Plantain

In Western herbal medicine plantain leaf is a vulnerary, demulcent, anti-inflammatory and drawing herb.

Its traditional indications include wounds, insect bites, skin irritation, splinters, boils, sore throat, reflux, coughs and inflammatory digestive complaints. It was also used for chronic inflammatory skin conditions and irritated mucous membranes.

Folk medicine across Europe and North America used plantain for wounds, infections, insect bites, burns and inflammation.

The fresh leaves were often chewed and applied straight to a bite or injury. Because the plant grows almost everywhere people do, it was one of the most familiar first-aid plants in rural medicine.

In traditional Persian medicine, Plantago major is used to treat stomach and intestinal ulcers and bleeding ^{12Reference 12Farid A et al. · 2022AnimalEvaluation of anti-inflammatory effects of leaf and seed extracts of Plantago major on acetic acid-induced ulcerative colitis in ratsView study →}.

In Türkiye, the subspecies P. major subsp. intermedia is used for wounds, abscesses, constipation, pain, ulcers, haemorrhoids and gynaecological complaints ^{14Reference 14Bacanak H et al. · 2026In vitroPhytochemical investigation and evaluation of anti-inflammatory and wound-healing activities of Plantago major subsp. intermedia — in vitro / animal modelView study →}.

In Taiwan, P. major and the related P. asiatica are folk remedies for infections of the respiratory, urinary and digestive tracts ^{31Reference 31Chiang LC et al. · 2003In vitroIn vitro cytotoxic, antiviral and immunomodulatory effects of Plantago major and Plantago asiaticaView study →}.

Small human trials of topical leaf preparations report benefit. A triple-blind randomised trial in 130 patients with stage-1 pressure ulcers found better healing with a quercetin-standardised P. major formulation ^{1Reference 1Ghiasian M et al. · 2021RCTClinical and phytochemical studies of Plantago major in pressure ulcer treatment: A randomized controlled trialView study →}.

An open-label randomised trial found a 10% leaf-extract gel sped the healing of diabetic foot and pressure ulcers: 64% of patients healed completely, against 20% with the comparison dressing ^{2Reference 2Ghanadian M et al. · 2024RCTThe effect of Plantago major hydroalcoholic extract on the healing of diabetic foot and pressure ulcers — randomised controlled trialView study →}.

A combination Aloe vera and P. major gel outperformed a placebo gel in 40 patients with diabetic foot ulcers ^{3Reference 3Najafian Y et al. · 2019RCTEfficacy of Aloe vera/Plantago major gel in diabetic foot ulcer: a randomized double-blind clinical trialView study →}.

In a case-control study of 15 patients with second-degree burns, a 10% ointment healed wounds in a similar time to silver sulfadiazine (11.7 against 13 days), with similar pain relief and infection control ^{4Reference 4Keshavarzi A et al. · 2022ObservationalTherapeutic efficacy of great plantain (Plantago major L.) in the treatment of second-degree burn wounds: a case-control studyView study →}.

A systematic review of four animal wound studies was more cautious. The best wound contraction came from 10–50% preparations, but every study carried a high risk of bias, and the review found no firm evidence of effect ^{5Reference 5Cardoso FCI et al. · 2021Systematic reviewThe effect of Plantago major on wound healing in preclinical studies: a systematic review — animal models, insufficient evidence, all at high risk of biasView study →}.

In rats, a gel of 5% plantain and 5% aloe increased fibroblast numbers, collagen and new blood vessels in skin wounds ^{6Reference 6Ashkani-Esfahani S et al. · 2019AnimalThe healing effect of Plantago major and Aloe vera mixture in excisional full-thickness skin wounds: stereological study — rat, in vivoView study →}. In cultured fibroblasts, a microencapsulated leaf infusion increased collagen I and III and sped scratch-wound closure ^{7Reference 7Bâldea I et al. · 2023In vitroAntioxidant, anti-inflammatory effects and ability to stimulate wound healing of a common-plantain extract in alginate gel formulations — in vitroView study →}.

Results are not uniform: in rats with mouth wounds, none of the nano-emulsified extracts sped overall healing ^{8Reference 8Jahanimoghadam F et al. · 2024AnimalThe healing effect of nano-emulsified Plantago major L. extract on oral wounds in a Wistar rat modelView study →}.

