Is There a Role for Arnica and Bromelain in Prevention of Post-Procedure Ecchymosis or Edema? A Systematic Review of the Literature

Dermatol Surg. 2016 Apr;42(4):445-63. doi: 10.1097/DSS.0000000000000701.


Background: The management of postprocedure skin care is of significant interest to dermatologists and other physicians. Ecchymosis and edema are common temporary postprocedure unwanted effects. Two botanically-derived products, arnica and bromelain, are used internationally by physicians to limit ecchymosis and edema that occur secondary to cosmetic, laser, and surgical skin procedures.

Objective: The authors review the published literature and provide evidence-based recommendations on arnica and bromelain for prevention and treatment of postprocedure ecchymosis and edema.

Methods and materials: A search of the computerized bibliographic databases Medline, EMBASE, Scopus, and CINAHL was performed on March 23, 2015. The key terms used were "arnica," and "bromelain."

Results: This review contains clinical trials that evaluated prevention and/or treatment of postprocedure ecchymosis or edema with oral arnica (11), topical arnica (2), and oral bromelain (7). No studies on topical bromelain were found. Clinical trials on arnica and bromelain have demonstrated mixed results. Some randomized controlled trials reported improvement postprocedure with arnica (4/13) and bromelain (5/7).

Conclusion: Based upon published studies, there is insufficient data to support use of arnica and bromelain post procedure, and the authors recommend additional research to determine the efficacy and safety of arnica and bromelain to prevent and/or treat ecchymosis and edema in patients.

Publication types

  • Review
  • Systematic Review

MeSH terms

  • Arnica*
  • Bromelains / therapeutic use*
  • Dermatologic Surgical Procedures*
  • Ecchymosis / prevention & control*
  • Edema / prevention & control*
  • Homeopathy*
  • Humans
  • Plant Extracts / therapeutic use*
  • Postoperative Complications / prevention & control*


  • Plant Extracts
  • Bromelains