Be aware that the U.S. Food and Drug Administration does not strictly regulate herbs and dietary supplements. There is no guarantee of strength, purity or safety of products containing or claiming to contain chamomile. Decisions to use herbs or supplements should be carefully considered. Individuals using prescription drugs should discuss taking herbs or supplements with their pharmacists or health care providers before starting.

German chamomile (Matricaria recutita) and Roman chamomile (Chamaemelum nobile) are the two major types of chamomile used for health conditions. They are believed to have similar medical effects, although German chamomile may be slightly stronger. Most research has used German chamomile, which is more commonly used everywhere except for England, where Roman chamomile is more common. Scientists have studied chamomile for the following health problems:

Quality of life in cancer patients

Some studies suggest that chamomile may improve anxiety and quality of life in cancer patients when used with massage therapy. However, this is not enough evidence to recommend chamomile for this use.

Common cold

Inhaling steam with chamomile extract has been reported to help common cold symptoms. More research is needed before a recommendation can be made.

Diarrhea in children

Preliminary study reports that chamomile with apple pectin reduces the length of time that children have diarrhea. However, it is unclear whether the chamomile or the pectin has this effect.

Skin conditions, wound healing

A few human studies suggest that chamomile ointment may work as well as hydrocortisone cream for rash or eczema. In one randomized, controlled clinical trial, both preparations seemed to equally aid in symptom relief of itching and inflammation.

Another study reports that chamomile cream does not work as well as almond oil for skin damage after X-ray therapy for breast cancer.

Preliminary study using chamomile to improve wound healing after tattoo removal suggests that it may help. More research is needed in this area before a recommendation can be made.

Hemorrhagic cystitis (bladder irritation with bleeding)

Preliminary study reports that chamomile instilled (pumped) into the bladder plus chamomile baths and antibiotics may work better than antibiotics alone for hemorrhagic cystitis. This does not provide enough evidence to recommend chamomile for this problem. Consult a health care provider if you notice blood in your urine.

Hemorrhoids

Preliminary study suggests that chamomile ointment may improve hemorrhoids. This is not enough evidence to recommend chamomile for this use.

Colic in infants

Chamomile is reported to improve colic in infants when given in an herbal tea with four other herbs. The effect of chamomile alone is not clear.

Mouth ulcers and irritation caused by cancer treatments (oral mucositis)

Chamomile mouthwash has been studied as a treatment for ulcers and swelling inside of the mouth caused by X-ray therapy or cancer drugs. Some studies report that chamomile helps, but others show no effect. Because these studies do not agree with each other, it is not clear if chamomile should be recommended.

Vaginitis (irritation or swelling of the vagina)

Chamomile douche may improve symptoms of vaginitis with few side effects. Further research is needed to confirm these results.

Insomnia

Chamomile may cause drowsiness and relaxation and may help people fall asleep. Well-designed clinical trials are needed before a recommendation can be made.

Sore throat

Chamomile extract spray has been studied for preventing sore throat after intubation (a breathing tube placed in the throat). The authors of the study concluded that chamomile extract does not prevent sore throat after intubation.

Chamomile has been suggested for many other uses, based on tradition or on scientific theories. However, these uses have not been thoroughly studied in humans, and there is limited scientific evidence about safety or effectiveness. Some of these suggested uses are for conditions that are potentially very serious and even life-threatening. You should consult a health care provider before taking chamomile for any unproven use.

Abscesses
Acne
Anorexia
Antibacterial
Antioxidant
Antiseptic
Anxiety
Arthritis
Asthma
Back pain
Bedsores
Bloating
Blocked tear ducts
Burns
Carpal tunnel syndrome
Chickenpox
Delirium tremens
Diaper rash
Digestion aid
Diuretic
Ear infections
Eye infections
Fever
Flu-like symptoms
Frostbite
Fungal infections
Gas

