Myrrh

Western herbal medicine classes myrrh as an antiseptic, astringent, vulnerary and emmenagogue, with a particular affinity for mucous membranes. The classic indications are gingivitis, spongy or bleeding gums, mouth ulcers, sore throat, and indolent or slow-healing wounds and ulcers.

It was also used to bring on delayed or scanty menstruation, for digestive complaints such as dyspepsia and loss of appetite, and as an expectorant for catarrh and bronchitis ^{39Reference 39Orwa et al. · 2009Commiphora myrrha — botanic description, ecology, biophysical limits, native range and products — tree databaseView study →}. It is a traditional ingredient of tooth powders and mouthwashes ^{39Reference 39Orwa et al. · 2009Commiphora myrrha — botanic description, ecology, biophysical limits, native range and products — tree databaseView study →}.

In Chinese medicine myrrh is Mo Yao, a blood-moving and pain-relieving herb. It is almost always prescribed with frankincense (Ru Xiang) for traumatic injury, swelling, bruising, sores, and painful absent menstruation ^{35Reference 35Cao B et al. · 2019ReviewSeeing the unseen of the combination of two natural resins, frankincense and myrrh — reviewView study →}.

Myrrh is one of the oldest recorded medicines, and it was used extensively in ancient Egypt ^{40Reference 40FernFern, K. (n.d.). Commiphora myrrha — habit, range, habitat, wild harvest and uses — plant database. Useful Tropical Plants Database. https://tropical.theferns.info/viewtropical.php?id=Commiphora+myrrhaView study →}. Its scent has been used since antiquity as an aid to prayer and meditation ^{39Reference 39Orwa et al. · 2009Commiphora myrrha — botanic description, ecology, biophysical limits, native range and products — tree databaseView study →}.

A 2026 systematic review and meta-analysis of periodontal and gingival healing pooled 15 studies (eight RCTs, six in vitro, one animal) and found myrrh improves gingival and plaque indices and reduces post-surgical swelling and redness as an adjunct, though certainty was graded low-to-moderate and preparations varied widely ^{7Reference 7Alnakhli RA et al. · 2026Meta-analysisMyrrh in the management of periodontal disease and gingival healing — systematic review and meta-analysisView study →}.

In a double-blind vehicle-controlled trial in recurrent aphthous stomatitis (n=90), a 0.5% myrrh mucoadhesive gel produced the greatest pain reduction of the arms tested by day 6 ^{8Reference 8Mansour et al. · 2014RCTClinical efficacy of aloe vera- and myrrh-based oral mucoadhesive gels in minor recurrent aphthous stomatitis — randomised, double-blind, vehicle-controlled trialView study →}.

Myrrh mouthwash accelerated wound healing after tooth extraction (reduced edema, tenderness, socket size) ^{9Reference 9Eid RAA · 2021Clinical trialEfficacy of myrrh mouthwash on wound healing after tooth extraction — controlled clinical trialView study →} and matched chlorhexidine for early soft-tissue healing after implant placement ^{10,11Reference 10Ibraheem WI et al. · 2022RCTSoft tissue healing after implant placement using myrrh vs chlorhexidine mouthwash — randomised controlled trialView study →Reference 11Casarin M et al. · 2023Systematic reviewEffect of mouthwashes on gingival healing after surgical procedures — systematic reviewView study →}.

Beyond the mouth, a myrrh sitz-bath outperformed frankincense and povidone-iodine for episiotomy healing on the REEDA scale in an RCT of 90 primiparous women ^{12Reference 12Faraji A et al. · 2021RCTEpisiotomy wound healing by Commiphora myrrha and Boswellia carteri in primiparous women — randomised controlled trialView study →}, and a small retrospective cohort reported faster healing after hemorrhoidectomy — but with more complications in the self-treating myrrh group ^{13Reference 13Al Amri FS · 2024ObservationalMyrrh sitz bath for wound healing after haemorrhoidectomy — retrospective cohort studyView study →}.

In rodents, resin extracts raise circulating leukocytes and support the proliferative phase of repair ^{24Reference 24Haffor AS · 2010AnimalEffect of myrrh (Commiphora molmol) on leukocyte levels during healing from gastric ulcer or skin injury — rat modelView study →}.

The trials are small, short, and heterogeneous in preparation — gels, rinses and sitz-baths at different concentrations, several inside combination products — and the optimal form and dose are unsettled.

