Alchemilla

Alchemilla (Lady's Mantle): A Comprehensive Reference

Identity

Botanical and Scientific Names

Alchemilla encompasses several medicinal species including Alchemilla vulgaris, Alchemilla xanthochlora, Alchemilla mollis, and Alchemilla caucasica. Common English names include lady's mantle, bear's foot, lion's foot, and common lady's mantle. The name Alchemilla xanthochlora Rothm. is recognized as a synonym for Alchemilla vulgaris in several taxonomic and pharmacopoeial contexts. The genus Alchemilla belongs to the family Rosaceae, comprising perennial or annual herbs or low shrubs.

The genus Alchemilla L. (lady's mantle) comprises approximately 1,000 species, of which more than 300 have been characterized from Europe. Alchemilla vulgaris is a perennial herbaceous plant distributed throughout Europe, western Asia, and North America. It is found across temperate regions of the Northern Hemisphere, mainly in low-temperature and subarctic regions of Europe and Asia.

Pharmacopoeial Status

Several pharmacopoeias contain monographs on Alchemilla species — for example, Alchemillae herba (the flowering aerial parts of A. vulgaris) appears in the European Pharmacopoeia 10 and the Polish Pharmacopoeia XII. According to the European Pharmacopoeia 6.0, A. vulgaris has been designated a medicinal plant with diverse pharmacodynamic activities.

Plant Morphology and the Medicinal Part

The plant is easily recognized by its unique, round, and serrated leaves that resemble a mantle, with the special ability to catch dew and raindrops. Lady's mantle blooms from late spring to early summer, with small, yellow-green flowers that appear in dense clusters. The medicinal part of the plant is the aerial parts, collected in the flowering season. A limited number of publications also address the phytochemical profile and biological activity of the roots; results show that extracts of both roots and aerial parts contain high levels of phenolic compounds, especially condensed tannins including ellagic acid and catechin.

Common Preparations and Dosage Forms

The main galenic form of the drug prepared from Alchemilla is infusions; however, to test phytochemical profiles and biological activity, aqueous, alcoholic, and deep eutectic solvent extracts have also been used. Above-ground parts are typically dried for later use as herbal teas, tinctures, liquid extracts, or topical gels. Research has examined topical gels containing 2% water or ethanolic extracts, or 6% propylene glycolic extracts of A. vulgaris. A commercial preparation evaluated clinically consisted of a 3% extract in glycerine applied topically to oral mucosa.

Traditional and Historical Use

European Folk Medicine

Since the Middle Ages, people have sought natural drugs to treat disease, and Alchemilla vulgaris has been a well-known plant used in folk medicine and ethnopharmacology specifically to treat gynecological disorders such as menorrhagia, dysmenorrhea, and menstrual pain. As folk medicines, Alchemilla species have long been prescribed for the treatment of dysmenorrhea, pruritus vulvae, menopausal complaints, and related diseases in women.

In folk medicine, lady's mantle was used to soothe menopausal complaints, dysmenorrhea, to treat flatulence, diarrhea, mouth and throat inflammation, and for eczema and skin rashes. A. vulgaris has also been traditionally used for gastrointestinal disorders and as a gargle for mouth and throat inflammation.

Because of its significant anti-inflammatory and astringent properties, lady's mantle has historically been a valued remedy for ailments such as ulcers, eczema, and menstrual disorders. Alchemilla species have also been used to diminish symptoms of sore throat and to alleviate nausea and vomiting.

Wound Healing Traditions

Alchemilla vulgaris is an important remedy in European folk medicine, known for its astringent and anti-inflammatory properties; it is traditionally used to heal gynecological and gastrointestinal diseases. Historically, herbalists particularly prized it for wound healing. Traditionally, among older herbalists, Alchemilla was prized as one of the very best wound-healing herbs, even for infected wounds and gangrene, a property most likely attributable to its rich tannin content — mainly glycosides of ellagic acid — as tannins give plants their astringent or binding qualities that, when applied to skin, make them valuable remedies for healing skin abrasions.

