of African Medicinal Plants. Elsevier; 2014:99-133. doi:10.1016/B978-0-12-800018-2.00006-6Staiger, C.Comfrey root: from tradition to modern clinical trials.Wien Med Wochenschr.2013;163:58–64. doi:10.1007/s10354-012-0162-4Mei N, Chen T, Ning B, Guo L.Transcriptomic profiling for safety and toxicity evaluation of nutraceuticals. In:Nutraceuticals. Elsevier; 2021:299-313. doi:10.1016/B978-0-12-821038-3.00022-7Frost R, MacPherson H, O’Meara S.A critical scoping review of external uses of comfrey (Symphytum spp.).Complement Ther Med. 2013;21(6):724-745. doi:10.1016/j.ctim.2013.09.009Moreira R, Pereira DM, Valentão P, Andrade PB.Pyrrolizidine Alkaloids: Chemistry, pharmacology, toxicology and food safety.Int J Mol Sci. 2018;19(6):1668. doi:10.3390/ijms19061668National Library of Medicine, National Institutes of Health.LiverTox: clinical and research information on drug-induced liver injury.Kucera A, Barna M, Holcova S, Horacek O, Hladiková M, Ottillinger B.Tolerability and effectiveness of an antitrauma cream with comfrey herb extract in pediatric use with application on intact and on broken skin.Int J Pediatr Adolesc Med. 2018;5(4):135-141. doi:10.1016/j.ijpam.2018.11.002Medline Plus, National Library of Medicine.Drug-induced liver injury.Navarro VJ, Khan I, Björnsson E, Seeff LB, Serrano J, Hoofnagle JH.Liver injury from herbal and dietary supplements.Hepatology. 2017;65(1):363-373. doi:10.1002/hep.28813National Center for Complementary and Integrative Health.Complementary health approaches for chronic pain: what the science says.Vickers AJ, Vertosick EA, Lewith G, et al.Acupuncture for chronic pain: Update of an individual patient data meta-analysis.J Pain. 2018;19(5):455-474. doi:10.1016/j.jpain.2017.11.005Gagnier JJ, Oltean H, van Tulder MW, Berman BM, Bombardier C, Robbins CB.Herbal medicine for low back pain: A Cochrane review.Spine(Phila Pa 1976). 2016 Jan;41(2):116-33. doi:10.1097/01.brs.0000249525.70011.feNIH Office of Dietary Supplements.Dietary Supplements: What you need to know.
20 Sources
Verywell Health uses only high-quality sources, including peer-reviewed studies, to support the facts within our articles. Read oureditorial processto learn more about how we fact-check and keep our content accurate, reliable, and trustworthy.Salehi B, Sharopov F, Boyunegmez Tumer T, et al.Symphytumspecies: a comprehensive review on chemical composition, food applications and phytopharmacology.Molecules. 2019;24(12):2272. doi:10.3390/molecules24122272Avila C, Breakspear I, Hawrelak J, Salmond S, Evans S.A systematic review and quality assessment of case reports of adverse events for borage (Borago officinalis), coltsfoot (Tussilago farfara) and comfrey (Symphytum officinale).Fitoterapia. 2020;142:104519. doi:10.1016/j.fitote.2020.104519National Library of Medicine, National Institutes of Health.Comfrey.Drugs and Lactation Database, National Library of Medicine.Comfrey.Dubey A.Possibility and scope of transdermal comfrey multipurpose nano patch: for the treatment of broken bones, wounds and external ulcers.Pharm Pharmacol Int J. 2017;5(1):4. doi:10.15406/ppij.2017.05.00106Pabst H, Schaefer A, Staiger C, Junker-Samek M, Predel HG.Combination of comfrey root extract plus methyl nicotinate in patients with conditions of acute upper or low back pain: a multicentre randomised controlled trial.Phytother Res. 2013;27(6):811-817. doi:10.1002/ptr.4790Cameron M, Chrubasik S.Topical herbal therapies for treating osteoarthritis.Cochrane Database Syst Rev. 2013;5(5):CD010538. doi:10.1002/14651858.CD010538Adeneye AA.Subchronic and chronic toxicities of african medicinal plants. In:Toxicological Survey of African Medicinal Plants. Elsevier; 2014:99-133. doi:10.1016/B978-0-12-800018-2.00006-6Staiger, C.Comfrey root: from tradition to modern clinical trials.Wien Med Wochenschr.2013;163:58–64. doi:10.1007/s10354-012-0162-4Mei N, Chen T, Ning B, Guo L.Transcriptomic profiling for safety and toxicity evaluation of nutraceuticals. In:Nutraceuticals. Elsevier; 2021:299-313. doi:10.1016/B978-0-12-821038-3.00022-7Frost R, MacPherson H, O’Meara S.A critical scoping review of external uses of comfrey (Symphytum spp.).Complement Ther Med. 2013;21(6):724-745. doi:10.1016/j.ctim.2013.09.009Moreira R, Pereira DM, Valentão P, Andrade PB.Pyrrolizidine Alkaloids: Chemistry, pharmacology, toxicology and food safety.Int J Mol Sci. 2018;19(6):1668. doi:10.3390/ijms19061668National Library of Medicine, National Institutes of Health.LiverTox: clinical and research information on drug-induced liver injury.Kucera A, Barna M, Holcova S, Horacek O, Hladiková M, Ottillinger B.Tolerability and effectiveness of an antitrauma cream with comfrey herb extract in pediatric use with application on intact and on broken skin.Int J Pediatr Adolesc Med. 2018;5(4):135-141. doi:10.1016/j.ijpam.2018.11.002Medline Plus, National Library of Medicine.Drug-induced liver injury.Navarro VJ, Khan I, Björnsson E, Seeff LB, Serrano J, Hoofnagle JH.Liver injury from herbal and dietary supplements.Hepatology. 