Gingivitis
Gum irritation
Hay fever
Heartburn
Heat rash
Impetigo
Inflammation
Insect bites
Intestinal cramps
Irritable bowel syndrome
Itching
Liver disorders
Malaria
Mastitis (breast swelling)
Menstrual period disorders
Morning sickness
Morphine withdrawal
Nausea
Nerve pain
Osteoporosis
Parasites/worms
Poison ivy
Psoriasis
Sea sickness
Seizures
Stomach ulcers
Teething pain (used as a mouth rinse)

People should avoid chamomile if they are allergic to plants in the Asteraceae (Compositae) family. Examples include aster, chrysanthemum, mugwort, ragweed and ragwort. Chamomile tea has been reported to cause difficulty breathing, anaphylaxis (a severe allergic reaction) and allergic skin reactions in some individuals. Chamomile eyewash may cause allergic conjunctivitis (pink eye).

Impurities in chamomile products may cause side effects. Studies report that chamomile is usually well tolerated, except in patients with allergic reactions triggering asthma or causing skin rash. Chamomile may cause drowsiness in some individuals. Use caution if you are driving or operating heavy machinery. In theory, chamomile may increase the risk of bleeding. You may need to stop taking chamomile before some types of surgery; discuss this with your health care provider. In large doses, chamomile can cause vomiting. An older, poor-quality study reports slight increases in blood pressure from chamomile, but this is not enough evidence to make a firm conclusion.

In theory, chamomile may act as a uterine stimulant or may cause abortion; it should be avoided during pregnancy. Chamomile is usually not recommended during breast-feeding, because there is not enough research in this area.

Interactions with drugs, supplements and other herbs have not been thoroughly studied. The interactions listed below have been reported in scientific publications. If you are taking prescription drugs, speak with your health care provider or pharmacist before using herbs or dietary supplements.

In theory, chamomile may increase the risk of bleeding when used with anticoagulants or antiplatelet drugs. Examples include warfarin (Coumadin), heparin and clopidogrel (Plavix). Some pain relievers may also increase the risk of bleeding if used with chamomile, such as aspirin, ibuprofen (Motrin, Advil) and naproxen (Naprosyn, Aleve, Anaprox). Chamomile may increase the amount of drowsiness caused by some drugs. Examples include benzodiazepines, such as lorazepam (Ativan); barbiturates, such as phenobarbital; narcotics, such as codeine; and alcohol. Caution is advised while driving or operating machinery. Be aware that many tinctures contain high levels of alcohol and may cause vomiting when taken with metronidazole (Flagyl) or disulfiram (Antabuse). An extract containing Marticaria chamomile, Sideritis euboea, Sideritis clandestine, and Pimpinella anisum was associated with selective estrogen receptor modulator (SERM) properties against osteoporosis. Theoretically, chamomile may interact with SERM drugs such as raloxifene or tamoxifen, a prescription drug used for cancer.

In theory, chamomile may increase the risk of bleeding when also taken with other products that are believed to increase the risk of bleeding. Examples include Ginkgo biloba and garlic (Allium sativum). Chamomile may increase the amount of drowsiness caused by some herbs or supplements, such as valerian. Caution is advised while driving or operating machinery. Tinctures contain alcohol and may increase these effects.

The doses listed below are based on scientific research, publications or traditional use. Because most herbs and supplements have not been thoroughly studied or monitored, safety and effectiveness may not be proven. Brands may be made differently, with variable ingredients even within the same brand. Combination products often contain small amounts of each ingredient and may not be effective. Appropriate dosing should be discussed with a health professional before starting therapy; always read the recommendations on a product's label. The dosing for unproven uses should be approached cautiously, because scientific information is limited in these areas.

Like other herbal products, chamomile concentration is not standardized. Storage and method of extraction are believed to play an important role on the stability of chamomile constituents.

Adults (Aged 18 Or Older)

Tea or infusion: A dose of 150 milliliters of boiling water poured over three grams of fresh flower heads then steeped for 10 minutes has been taken three times per day by mouth. One to four cups of chamomile tea (from tea bags) has also been used daily.

Liquid extract: A dose of one to four milliliters (1:1 in 45 percent alcohol) three times per day has been taken by mouth.

Tincture: A dose of 15 milliliters (1:5) three to four times per day has been taken by mouth.

