German (Matricaria recutita), Roman (Chamaemelum nobile)
Two distinct plants are known as chamomile and are used interchangeably: German and Roman chamomile. Although distantly related botanically, they both look like miniature daisies and are traditionally thought to possess similar medicinal benefits.
Over a million cups of chamomile tea are drunk daily, testifying to its good taste, at least. Chamomile was used by early Egyptian physicians for fevers, and by ancient Greeks, Romans, and Indians for headaches and disorders of the kidneys, liver, and bladder.
The modern use of chamomile dates back to 1921, when a German firm introduced a topical form. This cream became a popular treatment for a wide variety of skin disorders, including eczema, bedsores, skin inflammation caused by radiation therapy, and contact dermatitis (eg, poison ivy).
Germany's Commission E authorizes the use of topical chamomile preparations for a variety of diseases of the skin and mouth.
Chamomile tea is also said to reduce mild tension and stress and to aid indigestion.
There is no reliable evidence that chamomile is effective for the treatment of any health condition.
A controlled study of 161 individuals found chamomile cream equally effective as 0.25% hydrocortisone cream for the treatment of eczema.1 However, this study did not use a placebo group, and does not appear to have been double-blind. For this reason, the results are not reliable. (For information on why double-blind studies are so important, see Why Does This Database Rely on Double-blind Studies?)
A study of 72 individuals with eczema found somewhat odd results: In this trial, chamomile was not significantly more effective than placebo, but both were better than 0.5% hydrocortisone cream.2 It is difficult to interpret what these paradoxical results actually mean, but they certainly cannot be taken as proof that chamomile cream is effective.
In a double-blind study, chamomile cream proved less effective for reducing inflammation of the skin than hydrocortisone cream or witch hazel cream.7
Finally, in a single-blind trial, 50 women receiving radiation therapy for breast cancer were treated with either chamomile or placebo.4 Chamomile failed to prove superior to placebo for preventing skin inflammation caused by the radiation therapy.
A double-blind, placebo-controlled trial of 164 individuals did not find chamomile mouthwash effective for treating the mouth sores caused by chemotherapy with the drug 5-FU.3
Chamomile cream is applied to the affected area 1 to 4 times daily.
Chamomile tea can be made by pouring boiling water over 2 to 3 heaping teaspoons of flowers and steeping for 10 minutes.
Chamomile tinctures and pills should be taken according to the directions on the label. Alcoholic tincture may be the most potent form for internal use.
Chamomile is listed on the FDA's GRAS (generally recognized as safe) list.
Reports that chamomile can cause severe reactions in people allergic to ragweed have received significant media attention. However, when all the evidence is examined, it does not appear that chamomile is actually more allergenic than any other plant.5 The cause of these reports may be products contaminated with "dog chamomile," a highly allergenic and bad-tasting plant of similar appearance.
Chamomile also contains naturally occurring coumarin compounds that might act as "blood thinners" under certain circumstances. There is one case report in which it appears that use of chamomile combined with the anticoagulant warfarin led to excessive "blood thinning," resulting in internal bleeding.8 Some evidence suggests that chamomile might interact with other medications as well through effects on drug metabolism, but the extent of this effect has not been fully determined.6
Safety in young children, pregnant or nursing women, or those with liver or kidney disease has not been established, although there have not been any credible reports of toxicity caused by this common beverage tea.
If you are taking blood-thinning medications such as warfarin (Coumadin), heparin, clopidogrel (Plavix), ticlopidine (Ticlid), or pentoxifylline (Trental), you should avoid using chamomile as it might increase their effect. This could potentially cause problems.
1. Aertgeerts P, Albring M, Klaschka F, et al. Comparison of Kamillosan cream (2 g ethanolic extract from chamomile flowers in 100 g cream) versus steroid (0.25% hydrocortisone, 0.75% fluocortin butyl ester) and non-steroid (5% bufexamac) external agents in the maintenance therapy of eczema [translated from German]. Z Hautkr. 1985;60:270-277.
2. Patzelt-Wenczler R, Ponce-Poschl E. Proof of efficacy of KamillosanŴ cream in atopic eczema. Eur J Med Res. 2000;5:171-175.
3. Fidler P, Loprinzi CL, O'Fallon JR, et al. Prospective evaluation of a chamomile mouthwash for prevention of 5-FU-induced oral mucositis. Cancer. 1996;77:522-525.
4. Maiche AG, Grohn P, Maki-Hokkonen H. Effect of chamomile cream and almond ointment on acute radiation skin reaction. Acta Oncol. 1991;30:395-396.
5. Schulz V, Hansel R, Tyler VE. Rational Phytotherapy: A Physicians' Guide to Herbal Medicine. 3rd ed. Berlin, Germany: Springer-Verlag; 1998:256.
6. Budzinski JW, Foster BC, Vandenhoek S, et al. An in vitro evaluation of human cytochrome P450 3A4 inhibition by selected commercial herbal extracts and tinctures. Phytomedicine. 2000;7:273-282.
7. Korting HC, Schafer-Korting M, Hart H, et al. Anti-inflammatory activity of hamamelis distillate applied topically to the skin. Influence of vehicle and dose. Eur J Clin Pharmacol. 1993;44:315-318.
8. Segal R, Pilote L. Warfarin interaction with Matricaria chamomilla. CMAJ. 2006;174:1281-1282. Canadian Medical Association Journal website. Available at: http://www.cmaj.ca/cgi/content/full/174/9/1281. Accessed April 28, 2006.
Last reviewed September 2014 by EBSCO CAM Review Board
Last Updated: 9/18/2014