What Is Comfrey Cream?

Comfrey cream, salve, gel, and ointment

Verywell / Anastasia Tretiak

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Comfrey cream is a natural substance made from Symphytum officinale, an herb in the borage family. Also known as comfrey ointment, salve, or gel, it's said to reduce inflammation (swelling) and alleviate pain when applied to the skin. Proponents claim that comfrey cream can treat a variety of health conditions and injuries.

Comfrey cream contains several substances thought to have health benefits. These include anti-inflammatory compounds and allantoin, which is thought to speed up wound healing by stimulating new cell growth.

This article discusses the uses and benefits of comfrey cream. It also covers the possible side effects and what to look for when buying it.


Comfrey cream is typically used as a topical herbal remedy for painful muscle and joint conditions. These can include low back pain, osteoarthritis, and sprains. It's also used in alternative medicine for the following problems:

  • Bruises
  • Fractures
  • Gout (a form of arthritis)
  • Rheumatoid arthritis
  • Sprains and strains
  • Wounds

Does Comfrey Cream Have Any Benefits?

Researchers have studied the effects of comfrey cream on a number of health conditions. Here's a look at some key research on the potential health benefits of comfrey cream for back pain, osteoarthritis, and ankle sprains.

Back Pain

Comfrey cream could help ease back pain. A 2010 study from the British Journal of Sports Medicine included 120 patients with acute upper or lower back pain. Each of them was treated with comfrey ointment or a placebo (sham treatment) for five days.

Study results revealed that pain intensity decreased an average of 95.2% in the group given comfrey ointment. This was compared to 37.8% in the placebo group.


Comfrey cream may help treat osteoarthritis of the knee, according to a Cochrane review of topical herbal therapies.

This review included one study of 220 people with osteoarthritis of the knee, a degenerative "wear-and-tear" joint condition. The participants were assigned to three weeks of treatment with either comfrey ointment or a placebo.

Those who used the comfrey ointment experienced significantly greater improvement in pain, mobility, and quality of life.

Additionally, a 2011 study found that comfrey ointment was superior to a placebo in relieving pain and stiffness in osteoarthritis. The study involved 43 patients with knee osteoarthritis and a six-week treatment period.

A later study in 2012 found some evidence that topical comfrey cream led to reduced knee pain. However, it had no effect on markers of inflammation or cartilage breakdown over 12 weeks of treatment.

Ankle Sprains

Several studies show that comfrey cream may be helpful in the treatment of ankle sprains.

One study followed 142 patients with ankle sprains. One group used a cream with comfrey root fluid extract on the ankle while the others received a placebo. After eight days, the group that used the cream had significantly less pain than those who had the placebo.

In another study, participants with ankle sprains received either comfrey root extract cream or diclofenac gel, a nonsteroidal anti-inflammatory drug (NSAID). The ankle swelling decreased by 79.5% in the comfrey root group and 69.4% in the diclofenac group.


In several studies, comfrey cream was found to decrease back pain, relieve osteoarthritis stiffness, and reduce pain and swelling in ankle sprains. However, large-scale studies are needed to confirm these effects.

Possible Side Effects

Comfrey contains pyrrolizidine alkaloids, substances that can cause liver damage, cancer, and even death. Therefore, it should be never be taken by mouth. The Food and Drug Administration (FDA) has banned oral comfrey products.

Since these toxic substances can be absorbed through the skin, there's concern about the safety of comfrey cream applied to the skin. It's typically only used in small amounts for a very short period of time.

Experts suggest not using comfrey cream for longer than 10 days in a row. You should also use it no more than four to six weeks in a year as a general guideline.

If you're considering using the cream, consult your healthcare provider first. You and your healthcare provider should weigh the pros and cons and use only under their supervision.

Never apply comfrey cream to broken skin or open wounds. Don't take it if you have liver disease, cancer, or are taking any medication that affects the liver. Children, elderly people, and pregnant or nursing women shouldn't use comfrey in any form.