Capsules or tablets: A dose of 400 to 1,600 milligrams has been taken in divided doses by mouth daily.

There are no standard doses for chamomile used on the skin, in douches or as mouthwash. The following doses are based on natural medicine publications and textbooks:

Paste, plaster or ointment: A topical preparation containing 3 percent to 10 percent chamomile flower heads has been used.

Douches: Preparations of 3 percent to 10 percent chamomile have been used as a douche.

Mouth rinse or gargle: A dose of 1 percent fluid extract or 5 percent tincture has been used.

Bath: A dose of five grams of chamomile per liter (1/4 gallon) of water or 0.8 grams of alcoholic extract per liter of water has been used.

Children (Younger Than 18)

There are not enough scientific data to recommend chamomile for children. Some natural medicine textbooks recommend that the dose of chamomile tea for children should be half of the adult dose.

Chamomile is popular as a home remedy for many conditions. Teas and liquid extracts are used as a sleep aid and for anxiety. Ointments and baths are sometimes used to treat rashes, eczema and skin irritation. However, there is not enough scientific evidence to recommend chamomile for any health problem. Even though most people think of chamomile as being a mild plant, there are many reports of allergic reactions in those taking chamomile by mouth or using it on their skin. People taking drugs or herbs should be careful when taking chamomile because there may be a greater chance of bleeding. Chamomile may increase the amount of drowsiness caused by other drugs or herbs. Consult your health care provider immediately if you experience side effects.

The information in this monograph was prepared by the professional staff at Natural Standard, based on thorough systematic review of scientific evidence. The material was reviewed by the Faculty of the Harvard Medical School with final editing approved by Natural Standard.

Natural Standard: An organization that produces scientifically based reviews of complementary and alternative medicine (CAM) topics
National Center for Complementary and Alternative Medicine (NCCAM): A division of the U.S. Department of Health & Human Services dedicated to research

Natural Standard reviewed more than 150 articles to prepare the professional monograph from which this version was created.

Some of the more recent studies are listed below:

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(3):522-525.
Hur MH, Han SH. Clinical trial of aromatherapy on postpartum mother's perineal healing. Taehan Kanho Hakhoe Chi 2004;Feb, 34(1):53-62.
Kagawa D, Jokura H, Ochiai R, et al. The sedative effects and mechanism of action of cedrol inhalation with behavioral pharmacological evaluation. Planta Med 2003;Jul, 69(7):637-641.
Kassi E, Papoutsi Z, Fokialakis N, et al. Greek plant extracts exhibit selective estrogen receptor modulator (SERM)-like properties. J Agric Food Chem 2004;Nov 17, 52(23):6956-6961.
Kyokong O, Charuluxananan S, Muangmingsuk V, et al. Efficacy of chamomile-extract spray for prevention of post-operative sore throat. J Med Assoc Thai 2002;Jun, 85(Suppl 1):180-185.
Maiche A, Grohn P, Maki-Hokkonen H. Effect of chamomile cream and almond ointment on acute radiation skin reaction. Acta Oncol 1991;30:395-397.
Mazokopakis EE, Vrentzos GE, Papadakis JA, et al. Wild chamomile (Matricaria recutita L.) mouthwashes in methotrexate-induced oral mucositis. Phytomedicine 2005;Jan, 12(1-2):25-27.
Patzelt-Wenczler R, Ponce-Poschl E. Proof of efficacy of Kamillosan cream in atopic eczema. Eur J Med Res 2000;5:171-175.
Paulsen E. Contact sensitization from Compositae-containing herbal remedies and cosmetics. Contact Dermatitis 2002;Oct, 47(4):189-198.
Ross SM. An integrative approach to eczema (atopic dermatitis). Holist Nurs Pract 2003;Jan-Feb, 17(1):56-62.
Rycroft RJ. Recurrent facial dermatitis from chamomile tea. Contact Dermatitis 2003;Apr, 48(4):229.
Saller R, Beschomer M, Hellenbrecht D, et al. Dose dependency of symptomatic relief of complaints by chamomile steam inhalation in patients with common cold. Eur J Pharmacol 1990;183:728-729.