The Public Herbarium

Plantain (Plantago major) leaves

Wound Healing Physiology, Antimicrobial Mechanisms, and Emergency Phytotherapy

CRITICAL: This guide addresses MINOR injuries only. Seek immediate emergency medical care for serious injuries.

Why This Matters: Immediate natural remedies for minor injuries, complements (not replaces) conventional first aid, accessible FREE herbs, empowering home care, reduces need for minor medical visits.

Table of Contents

  1. Wound Healing Physiology Review
  2. Plantain: Drawing & Antimicrobial Mechanisms
  3. Calendula: Regenerative Pharmacology
  4. Arnica: Anti-Inflammatory & Anti-Bruising Science
  5. Honey: Medical-Grade Antimicrobial Properties
  6. Clinical Protocols for Common First Aid Situations

Wound Healing Physiology Review

The Four Phases of Cutaneous Wound Healing

This review provides essential context for understanding how herbal interventions support natural healing processes. For comprehensive wound healing physiology, see the Skin Health Deep Dive guide.

Phase 1: Hemostasis (Minutes to hours)

Phase 2: Inflammation (Hours to 3-5 days)

Phase 3: Proliferation (Days 4-21)

Phase 4: Remodeling (Weeks to months/years)

Key Cellular Players in Wound Healing

Platelets:

Neutrophils:

Macrophages:

Fibroblasts:

Keratinocytes:

Factors That Impair Healing

Local:

Systemic:

Plantain: Drawing & Antimicrobial Mechanisms

broad leaf plantain
Broad Leaf Plantain (Plantago major)
botanical cropped image of Plantago lanceolata (narrow leaf plantain)
Narrow leaf plantain (Plantago lanceolata)

Botanical Profile

Species: Plantago major (broadleaf), P. lanceolata (narrowleaf)

Family: Plantaginaceae

Parts used: Fresh leaves (primary), dried leaves (less potent), seeds

Phytochemical Constituents

Iridoid Glycosides:

Aucubin (most abundant):

Catalpol:

Mechanism of aucubin antimicrobial activity:

  1. Aucubin is enzymatically hydrolysed to aucubigenin
  2. Aucubigenin disrupts bacterial cell walls
  3. Particularly effective against Gram-positive bacteria (Staphylococcus aureus, Streptococcus species)

Mucilage (Polysaccharides):

Content: 2-6% depending on part (highest in seeds)

Structure:

Properties:

Mechanism in wound care:

Tannins:

Type: Hydrolysable tannins (gallotannins)

Content: 2-6%

Properties:

Mechanism:

Allantoin:

Content: 0.1-0.3%

Properties:

Mechanism:

Flavonoids:

Major compounds:

Properties:

Clinical Actions & Mechanisms

1. Drawing/Extracting Action (“Vulnerary Drawing”)

Traditional use: Splinters, venom, foreign material

Proposed mechanisms:

A. Osmotic gradient:

B. Enhanced lymphatic drainage:

C. Anti-inflammatory reduction of edema:

Evidence: Primarily traditional/empirical. Mechanism plausible based on constituent properties but lacking direct research.

2. Anti-Inflammatory

Mechanisms:

Aucubin:

Flavonoids:

Clinical manifestation: Rapid reduction in pain, redness, swelling from insect bites/stings

3. Antimicrobial

Spectrum:

Mechanisms:

Clinical relevance: Prevents infection in minor wounds

4. Antihistaminic

Mechanism: Flavonoids inhibit mast cell degranulation and histamine release

Clinical manifestation: Rapid relief of itching from insect bites, allergic reactions

Preparation Considerations

Fresh vs. Dried:

Fresh (optimal for first aid):

Dried:

Tincture (alcohol extraction):

Clinical Protocol: Insect Sting

Immediate (within seconds-minutes):

  1. Remove stinger if present (scrape, don’t squeeze)
  2. Locate fresh plantain leaf
  3. Wash leaf briefly
  4. Chew leaf thoroughly (15-30 seconds) OR crush extensively
  5. Apply chewed/crushed leaf directly to sting
  6. Secure with bandage or hold in place
  7. Replace every 1-2 hours for first 6 hours

Why chewing works:

Expected response:

Calendula: Regenerative Pharmacology

Calendula (Calendula officinalis) flower
Calendula (Calendula officinalis)

For comprehensive calendula phytochemistry and wound healing mechanisms, see Skin Health Deep Dive guide. This section focuses on first aid-specific applications.