Sesquiterpene fractions of the resin, principally furanoeudesma-1,3-diene, produce analgesia in mice that is blocked by the opioid antagonist naloxone, implicating opioid receptor engagement ^{1Reference 1Dolara et al. · 1996AnimalAnalgesic effects of myrrh — animal model, opioid mechanismView study →}.

Ethanolic and petroleum-ether extracts of C. myrrha are analgesic in the hot-plate and acetic-acid writhing tests and anti-inflammatory in formalin-induced paw edema, with the activity concentrated in the terpene-rich lipophilic fraction ^{2,3Reference 2Su et al. · 2011AnimalAnti-inflammatory and analgesic activity of different extracts of Commiphora myrrha — mouse modelView study →Reference 3Shalaby et al. · 2014AnimalAnalgesic, anti-inflammatory and anti-hyperlipidemic activities of Commiphora molmol extract (myrrh) — rat/mouse modelView study →}.

In humans, a placebo-controlled pilot of MyrLiq — a C. myrrha extract standardized to furanodienes (curzerene, furanoeudesma-1,3-diene, lindestrene) — reported pain relief across headache, joint, muscle, lower-back and menstrual pain at 200–400 mg/day over 20 days ^{4Reference 4Germano et al. · 2017RCTA pilot study on bioactive constituents and analgesic effects of MyrLiq, a Commiphora myrrha extract with high furanodiene content — placebo-controlled human pilotView study →}.

An aqueous extract also reduced paclitaxel-induced neuropathic pain in mice, partly via TRPV1 and Nrf2 signaling ^{5Reference 5Alhijjaj et al. · 2023AnimalAn aqueous Commiphora myrrha extract ameliorates paclitaxel-induced peripheral neuropathic pain — mouse modelView study →}, and a frankincense–myrrh combination raised pain tolerance in a rat cystitis model ^{6Reference 6Chen et al. · 2020In vitroEfficacy of frankincense and myrrha in treatment of acute interstitial cystitis/painful bladder syndrome — rat model and in vitroView study →}.

Gap: the human evidence is a single unreplicated pilot with subjective endpoints and a sex-dependent dose response; the strongest data remain rodent, and effects are tied to lipophilic furanodiene-rich extracts rather than aqueous tinctures.

C. myrrha extracts suppress formalin-induced paw edema and lower tissue PGE₂ in rodents ^{2,3Reference 2Su et al. · 2011AnimalAnti-inflammatory and analgesic activity of different extracts of Commiphora myrrha — mouse modelView study →Reference 3Shalaby et al. · 2014AnimalAnalgesic, anti-inflammatory and anti-hyperlipidemic activities of Commiphora molmol extract (myrrh) — rat/mouse modelView study →}.

The mechanism converges on NF-κB and COX-2 downregulation: myrrh reduces COX-2 in gastric-cancer models ^{16Reference 16Sun M et al. · 2020In vitroMyrrh induces apoptosis and inhibits proliferation and migration of gastric cancer cells via COX-2 downregulation — in vitro and mouse xenograftView study →} and blunts TLR4/NF-κB signaling with reduced TNF-α, IL-1β and IL-6 in a renal ischemia–reperfusion model ^{23Reference 23Younis NS · 2023AnimalMyrrh essential oil mitigates renal ischemia/reperfusion-induced injury — rat modelView study →}.

A resin water-extract and its polysaccharide fraction inhibit RANKL-induced osteoclastogenesis and reduce ovariectomy-induced bone loss in rats ^{25Reference 25Hwang YH et al. · 2021In vitroAnti-osteoporotic effects of Commiphora myrrha and its polysaccharide via osteoclastogenesis inhibition — rat model and in vitroView study →}.

In humans, a myrrh–chamomile–coffee-charcoal formula was non-inferior to mesalazine for maintaining remission in ulcerative colitis over 12 months ^{37Reference 37Langhorst et al. · 2013RCTRandomised clinical trial: a herbal preparation of myrrh, chamomile and coffee charcoal compared with mesalazine in maintaining remission in ulcerative colitis — double-blind, double-dummy studyView study →}, but myrrh’s individual contribution can’t be isolated from the combination. The mechanistic work uses extracts and essential oils that don’t map directly onto traditional tincture dosing.