Regional Traditions

In Turkey, Alchemilla species are traditionally used as diuretics and laxatives. More broadly, Alchemilla vulgaris is widely used in folk medicine for the treatment of dysmenorrhea, menorrhagia, and menopausal complaints in various countries. A. vulgaris has been used as a tonic, stomachic, diuretic, haemostatic, and astringent, and for relief of menstrual pains. Alchemilla vulgaris L. was used for centuries in Europe and Balkan countries for treatments of numerous conditions and diseases of the reproductive system.

Key Constituents and Active Compounds

Overview of Phytochemical Classes

Alchemilla species, as members of the Rosaceae family, produce tannins, phenolic acids, flavonoids, anthocyanins, coumarins, triterpenes, and violet compounds. The main phytochemicals in lady's mantle species are tannins, flavonoids, and phenolic acids.

Tannins

Pedunculagin and agrimoniin, as described in earlier reports for A. vulgaris, as well as other monomeric and oligomeric ellagitannins such as sanguiin H-10, castalagin/vescalagin, and galloyl-bis-hexahydroxydiphenoyl (HHDP) hexose, constitute the major phenolic fraction of the plant. Tannins are a typical feature of the Rosaceae family, especially ellagic acid, casuarictin, pedunculagin, and agrimoniin, which have documented antitumor activity. The dominant ellagitannin is agrimoniin, present at up to 10% of the dry weight.

Flavonoids

The flavonoid fraction of A. vulgaris comprises quercetin glucuronide as the major compound, in addition to several other quercetin glycosides. The aerial parts of A. vulgaris contain flavonoids including quercetin, isoquercetin, rutin, avicularin, and tiliroside. The plant contains tannins (catechin, gallic acid, and ellagic acid), flavonoids (quercetin, luteolin, and proanthocyanidins), phenolic acids, and terpenes, as well as fatty acids and their esters.

Phenolic Acids and Other Constituents

Gallic acid and chlorogenic acid are found in A. vulgaris extracts. The aerial parts also contain phenolic acids including ellagic acid, gallic acid, and caffeic acid, and tannins agrimoniin, pedunculagin, and laevigatin F. Additional identified constituents include phenolcarboxylic acids such as p-coumaric, sinapic, ferulic, caffeic, gallic, chlorogenic, and ellagic acids, as well as coumarins including umbelliferone, esculetin, scopoletin, and esculin.

A general accumulation of phenolic constituents was observed later in the year (when harvested in August versus May), especially with regard to the ellagitannins.

Mechanisms of Action

The active compounds responsible for antioxidant and antimicrobial activities are tannins (composed of gallic and ellagic acid) and flavonoids (quercetin, luteolin, and proanthocyanidins). The high tannin content explains the plant's well-documented astringency: tannins precipitate proteins and bind to mucosal tissues, producing a tightening, drying effect that is mechanistically consistent with traditional applications in wound healing, diarrhea, and inflammation of mucous membranes.

Both extracts of the roots and aerial parts of A. vulgaris contain high concentrations of phenolic compounds, especially condensed tannins including ellagic acid and catechin, which exert antioxidant, antibacterial, antifungal, and anti-inflammatory activities.

Research indicates that pre-treatment with A. vulgaris could alleviate cardiac damage triggered by isoproterenol, as revealed by considerable improvement in cardiac serum biomarkers in a dose-dependent manner. Heart-strengthening compounds such as pedunculin, agrimoniin, sanguin, castalagin, vescalagin, gallic acid, and chlorogenic acid may play critical roles in these actions.

Scientific Evidence by Area of Use

1. Gynecological Disorders (Dysmenorrhea, Menorrhagia, Menopause)

Traditional basis: Lady's mantle has been used in folk medicine and ethnopharmacology to treat gynecological disorders such as menorrhagia, dysmenorrhea, and menstrual pain.

Scientific evidence: The results of a clinical trial showed the possibility of using A. vulgaris extract in menstrual disorders. However, detailed parameters of this trial — including sample size, study design, controls, and outcomes — are not fully characterized in the available published literature. Despite the medical potential of Alchemilla extracts, clinical studies remain limited and require further performance to produce safer and less expensive plant-based drugs.