Comfrey contains toxic substances that cause liver damage, cancer, and death. It should never be taken by mouth. As a cream, it should only be used in small amounts for short periods of time. Consult your healthcare provider before using.

Comfrey ointment
Verywell / Anastasia Tretiak

Dosage and Preparation 

There is no daily recommended allowance for comfrey, which is sold in creams, ointments, gels, and salves. The following applications have been used in research:

  • Back pain: An ointment containing 35% comfrey root extract, with or without 1.2% methyl nicotinate. Applied three times a day for five days.
  • Osteoarthritis: A specific ointment containing 35% comfrey root extract, with or without tannic acid, aloe vera gel, eucalyptus oil, and frankincense oil. Applied to the knee three times a day for three to six weeks.
  • For sprains: An ointment containing 35% comfrey extract. Applied to ankle sprains four times daily for eight days.

What to Look For 

For topical comfrey cream, look for products labeled as free of pyrrolizidine alkaloids.

When selecting a brand of supplements, look for products that have been certified by Consumer Labs, the U.S. Pharmacopeial Convention, or NSF International.


Comfrey cream, an herbal remedy, is thought to reduce inflammation and pain when applied to the skin. Researchers have found it does seem to reduce pain in some conditions, including back pain, osteoarthritis, and ankle sprains.

However, comfrey can also contain toxic substances called pyrrolizidine alkaloids that cause liver damage, cancer, and death. You should never ingest comfrey by mouth. Before using comfrey cream, consult your healthcare provider.

A Word From Verywell 

While studies suggest that comfrey cream may offer some pain-relieving benefits, large-scale clinical trials are needed to confirm these effects. Given the safety concerns, it should only be used under the supervision of your healthcare provider.

Frequently Asked Questions

  • What alternatives to comfrey cream are there for back pain?

    Back pain is often treated with medication such as over-the-counter pain relievers.

    Other alternative therapies may help to ease the pain. Undergoing massage or taking up yoga may help alleviate pain and help people with back or joint problems function more easily.

    There's also some evidence that topical capsaicin cream may help to temporarily relieve pain.

8 Sources
Verywell Health uses only high-quality sources, including peer-reviewed studies, to support the facts within our articles. Read our editorial process to learn more about how we fact-check and keep our content accurate, reliable, and trustworthy.
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  3. Giannetti BM, Staiger C, Bulitta M, Predel HG. Efficacy and safety of comfrey root extract ointment in the treatment of acute upper or lower back pain: results of a double-blind, randomised, placebo-controlled, multicentre trial. Br J Sports Med. 2010;44(9):637-41. doi:10.1136/bjsm.2009.058677

  4. Cameron M, Chrubasik S. Topical herbal therapies for treating osteoarthritis. Cochrane Database Syst Rev. 2013;5(5):CD010538. doi:10.1002/14651858.CD010538

  5. Smith DB, Jacobson BH. Effect of a blend of comfrey root extract (Symphytum officinale L.) and tannic acid creams in the treatment of osteoarthritis of the knee: randomized, placebo-controlled, double-blind, multiclinical trials. J Chiropr Med. 2011;10(3):147-56. doi:10.1016/j.jcm.2011.01.003

  6. Laslett LL, Quinn SJ, Darian-Smith E, et al. Treatment with 4Jointz reduces knee pain over 12 weeks of treatment in patients with clinical knee osteoarthritis: a randomised controlled trial. Osteoarthritis Cartilage. 2012;20(11):1209-16. doi:10.1016/j.joca.2012.07.019

  7. Staiger C. Comfrey: A clinical overviewPhytother Res. 2012;26(10):1441–1448. doi:10.1002/ptr.4612

  8. Gagnier JJ, Oltean H, van Tulder MW, Berman BM, Bombardier C, Robbins CB. Herbal medicine for low back pain: A Cochrane reviewSpine (Phila Pa 1976). 2016 Jan;41(2):116-33. doi:10.1097/01.brs.0000249525.70011.fe

By Cathy Wong
Cathy Wong is a nutritionist and wellness expert. Her work is regularly featured in media such as First For Women, Woman's World, and Natural Health.