Ethanolic C. molmol extract inhibited the periodontal pathogens Porphyromonas gingivalis, Tannerella forsythia, Treponema denticola and Aggregatibacter actinomycetemcomitans, and acted synergistically with amoxicillin, metronidazole, tetracycline and azithromycin ^{14Reference 14Abullais Saquib S et al. · 2021In vitroSynergistic antibacterial activity of herbal extracts with antibiotics on periodontitis bacteria — in vitroView study →}.

GC-MS-profiled essential oils show antibacterial and larvicidal activity attributed to the furanosesquiterpene and germacrane terpenoid fractions ^{15Reference 15Alanazi NAH et al. · 2024In vitroGas chromatography–mass spectrometry chemical profiling of myrrh essential oil and antimicrobial activity — in vitroView study →}.

Antimicrobial activity may contribute to the periodontal healing outcomes in the clinical meta-analysis ^{7Reference 7Alnakhli RA et al. · 2026Meta-analysisMyrrh in the management of periodontal disease and gingival healing — systematic review and meta-analysisView study →}.

Activity is largely in vitro, concentration- and essential-oil-dependent, and often weaker than reference antiseptics, with no human data on systemic antimicrobial use.

In ethanol-induced gastric ulceration in rats, myrrh extract (better than the oil) restored the Nrf2 axis — raising glutathione and lowering malondialdehyde — and improved mucosal healing ^{21Reference 21Lebda MA et al. · 2021AnimalCommiphora myrrh supplementation protects and cures ethanol-induced oxidative gastric ulceration — rat modelView study →}.

It protected against methotrexate-induced nephrotoxicity by upregulating Nrf2/ARE/HO-1 signaling and scavenged DPPH, superoxide and nitric-oxide radicals in vitro ^{22Reference 22Mahmoud AM et al. · 2018In vitroCommiphora molmol protects against methotrexate-induced nephrotoxicity via Nrf2/ARE/HO-1 — rat model and in vitroView study →}, and mitigated renal ischemia–reperfusion injury by raising SOD, CAT and GPx while lowering lipid peroxidation ^{23Reference 23Younis NS · 2023AnimalMyrrh essential oil mitigates renal ischemia/reperfusion-induced injury — rat modelView study →}.

Direct radical-scavenging potency data are stronger for other Commiphora species than for C. myrrha itself, and all organ-protection findings are rodent models with no human confirmation.

Two furano-sesquiterpenoids from the resin — 2-methoxyfuranodiene and 2-acetoxyfuranodiene — were highly cytotoxic to HepG2 liver and MCF-7 breast cells (IC₅₀ ≈ 3.6–4.4 µM), inducing apoptosis and cell-cycle arrest, with anti-angiogenic activity in zebrafish ^{17Reference 17S Alqahtani A et al. · 2020In vitroCytotoxic evaluation and anti-angiogenic effects of two furano-sesquiterpenoids from Commiphora myrrh resin — in vitro and zebrafishView study →}.

Myrrh triterpenes are moderately cytotoxic to HeLa cervical cells ^{18Reference 18Kuck K et al. · 2023In vitroTerpenoids from myrrh and their cytotoxic activity against HeLa cells — in vitroView study →}, and C. myrrha essential oil is active against skin-cancer lines ^{19Reference 19Ulrich J et al. · 2022In vitroPhytochemical composition of Commiphora oleogum resins and cytotoxicity against skin cancer cells — in vitroView study →}.

Whole myrrh downregulated COX-2 and Bcl-2 while raising Bax to induce apoptosis in gastric-cancer cells and slowed tumor growth in a mouse xenograft ^{16Reference 16Sun M et al. · 2020In vitroMyrrh induces apoptosis and inhibits proliferation and migration of gastric cancer cells via COX-2 downregulation — in vitro and mouse xenograftView study →}.

A network-pharmacology analysis proposes multiple candidate targets in breast cancer ^{20Reference 20Shams A et al. · 2024The multifaceted roles of myrrha in the treatment of breast cancer: potential targets — network pharmacology (in silico)View study →}.

Gap: no human or even whole-animal efficacy beyond a single xenograft; effects are cell-line specific and driven by purified compounds at concentrations far above what tinctures deliver.