Animal evidence (PCOS): The species is widely used in folk medicine for the treatment of dysmenorrhea, menorrhagia, and menopausal complaints in various countries. A rat study used the DHEA-induced model of polycystic ovary syndrome (PCOS) to assess A. vulgaris effects. To prepare an infusion of the plant for administration, 5 g of dried herb was added to 1,000 mL of hot water and left for 10 minutes; after filtration, the extract was administered orally to rats at a daily dose of 50 mg/100 g body weight. This remains preclinical evidence only.

Evidence strength: Evidence for gynecological applications is primarily ethnopharmacological and preclinical. There are references to a clinical trial on menstrual disorders, but it has not been characterized with sufficient methodological detail in currently available literature to permit robust evaluation. Overall evidence is preliminary.

2. Wound Healing and Skin Barrier Repair

In vitro and in vivo evidence: Tasić-Kostov et al. conducted an extensive study on the effects of Alchemilla vulgaris on wound healing processes using an in vitro wound healing assay with L929 fibroblasts and an in vivo assessment of skin barrier repair potential. The most beneficial effect on fibroblast migration and wound healing in vitro was observed for the ethanolic extract, which contained ellagic acid at 3.4 mg/g and isoquercetin at 4.0 mg/g.

Gel with propyleneglycolic extract revealed the most favorable effect on in vitro wound healing and showed the highest value of adhesiveness in texture profile analysis. In vivo tests were carried out on 18 volunteers using corneometer measurements of stratum corneum hydration on SLS-irritated human skin and tewameter measurements of transepidermal water loss.

It was shown that a 3% hydroglycolic extract of A. vulgaris in glycerine exhibits significant wound healing potential, with efficacy confirmed in an in vivo study on human volunteers. Topical application of gels containing 2% A. vulgaris water or ethanolic, or 6% propylene glycolic extracts, accelerated wound closure in the scratch test with L929 fibroblasts and also promoted damaged skin barrier repair.

Results of the in vivo study were in line with in vitro findings. The healing potential may be attributed to phenolic compounds found in A. vulgaris extracts, the low pH of the gels, and the satisfying antioxidant activity of the extracts.

In vivo studies have shown that the wound healing activity of A. vulgaris is associated with promitotic activity in epithelial cells and myofibroblasts.

Evidence strength: Evidence is predominantly in vitro and in small-scale human volunteer studies (e.g., 18 volunteers). While mechanistically plausible and methodologically informative, no large randomized controlled trials on wound healing outcomes have been identified. Evidence is promising but preliminary.

3. Aphthous Stomatitis (Mouth Ulcers)

Alchemilla vulgaris has traditionally been used in oral hygiene and was shown to accelerate wound healing when combined with glycerine. An open-label clinical study was conducted in 48 otherwise healthy male and female patients aged 4 to 44 years to determine the putative healing properties and tolerability of a standard 3% extract of A. vulgaris in glycerine (Aphtarine®) on common minor oral ulcers.

The preparation was applied three times daily. The study revealed that the majority of patients experienced complete relief of discomfort and complete healing of the ulcers (60.4%) within 2 days and 75% within 3 days. Topical application of Aphtarine gel on minor mouth ulcers significantly reduced pain and aided in the completion of treatment in the majority of patients within 3 days; no adverse effects were reported. The investigators concluded that Aphtarine is a viable medication for treating oral ulcers because it is safe, well-tolerated, and effective.

Evidence strength: One open-label (non-blinded, uncontrolled) clinical study with 48 participants. While the reported outcomes are positive, the lack of a placebo group and blinding significantly limits interpretation. Aphthous ulcers can resolve spontaneously. This represents low-level clinical evidence.

4. Antioxidant Activity

The genus Alchemilla is a rich source of interesting secondary metabolites, including mainly flavonoids, tannins, and phenolic acids, which display a variety of biological activities such as anti-inflammatory, antimicrobial, and antioxidant effects. Extract of the plant exhibits high scavenging potential, especially towards superoxide anion radical. Results obtained in some studies indicate that tannins may contribute significantly to the antioxidant activity.

Evidence strength: Antioxidant activity is well-established in vitro (DPPH, ABTS, β-carotene-linoleic acid assays). Whether this translates to clinically meaningful antioxidant effects in humans has not been demonstrated in controlled trials.