2017;65(1):363-373. doi:10.1002/hep.28813National Center for Complementary and Integrative Health.Complementary health approaches for chronic pain: what the science says.Vickers AJ, Vertosick EA, Lewith G, et al.Acupuncture for chronic pain: Update of an individual patient data meta-analysis.J Pain. 2018;19(5):455-474. doi:10.1016/j.jpain.2017.11.005Gagnier JJ, Oltean H, van Tulder MW, Berman BM, Bombardier C, Robbins CB.Herbal medicine for low back pain: A Cochrane review.Spine(Phila Pa 1976). 2016 Jan;41(2):116-33. doi:10.1097/01.brs.0000249525.70011.feNIH Office of Dietary Supplements.Dietary Supplements: What you need to know.
Verywell Health uses only high-quality sources, including peer-reviewed studies, to support the facts within our articles. Read oureditorial processto learn more about how we fact-check and keep our content accurate, reliable, and trustworthy.
Salehi B, Sharopov F, Boyunegmez Tumer T, et al.Symphytumspecies: a comprehensive review on chemical composition, food applications and phytopharmacology.Molecules. 2019;24(12):2272. doi:10.3390/molecules24122272Avila C, Breakspear I, Hawrelak J, Salmond S, Evans S.A systematic review and quality assessment of case reports of adverse events for borage (Borago officinalis), coltsfoot (Tussilago farfara) and comfrey (Symphytum officinale).Fitoterapia. 2020;142:104519. doi:10.1016/j.fitote.2020.104519National Library of Medicine, National Institutes of Health.Comfrey.Drugs and Lactation Database, National Library of Medicine.Comfrey.Dubey A.Possibility and scope of transdermal comfrey multipurpose nano patch: for the treatment of broken bones, wounds and external ulcers.Pharm Pharmacol Int J. 2017;5(1):4. doi:10.15406/ppij.2017.05.00106Pabst H, Schaefer A, Staiger C, Junker-Samek M, Predel HG.Combination of comfrey root extract plus methyl nicotinate in patients with conditions of acute upper or low back pain: a multicentre randomised controlled trial.Phytother Res. 2013;27(6):811-817. doi:10.1002/ptr.4790Cameron M, Chrubasik S.Topical herbal therapies for treating osteoarthritis.Cochrane Database Syst Rev. 2013;5(5):CD010538. doi:10.1002/14651858.CD010538Adeneye AA.Subchronic and chronic toxicities of african medicinal plants. In:Toxicological Survey of African Medicinal Plants. Elsevier; 2014:99-133. doi:10.1016/B978-0-12-800018-2.00006-6Staiger, C.Comfrey root: from tradition to modern clinical trials.Wien Med Wochenschr.2013;163:58–64. doi:10.1007/s10354-012-0162-4Mei N, Chen T, Ning B, Guo L.Transcriptomic profiling for safety and toxicity evaluation of nutraceuticals. In:Nutraceuticals. Elsevier; 2021:299-313. doi:10.1016/B978-0-12-821038-3.00022-7Frost R, MacPherson H, O’Meara S.A critical scoping review of external uses of comfrey (Symphytum spp.).Complement Ther Med. 2013;21(6):724-745. doi:10.1016/j.ctim.2013.09.009Moreira R, Pereira DM, Valentão P, Andrade PB.Pyrrolizidine Alkaloids: Chemistry, pharmacology, toxicology and food safety.Int J Mol Sci. 2018;19(6):1668. doi:10.3390/ijms19061668National Library of Medicine, National Institutes of Health.LiverTox: clinical and research information on drug-induced liver injury.Kucera A, Barna M, Holcova S, Horacek O, Hladiková M, Ottillinger B.Tolerability and effectiveness of an antitrauma cream with comfrey herb extract in pediatric use with application on intact and on broken skin.Int J Pediatr Adolesc Med. 2018;5(4):135-141. doi:10.1016/j.ijpam.2018.11.002Medline Plus, National Library of Medicine.Drug-induced liver injury.Navarro VJ, Khan I, Björnsson E, Seeff LB, Serrano J, Hoofnagle JH.Liver injury from herbal and dietary supplements.Hepatology. 2017;65(1):363-373. doi:10.1002/hep.28813National Center for Complementary and Integrative Health.Complementary health approaches for chronic pain: what the science says.Vickers AJ, Vertosick EA, Lewith G, et al.Acupuncture for chronic pain: Update of an individual patient data meta-analysis.J Pain. 2018;19(5):455-474. doi:10.1016/j.jpain.2017.11.005Gagnier JJ, Oltean H, van Tulder MW, Berman BM, Bombardier C, Robbins CB.Herbal medicine for low back pain: A Cochrane review.Spine(Phila Pa 1976). 2016 Jan;41(2):116-33. doi:10.1097/01.brs.0000249525.70011.feNIH Office of Dietary Supplements.Dietary Supplements: What you need to know.