The one placebo-controlled human trial testing a myrrh-containing product used a three-herb capsule (Terminalia chebula + C. mukul + C. myrrha) and reported lower fasting glucose, total and LDL cholesterol with higher HDL in hyperlipidemic diabetic women ^{26Reference 26Shokoohi R et al. · 2017RCTEffects of an herbal combination (Terminalia chebula, Commiphora mukul, Commiphora myrrha) on glycemic control and lipid profile in diabetic women — randomised, double-blind, placebo-controlled trialView study →}. C. mukul (guggul) is the constituent with the established lipid-modifying pharmacology, and myrrh’s contribution can’t be separated. A rodent study of C. molmol extract found modest anti-hyperlipidemic effects on a high-fat diet ^{3Reference 3Shalaby et al. · 2014AnimalAnalgesic, anti-inflammatory and anti-hyperlipidemic activities of Commiphora molmol extract (myrrh) — rat/mouse modelView study →}.

Gap: no trial has tested C. myrrha alone for glucose or lipids; the human signal belongs to a guggul-containing combination, so attributing it to myrrh is unjustified.

A myrrh oleo-resin product (Mirazid) was marketed in Egypt from 2001 as an antischistosomal, and early open-label Egyptian studies reported high cure rates ^{38Reference 38Soliman OE et al. · 2004Evaluation of myrrh (Mirazid) therapy in fascioliasis and intestinal schistosomiasis in children — open-label parasitological/immunological studyView study →}.

Randomized and controlled evaluations found it largely ineffective: a randomized comparison against praziquantel reported a Mirazid cure rate of only 8.9% versus ~76% for praziquantel ^{27Reference 27Barakat et al. · 2005RCTEfficacy of myrrh (Mirazid) in the treatment of human Schistosomiasis mansoni — randomised controlled trialView study →}, and a dose-controlled study found negligible egg-count reduction against both schistosomiasis and fascioliasis ^{28Reference 28Osman MM et al. · 2010Clinical trialIneffectiveness of the myrrh-derivative Mirazid against schistosomiasis and fascioliasis in humans — clinical studyView study →}.

The Cochrane review of drugs for S. mansoni provides no support for myrrh over praziquantel ^{29Reference 29Danso-Appiah A et al. · 2013Meta-analysisDrugs for treating Schistosoma mansoni infection — Cochrane systematic review and meta-analysisView study →}.

Gap: the positive early reports came from methodologically weak studies; the better-controlled human trials are consistently negative, and myrrh should not be relied on for parasitic infection.

Tolerability. The short-term human trials reported no serious drug-related adverse effects for mouthwashes, gels and sitz baths, or for oral capsules of 500 mg three times daily over two weeks ^{12,36Reference 12Faraji A et al. · 2021RCTEpisiotomy wound healing by Commiphora myrrha and Boswellia carteri in primiparous women — randomised controlled trialView study →Reference 36Vafaei H et al. · 2020RCTEfficacy and safety of myrrh in patients with incomplete abortion — randomised, double-blind, placebo-controlled clinical studyView study →}.

Drug-metabolising enzymes. An aqueous myrrh resin extract raised CYP2C9 in liver cells by activating the pregnane X receptor ^{33Reference 33Alsharidah A et al. · 2025In vitroCommiphora myrrha resin extract modulates CYP2C9 expression via Pregnane X receptor binding — in vitro (HepG2) and in silicoView study →}. Water extracts made in the manner of a traditional decoction and maceration also raised the expression of CYP2C8, CYP2C19 and CYP3A4 in the same liver-cell line ^{42Reference 42Alehaideb et al. · 2021In vitroCommiphora myrrha (Nees) Engl. resin extracts induce phase-I cytochrome P450 2C8, 2C9, 2C19, and 3A4 isoenzyme expressions in human hepatocellular carcinoma (HepG2) cells — in vitro (HepG2)View study →}.

This could lower blood levels of drugs cleared by these enzymes, such as warfarin, sulfonylureas and phenytoin. No animal or human interaction study has been done, and transporters have not been assessed.

Essential oil. Myrrh essential oil was genotoxic in micronucleus and comet assays in human lymphocytes only at the highest concentration tested, and it was not mutagenic in the Ames test ^{32Reference 32Abdelsalam AH · 2022In vitroIn vitro cytogenotoxic and mutagenic effects of Commiphora myrrha essential oil — in vitroView study →}. The finding concerns the concentrated oil rather than dilute preparations.

Surgical wounds. In a retrospective post-hemorrhoidectomy cohort, the self-treating myrrh group healed faster but recorded more complications ^{13Reference 13Al Amri FS · 2024ObservationalMyrrh sitz bath for wound healing after haemorrhoidectomy — retrospective cohort studyView study →}.