5. Anti-Inflammatory Activity

In A. mollis studies (a closely related species sharing phytochemical characteristics), the anti-inflammatory activities of the most potent antioxidant extracts (methanol, 70% methanol, and water extracts) were determined by measuring the inhibitory effects on nitric oxide production and pro-inflammatory cytokine TNF-α levels in lipopolysaccharide-stimulated RAW 264.7 macrophage cells. These findings are representative of documented anti-inflammatory mechanisms across the Alchemilla genus at the cellular level.

Evidence strength: Anti-inflammatory evidence is exclusively in vitro. No human clinical trials have specifically examined anti-inflammatory outcomes for A. vulgaris administration.

6. Antimicrobial Activity

A. vulgaris root extract is considered a potent antibacterial agent. High antibacterial activity has been reported against Enterococcus faecalis, Salmonella typhimurium, Micrococcus lysodeikticus, and Bacillus mycoides, which were the most sensitive examined bacterial species to the aerial part and root extracts of A. vulgaris. Antifungal activity for root extracts has been recorded against Phialophora fastigiata, Penicillium canescens, Trichoderma viride, T. longibrachiatum, Aspergillus glaucus, and Fusarium oxysporum.

Evidence strength: All antimicrobial evidence is in vitro. No human clinical trials have assessed antimicrobial applications of A. vulgaris.

7. Cardiovascular Effects (Vasorelaxation and Blood Pressure)

Preclinical results demonstrated that the methanol extract of Alchemilla vulgaris has more prominent and favorable vascular effects in normal and experimental hypertensive conditions, reinforcing its traditional use in cardiovascular disorders. Endothelial tissue of pre-contracted arteries displayed vasorelaxant activities in both extract types. Opposing vascular effects were observed when extracts were applied in potassium-pre-contracted arteries. Oral administration of the methanol extract produced significant hypotensive effects. This study suggests that methanol extracts of lady's mantle produce positive vascular effects in normal and experimental hypertensive conditions.

Takır et al. (2015) demonstrated that the methanolic extract of Alchemilla vulgaris has vasorelaxant and hypotensive effects.

Evidence strength: Cardiovascular effects have been demonstrated in isolated vessel preparations and animal models. No human clinical trials have been conducted on blood pressure outcomes.

8. Anticancer and Genoprotective Activity

In vitro research reports a first report on anticancer activity of hormone-dependent cancer lines for this plant. The ethyl acetate extract was emphasized for exceptional antioxidant, enzyme inhibitory, and antitumor activity, attributed to phenolic compounds such as catechin, quercetin, and phenolic acids.

A PMC-published study investigated the genoprotective and antitumor activity of A. vulgaris ethanolic extract from Southeast Serbia in vitro. Studies showed that extracts of roots and aerial parts include high content of phenolic compounds, especially condensed tannins including ellagic acid and catechin, with demonstrated antiproliferative activity against prostate (PC-3), breast (MCF-7), and colorectal adenocarcinoma (Caco-2) cancer cell lines in vitro.

Evidence strength: All anticancer evidence is in vitro (cell line studies). Further research is needed to focus on mechanisms of anticancer activity and modes of action of the key most efficient plant metabolites. No animal tumor models or human trials have been conducted for A. vulgaris as an anticancer agent.

9. Dermatological Applications

Due to antioxidant, anti-inflammatory, astringent, antimicrobial, elastase-inhibiting, and tyrosinase-inhibiting properties of various Alchemilla species, extracts obtained from these plants can potentially be applied in skin rashes, acne, stretch marks, eczema, psoriasis, wrinkles, and other dermatological issues.

The existing models have efficiently identified Alchemilla extract potential, but human trials will be needed to confirm real-world effectiveness. For example, a small clinical study on an Alchemilla cream for acne or eczema would test whether in vitro antimicrobial and anti-inflammatory effects translate to patient improvement. The combination of simple and complex models used so far has been effective in characterizing activities; the next step is to employ clinical and translational models, which is currently a gap.

