Marshmallow

Marshmallow is an incredibly supportive herb. Its deeply nourishing, soothing and nurturing effects can be felt in both the physical and emotional sense. It gives an instant feeling of softness. It is energetically cooling and moist and is most specific for hot, dry tissue states.

Marshmallow is indicated for the fiery choleric type. Those who push themselves into exhaustion through over-striving or by other intense fast paced lifestyles. Energetically, marshmallow ‘grounds’ and roots one into themselves with its solid, yet softening and cooling qualities that bring balance to the choleric temperament (4).

Mucilage such as that found in marshmallow moistens the tissues by drawing water to them. It also has a drawing action on the tissues which makes it useful for drawing out toxins. 

In traditional western herbalism, marshmallow is understood to be one of the primary herbs for dry, atrophic tissue states. In this tissue state there may be weakness or poor function of the mucous membranes, withered, dry looking skin and complexion as well as dryness on the tongue. Constipation is also a common symptom. Dry or atrophic tissue states may be caused by lack of fluid or oil. So it is important to assess a patient for low dietary oils (such as essential fatty acids) as a possible cause and ensure adequate fluid intake (4). 

In traditional Chinese medicine, marshmallow is understood to promote yin, seen as the feminine aspect. This view is also held in Western traditional herbalism. Marshmallow is deemed as being the ‘caregiver’. This may be a herb for someone who is in need of maternal energy or connection to the matriarch (4).

The subtle sweet taste of marshmallow tells us that it is a source of energising saccharides (sugars) and would indicate its use for depletion, where there is need for deeper support and nourishment in the body. This works by its protective actions in the digestive tract and by improving the health and function of the inner surface of the digestive tract (3).

The primary medicinal constituent of marshmallow is mucilage, which constitutes ~11% of the herb’s composition in the root, and slightly less in the leaf (7). Mucilage will trap liquid to form gel like substances and will also swell to many times its original volume. Mucilage forms a protective layer over damaged mucosal membranes, allowing time for cellular regeneration and healing to occur. It also protects the membranes from further deterioration, for example, damage from gastric acid exposure. Longer-term use of mucilage allows time for damaged cells to heal (8).

Digestive system

Marshmallow is used in all hot, inflamed, irritated and dry conditions of the digestive mucosa, such as hyperacidity, reflux oesophagitis, hiatus hernia, and gastritis and peptic ulcers.

This type of heat and irritation in the gastrointestinal tract can cause damage to the mucosa, thereby inhibiting proper absorption of nutrients and even lead to ‘leaky gut’ and sensitivities. Marshmallow’s protective healing mucilage supports these tissues in their recovery. This makes marshmallow an important part of any protocol for systemic, hot, dry and inflamed conditions. Calendula (Calendula officinalis) is a herb that pairs well with marshmallow for the treatment of chronic inflammation in the digestive system (1,8).

In lower dosages, mucilaginous compounds restrain the peristaltic action within the gut and work well to promote an antidiarrheal action. In larger dosages, they exhibit a gentle laxative effect. 

Respiratory system

Marshmallow is one of the best medicines for irritated and dry conditions of the airways. Specifically for dry, unproductive and tickly coughs. Marshmallow can help provide long-term relief in lung infections and inflammatory lung conditions by allowing time for the inflamed and infected mucosa to heal. Marshmallow works well with thyme (Thymus vulgaris) or astragalus (Astragalus membranaceus) for these types of respiratory conditions (1,2,8).

Immune system

Healthy, well-coated mucous membranes and tissues directly support our defence systems. The mucilage from marshmallow helps to enhance the protective barrier, which in turn supports a healthy immune system by preventing pathogens from entering the body. When the mucous membranes are dry, it’s harder to stimulate the immune cells and eliminate pathogens from the body. Marshmallow has an important role in supporting this first line of defence by improving the health of the body’s mucous membranes (8).

Urinary system

Marshmallow helps to relieve urinary inflammations such as cystitis, urethritis, urinary stones and nephritis due to its demulcent properties. This works in the same way as described above via its protective action on the mucous membranes. This herb may be used both during the active phase of these conditions to protect the tissues but also during the recovery phase to allow the tissues to heal. 

In the treatment of urinary tract infections, however, it is important to note that marshmallow does not treat the infection itself. It may be used in combination with antimicrobial herbs, such as bearberry (Arctostaphylos uva-ursi) and cranberry (Vaccinium oxycoccos) and in some cases antibiotics may be needed. Urinary tract infections need to be addressed with care due to the potential secondary infections in the kidneys. Any lower back pain would usually indicate that the kidneys are affected — in which case there is an immediate need for medical attention (3,4).