Quick Phytochemistry Review

Primary actives for wound healing:

—

Mechanisms Relevant to First Aid

1. Rapid Hemostasis Support

Mechanism:

2. Infection Prevention

Antimicrobial spectrum:

Mechanism:

Clinical application: Apply to clean wounds to prevent secondary infection

3. Accelerated Granulation Tissue Formation

Timeline: Days 4-14 post-injury

Mechanism:

Clinical manifestation: Pink, healthy granulation tissue fills wound bed faster

4. Enhanced Epithelialisation

Timeline: Days 3-21 post-injury

Mechanism:

Clinical manifestation: Wound closes (epithelial coverage) more rapidly

Evidence: Multiple clinical studies show 25-50% reduction in healing time for partial-thickness wounds

5. Anti-Inflammatory (Reduces Excessive Inflammation)

Key compound: Faradiol

Mechanism:

Clinical benefit: Reduces redness, swelling, pain WITHOUT impairing necessary inflammation for healing

Clinical Protocol: Minor Laceration

Immediate care (Minutes 0-15):

  1. Apply direct pressure with clean cloth (5-10 minutes)
  2. Once bleeding controlled, irrigate with clean water
  3. Pat dry gently
  4. Apply thin layer calendula salve
  5. Cover with sterile non-adherent dressing
  6. Secure with tape or bandage

Ongoing care (Days 1-14):

  1. Clean gently with water once daily
  2. Reapply calendula salve 2-4x daily
  3. Keep covered until epithelialisation complete
  4. Monitor for infection signs (see below)

Infection monitoring:

Expected timeline:

Arnica: Anti-Inflammatory & Anti-Bruising Science

Botanical drawing of Arnica (Arnica montana) leaves and flowers
Arnica (Arnica montana)

Botanical Profile

Species: Arnica montana (European), A. cordifolia (North American)

Family: Asteraceae

Parts used: Flowers (exclusively for medicinal use)

CRITICAL SAFETY: External use ONLY. Arnica is TOXIC if taken internally in herbal doses. Homeopathic preparations (ultra-dilute) are different and may be taken orally under appropriate guidance.

Phytochemical Constituents

Sesquiterpene Lactones (0.4-0.6% required by European Pharmacopoeia):

Helenalin and helenalin esters:

11α,13-Dihydrohelenalin and esters:

Chamissonolide:

Flavonoids (0.4-0.6%):

Volatile Oil (0.5-1%):

Carotenoids:

Phenolic Acids:

Anti-Inflammatory Mechanisms

Primary Mechanism: NF-κB Inhibition

Helenalin’s mode of action:

Structure-activity relationship:

Specific NF-κB inhibition:

NF-κB overview:

Helenalin mechanism:

Selectivity:

Downstream effects:

Secondary Mechanism: Platelet Function Inhibition

Helenalin and dihydrohelenalin:

Clinical relevance:

Tertiary Mechanism: MMP Inhibition

Matrix metalloproteinases (MMPs):

Arnica effect:

Anti-Bruising Mechanisms

What is a bruise (ecchymosis)?

How arnica accelerates resolution:

1. Enhanced circulation:

2. Macrophage activation:

3. Reduced secondary inflammation:

4. Lymphatic drainage:

Clinical Evidence

Osteoarthritis:

Post-surgical bruising:

Sports injuries:

Dosing in studies: Typically 10% arnica extract or gel, applied 2-3x daily

Safety & Contraindications

CRITICAL – External Use ONLY:

  • Oral ingestion of herbal arnica → gastroenteritis, cardiovascular toxicity
  • Helenalin is TOXIC systemically
  • Homeopathic arnica (ultra-diluted) is different – safe orally

Contraindications:

  • Broken skin/open wounds: Arnica absorbed systemically through broken skin → toxicity risk
  • Pregnancy/lactation: Theoretical risk of uterine stimulation
  • Anticoagulant/antiplatelet medications: Additive effects, bleeding risk
  • Pre-surgery: Discontinue 2 weeks before surgery (bleeding risk)