10. Gut Microbiota and Metabolite Formation

A review regarding the Alchemilla genus confirmed that A. vulgaris possesses a broad phytochemical composition including phenolic acids, flavonoids, anthocyanins, coumarins, and triterpenes. A 2025 study published in Frontiers in Pharmacology investigated the ex vivo biotransformation of lady's mantle extracts via the human gut microbiota, examining the formation of phenolic metabolites and their impact on human normal and colon cancer cell lines — reflecting emerging interest in the gut-based bioavailability and downstream effects of Alchemilla polyphenols.

Body Systems and Health Areas Associated with Alchemilla

• Reproductive and gynecological system: Dysmenorrhea, menorrhagia, menopausal complaints, pruritus vulvae, and polycystic ovary syndrome (animal model evidence).
• Integumentary system (skin): Wound healing, eczema, skin rashes, acne, stretch marks, wrinkles; skin barrier repair.
• Oral mucosa: Aphthous stomatitis (mouth ulcers), mouth and throat inflammation, gargle use.
• Gastrointestinal system: Diarrhea, flatulence, ulcers, gastric complaints; used traditionally as stomachic.
• Cardiovascular system: Vasorelaxation, blood pressure lowering (preclinical).
• Immune and inflammatory pathways: Anti-inflammatory and antioxidant properties demonstrated in vitro.
• Microbiological defense: Antimicrobial and antifungal activity in vitro against a range of bacterial and fungal pathogens.
• Oncological (investigational): In vitro antiproliferative effects against prostate, breast, cervical, ovarian, and colorectal cancer cell lines.

Dosage Forms and Reported Dosages

The main galenic form of the drug prepared from Alchemilla is infusions; however, aqueous, alcoholic, and deep eutectic solvent extracts have also been used in research contexts.

• Oral infusion (animal study): 5 g of dried herb added to 1,000 mL of hot water, infused for 10 minutes, filtered, and administered orally to rats at a daily dose of 50 mg/100 g body weight.
• Topical gel (human study): Gels containing 2% A. vulgaris water or ethanolic extract, or 6% propylene glycolic extract, were tested in vitro and on 18 human volunteers for skin barrier repair.
• Topical oral preparation (clinical study): A standard 3% extract of A. vulgaris in glycerine (Aphtarine®) was studied in 48 patients for treatment of minor oral ulcers. The preparation was applied three times daily.

No human oral dosage has been established through adequately powered randomized controlled trials. Dosages used in traditional preparations vary substantially across European herbal practice traditions.

Safety Considerations

General Safety Data

When taken by mouth, there is not enough reliable information to know if alchemilla is safe or what the side effects might be. When applied to the skin, there is also insufficient reliable information to determine safety. This reflects the lack of formal toxicological studies in humans.

High Tannin Content

The high tannin content of A. vulgaris (tannins reported at up to 15% of dry weight, with ellagitannins comprising 5–8%) is relevant to safety considerations. Caution is advised with long-term use in individuals with anaemia, as tannins are known to reduce dietary iron absorption by forming insoluble complexes with non-heme iron.

Pregnancy and Lactation

There is not enough reliable information to know if alchemilla is safe to use when pregnant or breast-feeding; the conservative position is to avoid use during these periods. Lady's mantle is considered not suitable in pregnancy or lactation.

Species Adulteration

Adulteration with other Alchemilla species can occur, which is a practical consideration given the large size of the genus and the morphological similarity of many species. Different species may have different phytochemical profiles, affecting both efficacy and safety.

Clinical Evidence on Tolerability

In the clinical study on aphthous stomatitis, topical application of Aphtarine gel significantly reduced pain and aided healing in the majority of patients within 3 days; no adverse effects were reported. This represents the most direct human tolerability data available, though it is specific to short-term topical use only.

Evidence Gaps

Regardless of the remarkable medical potential of Alchemilla extracts, clinical studies are limited and need to be performed to produce safer and less expensive plant-based drugs. Both in vitro and in vivo studies have indicated that Alchemilla plants possess an extensive spectrum of biological activities, but clinical studies remain limited. Systematic pharmacokinetic data, drug–herb interaction studies, and formal toxicological evaluation in humans are largely absent from the published literature.