A clinical herbalist will be able to support through active stages of an infection, as well as to improve recovery outcomes and lower the risks of recurrences. The holistic approach will usually address the root causes of recurring UTIs with an integrated approach that may include dietary changes and herbs as well as redressing the microfloral balance.

Skin health

Marshmallow may be applied as an external preparation such as a poultice or gel to inflamed, irritated and dry conditions of the skin such as wounds, burns, scar tissue, ulcers and swellings.

It provides symptomatic relief whilst also directly protecting and healing the skin cells. Used as a drawing agent marshmallow may be used to draw fluid and toxicity from wounds and infections when used externally (3).

Marshmallow root extract for the treatment of irritative cough: Two surveys on users’ view on effectiveness and tolerability

Two surveys were carried out which included 822 consumers who bought either lozenges or syrup of the aqueous marshmallow root extract to treat a dry cough. The participants who were recruited by pharmacies in two independently performed surveys were asked to complete a questionnaire. 

The treatment duration was seven days. The reported outcome showed that both preparations were effective for the symptomatic treatment of oral or pharyngeal irritation and associated dry cough. A very rapid onset of therapeutic effects was also reported in the majority of cases within ten minutes (9).

Comparison of the effects of Althaea officinalis and eucalyptus nebulizers on the severity of cough in patients with Covid-19: Clinical trial

This randomised clinical trial aimed to compare the effects of nebulised Althaea officinalis and eucalyptus on cough severity in hospitalised COVID-19 patients. Thirty-six adults with confirmed COVID-19 (sex and age not specified) were randomly allocated to three groups: marshmallow nebuliser, eucalyptus nebuliser, or control (no intervention). Cough severity was assessed using a visual analogue scale (VAS) two hours before intervention and two hours after daily treatment.

The marshmallow group received 1 cc aqueous extract plus 5 cc normal saline, and the eucalyptus group received 4 cc aqueous extract plus 5 cc normal saline, nebulised once daily for 15 minutes, continued throughout hospitalisation. The primary outcome was a change in cough intensity.

By days two and three post-intervention, cough severity was significantly reduced across groups, with greater improvement in the marshmallow group compared to eucalyptus and control (p < 0.05). Both active treatments showed progressive improvement over time (Friedman test), with marshmallow offering the most significant results. The authors concluded that nebulised Althaea officinalis may be an effective adjunctive therapy for COVID-19-related cough (10).

Comparing the effect of body wash with marshmallow plant and lukewarm water on reducing the temperature of febrile children: A randomised clinical trial

This randomised clinical trial was carried out to examine whether body washing with Althaea officinalis (marshmallow) extract could reduce fever in children. Ninety-two children aged 6 months to 10 years with temperatures above 38.3 °C were randomly assigned to a control group (lukewarm water wash) or an intervention group (white marshmallow extract wash); both groups received standard acetaminophen. Temperature was recorded every 15 minutes during the first hour and again at four and six hours.

Primary outcomes included time to fever resolution, proportion of afebrile children, and magnitude of temperature reduction; secondary outcomes were heart rate change, need for further acetaminophen, and time to fever recurrence. The intervention group showed a significantly shorter time to fever resolution (B = 8.18, 95% CI 3.78–12.58, p < 0.001) and a higher proportion of afebrile children (p < 0.001). No significant differences were observed in secondary outcomes. The authors concluded that marshmallow body wash may be a safe complementary approach to support fever reduction in children (11).

Effect of topical marshmallow (Althaea officinalis) on atopic dermatitis in children: A pilot double‐blind active‐controlled clinical trial of an in‐silico‐analyzed phytomedicine

A pilot double-blind active-controlled clinical trial was carried out to evaluate the efficacy of marshmallow in children with mild-to-moderate atopic dermatitis. The children aged between three months and 12 years old were randomly allocated into two parallel intervention and control groups.

The intervention group used a marshmallow 1% ointment while the positive control group used hydrocortisone 1% ointment twice a day for a week and after that, three times per week for a period of three weeks. A significant decrease of the symptom score was observed in both groups. The study concluded that the improvement of the patients was significantly higher in the intervention group in comparison to the control (12).

The efficacy of complementary treatment with marshmallow (Althaea officinalis L.) on vulvovaginal candidiasis: A randomised double-blinded controlled clinical trial

A randomised, double-blinded controlled clinical trial was carried out to investigate the efficacy of marshmallow in the treatment of vulvovaginal candidiasis (VVD). One hundred women with VVC were randomly assigned into two groups, with 50 participants in each. The target group was treated with CLOT-M (marshmallow aqueous extract 4% plus clotrimazole 1%) while controls received clotrimazole 1% vaginal cream for seven consecutive nights.