Gap: human trials are small (n≈15–130), several open-label or combination products, and preparations differ (gel, ointment, syrup, dressing), so no standard topical formulation or dose is established.

In rats, a dichloromethane extract of P. major and its two hexane fractions reduced carrageenan paw swelling by about 47–56% at 560 mg/kg, and reduced leukocyte migration in mice ^{10Reference 10Triastuti A et al. · 2022AnimalIn vivo anti-inflammatory activities of Plantago major extract and fractions — rat/mouse, in vivoView study →}. The fatty acids oleic, linoleic and palmitic acid were identified as possible active compounds ^{10Reference 10Triastuti A et al. · 2022AnimalIn vivo anti-inflammatory activities of Plantago major extract and fractions — rat/mouse, in vivoView study →}.

In rats with adjuvant arthritis, a hexane-insoluble fraction reduced paw swelling, the arthritis score and TNF-α and IL-6 ^{11Reference 11Triastuti A et al. · 2022AnimalAnti-rheumatoid activity of a hexane-insoluble fraction from Plantago major in female Wistar ratsView study →}.

In rats with acetic-acid colitis, a high dose of leaf extract given by injection lowered the ulcer index and tissue IL-6, TNF-α, PGE₂, IL-1β, MPO and MDA. The seed extract gave only modest protection ^{12Reference 12Farid A et al. · 2022AnimalEvaluation of anti-inflammatory effects of leaf and seed extracts of Plantago major on acetic acid-induced ulcerative colitis in ratsView study →}.

In vitro, a leaf extract inhibited snake-venom phospholipase A₂ by about 45% ^{13Reference 13Yarleque-Chocas M et al. · 2023In vitroIn vitro anti-inflammatory activity of Plantago major L. on phospholipase A₂ from snake venomView study →}. Compounds isolated from P. major subsp. intermedia, among them aucubin, acteoside and martynoside, inhibited nitric-oxide production in cells ^{14Reference 14Bacanak H et al. · 2026In vitroPhytochemical investigation and evaluation of anti-inflammatory and wound-healing activities of Plantago major subsp. intermedia — in vitro / animal modelView study →}.

There is no standalone human anti-inflammatory trial, and the active animal doses (hundreds of mg/kg of concentrated fractions) are far above what a leaf tea or tincture delivers.

A double-blind, placebo-controlled trial in 46 patients having radiotherapy for head and neck cancer found that P. major syrup, taken for 7 weeks, significantly reduced both the severity of mucositis and pain ^{15Reference 15Soltani GM et al. · 2020RCTEfficacy of Plantago major L. syrup on radiation-induced oral mucositis in head-and-neck cancer patients: a randomized, double-blind, placebo-controlled trialView study →}.

A randomised triple-blind trial in 50 chemotherapy patients compared a P. major extract rinse with chlorhexidine 0.12% and with extra sodium bicarbonate. The plantain rinse was no better than either, and the authors suggested reconsidering its use ^{16Reference 16Cabrera-Jaime S et al. · 2018RCTEfficacy of Plantago major, chlorhexidine 0.12% and sodium bicarbonate 5% in oral mucositis in cancer patients: a randomised triple-blind phase III trialView study →}.

Two systematic reviews of natural products for mucositis from cancer treatment include plantain among the agents that reduced severity ^{17,18Reference 17Pranadwista ZF · 2023Systematic reviewEffectiveness of natural-based products for radiation-induced oral mucositis therapy: a systematic reviewView study →Reference 18Wen S et al. · 2023Systematic reviewUpdate on the treatment of chemotherapy- and radiotherapy-induced buccal mucositis: a systematic reviewView study →}.

The trials are small and use non-standardised syrups and rinses.

Plantain leaf is antioxidant in vitro, in line with its polyphenol, flavonoid and phenylpropanoid content. Hydroalcoholic extracts of both P. major and P. lanceolata showed considerable antioxidant capacity, with plantamajoside and acteoside the most abundant non-volatile constituents ^{20Reference 20Laanet PR et al. · 2024In vitroPlantago major and Plantago lanceolata exhibit antioxidant and Borrelia burgdorferi-inhibiting activities — in vitroView study →}.

In rats with testicular torsion, a leaf extract given by injection (50 or 100 mg/kg) prevented the rise in lipid peroxidation and limited tissue damage after the blood supply was restored ^{19Reference 19Moradi-Ozarlou M et al. · 2020AnimalAntioxidant property of Plantago major leaf extracts reduces testicular torsion/detorsion-induced ischemia/reperfusion injury in ratsView study →}.