Salehi B, Sharopov F, Boyunegmez Tumer T, et al.Symphytumspecies: a comprehensive review on chemical composition, food applications and phytopharmacology.Molecules. 2019;24(12):2272. doi:10.3390/molecules24122272
Avila C, Breakspear I, Hawrelak J, Salmond S, Evans S.A systematic review and quality assessment of case reports of adverse events for borage (Borago officinalis), coltsfoot (Tussilago farfara) and comfrey (Symphytum officinale).Fitoterapia. 2020;142:104519. doi:10.1016/j.fitote.2020.104519
National Library of Medicine, National Institutes of Health.Comfrey.
Drugs and Lactation Database, National Library of Medicine.Comfrey.
Dubey A.Possibility and scope of transdermal comfrey multipurpose nano patch: for the treatment of broken bones, wounds and external ulcers.Pharm Pharmacol Int J. 2017;5(1):4. doi:10.15406/ppij.2017.05.00106
Pabst H, Schaefer A, Staiger C, Junker-Samek M, Predel HG.Combination of comfrey root extract plus methyl nicotinate in patients with conditions of acute upper or low back pain: a multicentre randomised controlled trial.Phytother Res. 2013;27(6):811-817. doi:10.1002/ptr.4790
Cameron M, Chrubasik S.Topical herbal therapies for treating osteoarthritis.Cochrane Database Syst Rev. 2013;5(5):CD010538. doi:10.1002/14651858.CD010538
Adeneye AA.Subchronic and chronic toxicities of african medicinal plants. In:Toxicological Survey of African Medicinal Plants. Elsevier; 2014:99-133. doi:10.1016/B978-0-12-800018-2.00006-6
Staiger, C.Comfrey root: from tradition to modern clinical trials.Wien Med Wochenschr.2013;163:58–64. doi:10.1007/s10354-012-0162-4
Mei N, Chen T, Ning B, Guo L.Transcriptomic profiling for safety and toxicity evaluation of nutraceuticals. In:Nutraceuticals. Elsevier; 2021:299-313. doi:10.1016/B978-0-12-821038-3.00022-7
Frost R, MacPherson H, O’Meara S.A critical scoping review of external uses of comfrey (Symphytum spp.).Complement Ther Med. 2013;21(6):724-745. doi:10.1016/j.ctim.2013.09.009
Moreira R, Pereira DM, Valentão P, Andrade PB.Pyrrolizidine Alkaloids: Chemistry, pharmacology, toxicology and food safety.Int J Mol Sci. 2018;19(6):1668. doi:10.3390/ijms19061668
National Library of Medicine, National Institutes of Health.LiverTox: clinical and research information on drug-induced liver injury.
Kucera A, Barna M, Holcova S, Horacek O, Hladiková M, Ottillinger B.Tolerability and effectiveness of an antitrauma cream with comfrey herb extract in pediatric use with application on intact and on broken skin.Int J Pediatr Adolesc Med. 2018;5(4):135-141. doi:10.1016/j.ijpam.2018.11.002
Medline Plus, National Library of Medicine.Drug-induced liver injury.
Navarro VJ, Khan I, Björnsson E, Seeff LB, Serrano J, Hoofnagle JH.Liver injury from herbal and dietary supplements.Hepatology. 2017;65(1):363-373. doi:10.1002/hep.28813
National Center for Complementary and Integrative Health.Complementary health approaches for chronic pain: what the science says.
Vickers AJ, Vertosick EA, Lewith G, et al.Acupuncture for chronic pain: Update of an individual patient data meta-analysis.J Pain. 2018;19(5):455-474. doi:10.1016/j.jpain.2017.11.005
Gagnier JJ, Oltean H, van Tulder MW, Berman BM, Bombardier C, Robbins CB.Herbal medicine for low back pain: A Cochrane review.Spine(Phila Pa 1976). 2016 Jan;41(2):116-33. doi:10.1097/01.brs.0000249525.70011.fe
NIH Office of Dietary Supplements.Dietary Supplements: What you need to know.
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