Symptoms and signs, and yeast culture from vaginal discharge were evaluated as the outcome measures before the intervention, and seven and 30 days after. The target group experienced a significant decrease in itching, dyspareunia (painful intercourse) and dysuria. The study concludes that the marshmallow extract cream gave significantly improved results when compared to the control group (13).

The effect of hollyhock (Althaea officinalis L) leaf compresses combined with warm and cold compress on breast engorgement in lactating women

This randomised, controlled clinical trial aimed to evaluate whether topical Althaea officinalis leaf compress, combined with routine care, improves breast engorgement in lactating women. Forty postpartum women (1–15 days after delivery) with clinically significant breast engorgement were randomised to either the intervention (n = 20) or control (n = 20). Both groups received standard care: warm compress before breastfeeding, breast massage during feeding, and cold compress after feeding, repeated three times daily for two days (six sessions).

The intervention group additionally applied 40–50 ml of hollyhock leaf compress for 10 minutes after routine care. The primary outcome was change in breast engorgement severity score (erythema, tension, and pain; scale 0–19). Both groups improved over time, but the reduction was significantly greater in the A. officinalis group (mean difference B = 4.103, p < .001), with a significant time effect (p < .001). The authors concluded that A. officinalis compress is significant in symptom improvement and may offer a safe complementary approach for managing postpartum breast engorgement (14).

Marshmallow root is a wonderfully accessible and versatile medicine for use in a number of simple conditions that can be managed with home herbalism. It is one of the best demulcent and moistening agents in the materia medica for its protective effects on mucosal linings. The most common uses are for inflammation of the respiratory and digestive systems (1,2).

The primary compound in marshmallow is mucilage, which forms a slimy substance. This mucilage forms a protective layer over the mucosa — found throughout the body’s visceral organs including in the digestive, respiratory and urinary systems. These soothing, protective and coating effects are the dominant actions of marshmallow. Mucilage is sensitive to both heat and alcohol; therefore, it is best taken as a powder or extracted in cold or warm water.

Marshmallow soothes irritation in the digestive system, such as that which is caused by gastritis or stomach upsets. This provides almost immediate relief. This is because the effect is almost entirely from the physical properties of the mucilage on the mucosal lining of the upper digestive tract. It can also be used to help with short term constipation by softening the stool. Its effects on the lower digestive tract for constipation may take several hours due to transit time of the marshmallow through the body. 

Marshmallow may be used for dry, irritable coughs. It is particularly helpful in recovery from a chest infection or virus which has left irritation in the lungs. Its soothing actions may also be useful for laryngitis and other inflammations in the mouth or throat (1,2).

Powdered marshmallow acts as a drawing agent when made into a poultice. This may be used on skin eruptions, insect bites or even left over splinters or tick bites (if there is concern that parts have been left under the skin. A drawing ointment can be used to draw out any remnants or infection. See the ‘Dosage’ section below to learn how to make this simple drawing ointment (3).

In ancient Egypt, the root pulp of A. officinalis was boiled with honey to produce a sticky, sweet preparation that was both prized as a delicacy and applied to soothe sore throats and other ailments. Over the centuries, variations of these sweets appeared in Greco-Roman and medieval European contexts.

In the 19th century, French confectioners developed what are recognised today as marshmallows (pâte de guimauve) by whipping the plant’s root extract with sugar and egg white. Manufacturers later replaced the plant extract with gelatin, corn syrup and other stabilisers (15).