A microencapsulated leaf infusion also had antioxidant effects in fibroblast cultures ^{7Reference 7Bâldea I et al. · 2023In vitroAntioxidant, anti-inflammatory effects and ability to stimulate wound healing of a common-plantain extract in alginate gel formulations — in vitroView study →}.

These readouts are almost entirely chemical or cell-based — there is no human biomarker trial, and whole-herb dosing to a meaningful systemic antioxidant effect is unquantified.

Leaf extracts show broad but moderate antimicrobial activity in vitro. An ethanolic leaf extract produced inhibition zones of 9.9–22.2 mm, growing with concentration, against drug-resistant Pseudomonas aeruginosa from burn wounds ^{21Reference 21Turki Monawer A · 2023In vitroAntibacterial activity of ethanolic extracts of Plantago major leaves against Pseudomonas aeruginosa from burn infections — in vitroView study →}. Against the tooth-decay bacterium Streptococcus mutans, an extract gave zones of about 10 mm, smaller than chlorhexidine’s 15 mm ^{22Reference 22Souza HMM et al. · 2026In vitroAntimicrobial effect of Plantago major extract against Streptococcus mutans in dental caries formation — in vitroView study →}.

A dichloromethane root extract inhibited Salmonella paratyphi, with a lowest inhibitory concentration of 1.5 mg/mL ^{23Reference 23Rahamouz-Haghighi S · 2025In vitroSeparation of crude methanol extract of Plantago major root: phytochemicals and biological activities — in vitroView study →}.

Extracts of P. major and P. lanceolata cut the viability of stationary-phase Borrelia burgdorferi, the Lyme disease bacterium, to as low as 15%, and the leaf extracts reduced biofilm formation by 30% ^{20Reference 20Laanet PR et al. · 2024In vitroPlantago major and Plantago lanceolata exhibit antioxidant and Borrelia burgdorferi-inhibiting activities — in vitroView study →}.

A review catalogues antibacterial, antiviral and antifungal activity across P. major preparations ^{24Reference 24Zhakipbekov K et al. · 2023ReviewAntimicrobial and other biomedical properties of extracts from Plantago major — reviewView study →}.

All of it is in vitro with modest potency (MICs in the mg/mL range for crude extracts); no clinical antimicrobial use is validated.

The liver findings rest on the iridoid aucubin, which plantain leaf contains but which has been studied chiefly as an isolated compound. Aucubin blocked hepatic stellate-cell activation through the Nrf2/Smad7 axis and eased carbon-tetrachloride liver fibrosis in mice ^{25Reference 25Shi X et al. · 2023In vitroAucubin inhibits hepatic stellate cell activation through stimulating the Nrf2/Smad7 axis — mouse, in vivo / in vitroView study →}. It also protected against LPS-induced acute hepatitis ^{26Reference 26Huang H et al. · 2022In vitroAucubin as a natural potential anti-acute-hepatitis candidate: inhibitory potency and hepatoprotective mechanism — mouse, in vivo / in vitroView study →}.

A review of aucubin’s pharmacology and toxicology confirms its anti-fibrotic and liver-protective profile and notes its poor oral bioavailability in rats ^{27Reference 27Zeng X et al. · 2020ReviewA review of the pharmacology and toxicology of aucubinView study →}.

The only human liver trial used P. major seed. In a double-blind trial in 74 people with non-alcoholic fatty liver disease, 2 g of seed taken twice daily for 12 weeks lowered ALT, AST and triglycerides against placebo ^{28Reference 28Jazayeri SF et al. · 2021RCTThe efficacy of Plantago major seed on liver enzymes in non-alcoholic fatty liver disease: a randomized double-blind clinical trialView study →}.

Gap: no leaf-extract human hepatoprotection data; the mechanism is compelling but demonstrated with isolated aucubin in other species, and aucubin’s low oral bioavailability limits extrapolation to a leaf tea.

A narrative review reports effects of P. major in animal models of inflammation, asthma and COPD, and clinical reports of reduced cough and wheeze in asthmatic patients, while noting that clinical studies are limited ^{29Reference 29Boskabadi SJ et al. · 2025ReviewThe therapeutic effects of Plantago major and its main constituents on respiratory diseases: a narrative reviewView study →}.

