Oral and Topical Centella asiatica in Type 2 Diabetes Mellitus Patients with Dry Skin: A Three‐Arm Prospective Randomized Double‐Blind Controlled Trial
Open accessAbstract
Introduction. Uncontrolled diabetes mellitus (DM) is related to skin disorders, particularly dry skin. Pathogenesis of dry skin in type 2 diabetes mellitus (T2DM) rises from the chronic hyperglycemia causing an increase in advanced glycation end-products (AGEs), proinflammatory cytokines, and oxidative stress. Combination of oral and topical Centella asiatica (CA) is expected to treat dry skin in T2DM patients more effectively through decreasing N(6)‐carboxymethyl‐lysine (CML) and interleukin‐1α (IL‐1α) and increasing superoxide dismutase (SOD) activity. Methods. A three‐arm prospective, double‐blind, randomized, controlled study was performed to evaluate the efficacy of the oral and topical CA extract in 159 T2DM patients with dry skin. The subjects were divided into the CA oral (CAo) 2 × 1.100 mg + CA topical (CAt) 1% ointment group, oral placebo (Plo) + CAt group, and Plo and topical placebo (Plt) group. Dry skin assessment was performed on day 1, 15, and 29, while evaluation of CML, IL‐1α, and SOD activity was on day 1 and 29. Result. Effectivity of CAo + CAt combination was assessed based on HbA1c and random blood glucose (RBG). In well‐controlled blood glucose, on day 29, the percentage of SRRC decrement was greater in the CAo + CAt group compared to the control group (p = 0.04). SCap value in the CAo + CAt group was greater than that in the control group (p = 0.01). In the partially controlled blood glucose, increment of SOD activity in the CAo + CAt group was greater than that in the control group (p = 0.01). There were medium‐to‐strong correlation between CML with SOD (r = 0.58, p < 0.05) and IL‐1α with SOD (r = 0.70, p < 0.05) in well‐controlled blood glucose. Systemic and topical adverse events were not significantly different between groups. Conclusion. CAo and CAt combination can be used to significantly improve dry skin condition through increasing SOD activity in T2DM patients with controlled blood glucose.
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Existing human intervention studies of oral Centella asiatica have often been constrained by small sample sizes, short intervention periods, or subjective outcome measures.
“While Centella asiatica has been extensively studied in topical formulations, randomized controlled trials evaluating oral supplementation remain limited, and existing human intervention studies have often been constrained by small sample sizes, short intervention periods, or subjective outcome measures [25,30,31,32].”
From A Randomized, Double-Blind, Placebo-Controlled Trial Assessing the Effects of Oral Centella asiatica Extract on Skin Aging-Related Parameters in Middle-Aged Korean Women. (2026) · cites this paper as [30]
This paper is a randomized human trial of oral Centella asiatica, so it supports the existence of such intervention research. The Results (§3.1) report 159 randomized patients, and Outcomes and Measurements (§2.7) describe assessments through day 29, including subjective scales but also instrument-based and laboratory measures. It does not establish that oral trials generally are limited or that existing studies have often had small samples or relied on subjective outcomes. (LLM, conf=0.82)
Experimental — accuracy not yet measuredLegiawati et al. reported that combined oral and topical administration of C. asiatica improved skin hydration and reduced pro-aging markers in patients with type 2 diabetes and dry skin.
“Legiawati et al. [24] reported that combined oral and topical administration of C. asiatica improved skin hydration and reduced pro-aging markers in patients with type 2 diabetes and dry skin.”
From Oral Centella asiatica Extract Attenuates UVB-Induced Skin Photoaging via Antioxidant, Anti-Inflammatory, and Extracellular Matrix-Preserving Effects in Hairless Mice (2025) · cites this paper as [24]
The Abstract’s Results report higher skin capacitance, a measure of hydration, with combined oral and topical Centella asiatica than with control in patients with well-controlled blood glucose. But Results §§3.3–3.4 report that CML and IL-1α were not reduced relative to the other groups; CML increased in the combination group. The claim’s reduction of pro-aging markers is therefore not supported. (LLM, conf=0.91)
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Centella asiatica and Its Metabolite Asiatic Acid: Wound Healing Effects and Therapeutic Potential
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- Authors
- Legiawati, L., Bramono, K., Indriatmi, W., Yunir, E., Setiati, S., Jusman, S. W. A., Purwaningsih, E. H., Wibowo, H., & Danarti, R.
- Affiliations
- University of Indonesia (ID)
- Universitas Gadjah Mada (ID)
- Corresponding author
- Legiawati, Lili
- ORCID
- Venue
- Evidence-Based Complementary and Alternative Medicine
- Publisher
- Wiley
- Published
- 2020-01
- Volume
- 2020
- Issue
- 1
- Pages
- 7253560-7253560
- ISSN
- 1741-427X (ISSN-L)
- 1741-4288
- PMC
- PMC7471832
- OpenAlex
- W3080167032
- Cited by
- 22
- References
- 22
- Citations by year
- 2026: 1 · 2025: 5 · 2024: 5 · 2023: 7 · 2021: 4
- FWCI
- 2.01
- Type
- journal article
- Language
- en
- Open access
- hybrid
- doi.org
- Locations
- Evidence-based Complementary and Alternative Medicine (publishedVersion, cc-by)
- PubMed Central (publishedVersion, cc-by)
- PubMed (publishedVersion)
- DOAJ (DOAJ: Directory of Open Access Journals) (submittedVersion, cc-by-sa)
- Funders
- Universitas Indonesia
- Topics
- Health Sciences › Medicine › Dermatology › Skin Diseases and Diabetes
- Health Sciences › Medicine › Dermatology › Skin Protection and Aging
- Health Sciences › Medicine › Endocrinology, Diabetes and Metabolism › Natural Antidiabetic Agents Studies
- Keywords
- Centella asiatica, type 2 diabetes, dry skin, advanced glycation end products, interleukin-1 alpha, superoxide dismutase, oxidative stress, glycemic control, HbA1c, skin hydration, anti-inflammatory activity, adverse events
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