Summary of Evidence Quality

Comprehensive reviews have highlighted a broad spectrum of activities of Alchemilla plants, including antioxidant, anti-inflammatory, neuroprotective, antimicrobial, anti-obesity, cardiovascular, anticancer, and wound healing effects. However, the overwhelming majority of this evidence derives from in vitro cell studies and animal experiments. The only clinical trial data identified in the peer-reviewed literature relates to: (1) topical use in aphthous stomatitis (open-label, 48 patients), (2) topical gel for wound healing and skin barrier repair (18 volunteers), and (3) a referenced but incompletely characterized trial on menstrual disorders. There is currently a significant gap in clinical and translational research models. Rigorous randomized controlled trials are needed before any clinical recommendations can be established.

References

• Jakimiuk K, Tomczyk M. A review of the traditional uses, phytochemistry, pharmacology, and clinical evidence for the use of the genus Alchemilla (Rosaceae). Journal of Ethnopharmacology, 2024. PubMed PMID: 37981119
• Jakimiuk K, Tomczyk M. A review of the traditional uses, phytochemistry, pharmacology, and clinical evidence for the use of the genus Alchemilla (Rosaceae). ScienceDirect, Journal of Ethnopharmacology, 2023.
• Alchemilla — Overview. ScienceDirect Topics (Pharmacology, Toxicology and Pharmaceutical Science).
• Jurić A, et al. Phytochemical Characterization, Antimicrobial Activity and In Vitro Antiproliferative Potential of Alchemilla vulgaris Auct Root Extract against Prostate (PC-3), Breast (MCF-7) and Colorectal Adenocarcinoma (Caco-2) Cancer Cell Lines. PMC, 2022.
• Duckstein SM, et al. Phenolic constituents from Alchemilla vulgaris L. and Alchemilla mollis (Buser) Rothm. at different dates of harvest. PubMed, Z Naturforsch C J Biosci, 2012.
• Boroja T, et al. Alchemilla vulgaris agg. (Lady's mantle) from central Balkan: antioxidant, anticancer and enzyme inhibition properties. RSC Advances, 2019.
• Kanak S, et al. Phenolic Composition and Antioxidant Activity of Alchemilla Species. PMC / Plants (Basel), 2022.
• Harnessing the Power of Alchemilla: A Natural Solution for Skin Health and Dermatological Disorders. PMC / Molecules, 2025.
• Tasić-Kostov M, et al. Towards a modern approach to traditional use: in vitro and in vivo evaluation of Alchemilla vulgaris L. gel wound healing potential. Journal of Ethnopharmacology, 2019.
• Takır S, et al. Vasorelaxant and blood pressure lowering effects of Alchemilla vulgaris: A comparative study of methanol and aqueous extracts. PubMed / Pharmacognosy Magazine, 2015.
• Shrivastava R, John GW. Treatment of Aphthous Stomatitis with Topical Alchemilla vulgaris in Glycerine. Clinical Drug Investigation, 2006.
• Beneficial Effects of Alchemilla vulgaris in DHEA-Induced Rat Model of Polycystic Ovary Syndrome. PMC, 2025.
• Alchemilla vulgaris modulates isoproterenol-induced cardiotoxicity: interplay of oxidative stress, inflammation, autophagy, and apoptosis. Frontiers in Pharmacology, 2024.
• Ex vivo biotransformation of lady's mantle extracts via the human gut microbiota: the formation of phenolic metabolites and their impact on human normal and colon cancer cell lines. Frontiers in Pharmacology, 2025.
• Jelača S, et al. Beyond Traditional Use of Alchemilla vulgaris: Genoprotective and Antitumor Activity In Vitro. Molecules, 2022.
• Optimization of Deep Eutectic Solvent Extraction of Phenolic Acids and Tannins from Alchemilla vulgaris L. PMC, 2022.
• Phenolic Composition, Anti-Inflammatory, Antioxidant, and Antimicrobial Activities of Alchemilla mollis (Buser) Rothm. PubMed, 2017.
• Lady's Mantle (Alchemilla vulgaris): Benefits, Safety, Uses. Herbal Reality.