The strongest controlled human data come from a combination syrup. In a randomised, double-blind trial in 106 children with acute cough, KalobaTUSS®, which contains P. major with mallow, elecampane and Helichrysum in acacia honey, reduced day- and night-time cough and shortened its duration ^{30Reference 30Carnevali I et al. · 2021RCTEfficacy and safety of the syrup “KalobaTUSS®” as a treatment for cough in children: a randomized, double-blind, placebo-controlled trialView study →}.

Gap: essentially no monopreparation human respiratory trial; clinical evidence is confounded by multi-herb formulations.

Plantain’s immune effects run in both directions depending on dose. Hot-water extracts of P. major and P. asiatica enhanced lymphocyte proliferation and interferon-γ secretion at low concentrations (<50 µg/mL) but suppressed them at higher concentrations ^{31Reference 31Chiang LC et al. · 2003In vitroIn vitro cytotoxic, antiviral and immunomodulatory effects of Plantago major and Plantago asiaticaView study →}.

P. major extract and its constituents aucubin and baicalein inhibited the neutrophil respiratory burst, reducing reactive-oxygen output ^{32Reference 32Reina E et al. · 2013In vitroThe effects of Plantago major on the activation of the neutrophil respiratory burst — in vitroView study →}.

All the data are in vitro, with no human immune-outcome study.

Antiproliferative activity appears repeatedly in cell lines. A leaf extract reduced the viability of gastric (AGS) and colorectal (Caco-2) cancer cells, raising intracellular ROS and activating caspase-3/7, while sparing normal fibroblasts. Docking pointed to apigenin, aucubin, baicalein, caffeic acid and luteolin ^{33Reference 33Yilmaz Ozturk R et al. · 2025In vitroAnticancer effects of Plantago major extract on colorectal and gastric cancer cell lines: an in vitro study and molecular docking analysisView study →}.

Across breast, cervical, lung and oral cancer lines, P. major seed extracts were the most active. Root extracts matched leaf and stalk, and of the isolated compounds ursolic acid was stronger than oleanolic acid or aucubin ^{34Reference 34Kartini et al. · 2017In vitroEffects of Plantago major extracts and its chemical compounds on proliferation of cancer cells and cytokine production of LPS-activated THP-1 macrophages — in vitroView study →}.

In mice, P. major extract inhibited Ehrlich ascites tumours ^{35Reference 35Ozaslan M et al. · 2007AnimalIn vivo antitumoral effect of Plantago major L. extract on Balb/C mice with Ehrlich ascites tumourView study →}. Hot-water extracts of P. major and P. asiatica also showed antileukaemia and anticarcinoma activity in vitro ^{31Reference 31Chiang LC et al. · 2003In vitroIn vitro cytotoxic, antiviral and immunomodulatory effects of Plantago major and Plantago asiaticaView study →}.

Gap: no human data; effects are cell-line dominant, the most active material is often seed or root rather than the medicinal leaf, and concentrations tested exceed plausible tissue exposure.

Tolerability. Plantain leaf is well tolerated on the skin and by mouth. The topical pressure-ulcer and foot-ulcer trials reported no side effects ^{1,3Reference 1Ghiasian M et al. · 2021RCTClinical and phytochemical studies of Plantago major in pressure ulcer treatment: A randomized controlled trialView study →Reference 3Najafian Y et al. · 2019RCTEfficacy of Aloe vera/Plantago major gel in diabetic foot ulcer: a randomized double-blind clinical trialView study →}, and the burn study judged the ointment safe ^{4Reference 4Keshavarzi A et al. · 2022ObservationalTherapeutic efficacy of great plantain (Plantago major L.) in the treatment of second-degree burn wounds: a case-control studyView study →}. The leaf is traditionally used for children and sensitive tissue.

Allergy. Allergic reactions are uncommon. Plantago pollen is a recognised airborne allergen, so people with hay fever may cross-react.

Interactions. No drug interaction has been reported for the leaf, and none has been studied. A review of the iridoid aucubin reports good tolerance and no serious adverse reactions to date ^{27Reference 27Zeng X et al. · 2020ReviewA review of the pharmacology and toxicology of aucubinView study →}.

Sourcing. Plantain grows on paths, verges and trafficked ground, where it can take up heavy metals and other pollutants. Gather it only from clean sites.