1. Mcintyre A. Complete Herbal Tutor : The Definitive Guide to the Principles and Practices of Herbal Medicine (Second Edition). Aeon Books Limited; 2019.
2. Thomsen M. Phytotherapy Desk Reference. 6th ed. Aeon Books; 2022.
3. Hoffmann D. Medical Herbalism: The Science and Practice of Herbal Medicine. Healing Arts Press; 2003.
4. Wood M. The Practice of Traditional Western Herbalism : Basic Doctrine, Energetics, and Classification. North Atlantic Books, Cop; 2004.
5. Fisher C. Materia Medica of Western Herbs. Aeon Books; 2018.
6. Hedley C, Shaw N. Plant Medicine. (Waddell G, ed.). Aeon Books; 2023.
7. Graeme Tobyn, Denham A, Whitelegg M. Althaea officinalis, marshmallow; Malva sylvestris, common mallow; Alcea rosea, hollyhock. Elsevier eBooks. Published online December 28, 2010:67-78. https://doi.org/10.1016/b978-0-443-10344-5.00013-6 
8. Bone K, Mills S. Principles and Practice of Phytotherapy: Modern Herbal Medicine. 2nd ed. Edinburgh Churchill Livingstone, Elsevier; 2013.
9. Fink C, Schmidt M, Kraft K. Marshmallow Root Extract for the Treatment of Irritative Cough: Two Surveys on Users’ View on Effectiveness and Tolerability. Complementary Medicine Research. 2018;25(5):299-305. https://doi.org/10.1159/000489560 
10. Fatemeh N, Masoumeh AD, Maryam M, et al. Comparison of the effects of Althaea officinalis and eucalyptus nebulizers on the severity of cough in patients with Covid-19: Clinical trial. مرکز اطلاعات علمی جهاد دانشگاهی SID. 2024;82(1):46-53. https://www.sid.ir/paper/1518587/en 
11. Goodarzi H, Valizadeh F, Ghasemi F, et al. Comparing the effect of body wash with marshmallow plant and lukewarm water on reducing the temperature of febrile children: a randomized clinical trial. BMC Complementary Medicine and Therapies. 2022;22(1). https://doi.org/10.1186/s12906-022-03762-3 
12. Naseri V, Chavoshzadeh Z, Mizani A, et al. Effect of topical marshmallow ( Althaea officinalis ) on atopic dermatitis in children: A pilot double‐blind active‐controlled clinical trial of an in‐silico ‐analyzed phytomedicine. Phytotherapy Research. 2020;35(3):1389-1398. https://doi.org/10.1002/ptr.6899 
13. Amini F, Namjooyan F, Zomorodian K, et al. The efficacy of complementary treatment with marshmallow (Althaea officinalis L.) on vulvovaginal candidiasis: A randomized double-blinded controlled clinical trial. EXPLORE. Published online April 17, 2023. https://doi.org/10.1016/j.explore.2023.04.005  
14. Khosravan S, Mohammadzadeh-Moghadam H, Mohammadzadeh F, Fadafen SAK, Gholami M. The Effect of Hollyhock (Althaea officinalis L) Leaf Compresses Combined With Warm and Cold Compress on Breast Engorgement in Lactating Women. Journal of Evidence-Based Complementary & Alternative Medicine. 2016;22(1):25-30. https://doi.org/10.1177/2156587215617106 
15. McGuffin M, Hobbs C, Upton R, editors. HerbalGram: Marshmallow (Althaea officinalis): History and Uses. American Botanical Council; HerbalGram Issue 75. February 2008.
16. Sendker J, Böker I, Lengers I, et al. Phytochemical Characterization of Low Molecular Weight Constituents from Marshmallow Roots (Althaea officinalis) and Inhibiting Effects of the Aqueous Extract on Human Hyaluronidase-1. Journal of Natural Products. 2017;80(2):290-297. https://doi.org/10.1021/acs.jnatprod.6b00670 
17. Encyclopaedia Brittanica. marsh mallow | plant | Britannica. www.britannica.com. Published 2024. https://www.britannica.com/plant/marsh-mallow 
18. Royal Botanical Gardens Kew. Althaea officinalis L. | Plants of the World Online | Kew Science. Plants of the World Online. Published 2019. Accessed December 25, 2024. https://powo.science.kew.org/taxon/urn:lsid:ipni.org:names:558872-1 
19. Khela S. IUCN Red List of Threatened Species: Althaea officinalis. IUCN Red List of Threatened Species. Published June 26, 2013. Accessed April 28, 2023. https://www.iucnredlist.org/species/202921/2758027 
20. Cox J, Mountford J. PlantAtlas. plantatlas2020.org. Published 2020. https://plantatlas2020.org/atlas/2cd4p9h.fz 
21. Marshmallow — FairWild Foundation. FairWild Foundation. FairWild Foundation. Published 2018. Accessed December 28, 2025. https://www.fairwild.org/ingredients/marsh-mallow
22. Evans WC, Trease GE, Evans D. Trease and Evans’ Pharmacognosy. 16th ed. Saunders/Elsevier; 2009.
23. Heinrich M, Barnes J, José M Prieto Garcia, et al. Fundamentals of Pharmacognosy and Phytotherapy. Elsevier; 2018.
24. British Pharmacopoeia Commission. British Pharmacopoeia 2025. London TSO; 2025.
25. British Herbal Medicine Association. Scientific Committee. British Herbal Pharmacopoeia. Conran Octopus; 1983.
26. Tobyn G, Denham A. The Western Herbal Tradition. Churchill Livingstone; 2011.
27. Eden Brothers. Marshmallow Seeds – Gardener’s Toolkit. Gardener’s Toolkit – Eden Brothers. Published October 21, 2024. Accessed December 25, 2024. https://grow.edenbrothers.com/planting-guides/marshmallow-seeds/