Allergic reactions:

  • Asteraceae family allergy (ragweed, chrysanthemum, daisies)
  • Contact dermatitis possible (sesquiterpene lactones are allergens)
  • Patch test recommended if sensitive skin

Drug interactions:

  • Warfarin, heparin: Increased bleeding risk
  • Aspirin, NSAIDs, clopidogrel: Additive antiplatelet effects

Clinical Protocol: Acute Bruise/Contusion

Immediate (0-24 hours):

  1. ICE first (15-20 minutes, repeat hourly)
  1. Do NOT apply arnica in first 24 hours (vasodilation could worsen bleeding)
  2. Compression, elevation
  3. Rest injured area

Days 1-7:

  1. Begin arnica gel 24 hours post-injury
  2. Apply to bruised area 3-4x daily
  3. Massage gently (once tolerable)
  4. Continue ice if swelling persists
  5. Gradual return to activity

Expected timeline:

Honey: Medical-Grade Antimicrobial Properties

Types of Honey

Raw honey:

Manuka honey (New Zealand):

Medical-grade honey:

Antimicrobial Mechanisms

Mechanism 1: Hyperosmolarity

High sugar content (~80%):

Low water activity (aw ~0.6):

Mechanism 2: Acidity

pH 3.2-4.5:

Mechanism 3: Hydrogen Peroxide (Peroxide Activity)

Source:

Antimicrobial mechanism:

Limitation:

Mechanism 4: Non-Peroxide Activity (Manuka Honey)

Methylglyoxal (MGO):

Antimicrobial mechanism:

Clinical significance:

Rating systems:

Mechanism 5: Immunomodulation

Effects:

Wound Healing Promotion

Beyond antimicrobial:

1. Maintains moist wound environment:

2. Autolytic debridement:

3. Reduces inflammation:

4. Stimulates angiogenesis:

5. Odor control:

Clinical Evidence

Wound types shown effective:

Cochrane reviews:

Clinical Protocol: Clean Minor Wound

Appropriate wounds:

Application:

  1. Clean wound thoroughly with water
  2. Pat dry gently
  3. Apply thin layer honey directly to wound
  4. Cover with sterile non-adherent dressing
  5. Secure with bandage
  6. Change dressing daily (or when saturated)

Which honey:

Expected effects:

Clinical Protocols for Common First Aid Situations

Protocol 1: Bee/Wasp Sting

Severity assessment:

Management (mild-moderate local reaction):

Immediate (0-5 minutes):

  1. Remove stinger if present (scrape with edge, don’t squeeze)
  2. Apply fresh plantain poultice immediately
  3. Replace every 30-60 minutes for first 2-6 hours

Hours 1-24:

  1. Ice if swelling persists (10-15 min every hour)
  2. Continue plantain applications as needed for itching
  3. Oral antihistamine if itching severe (diphenhydramine 25-50mg)
  4. Elevation if extremity

Days 1-3:

  1. If residual swelling: Arnica cream 3x daily (after 24h)
  2. Monitor for signs of infection (rare but possible)

Expected timeline:

Protocol 2: Sprained Ankle (Mild-Moderate)

Severity assessment:

Immediate (RICE protocol + herbs):

  1. Rest: No weight bearing
  2. Ice: 15-20 minutes every 2 hours (first 48-72h)
  3. Compression: Elastic bandage (not too tight)
  4. Elevation: Above heart level

Days 1-3 (acute phase):

  1. Continue RICE
  2. No arnica yet (could worsen swelling if vascular damage)
  3. Oral anti-inflammatory: Ginger tincture 2-4ml TID
  4. Turmeric: 500mg 2-3x daily

Days 3-14 (subacute phase):

  1. Begin arnica gel 3-4x daily
  2. Gentle range-of-motion exercises (no weight bearing initially)
  3. Gradual weight bearing as tolerated
  4. Continue compression and elevation

Weeks 2-6 (rehabilitation):

  1. Progressive strengthening exercises
  2. Proprioceptive training
  3. Continue arnica as needed for residual swelling

Red flags (seek medical care):

Protocol 3: Minor Burn (First-Degree, Small Second-Degree)

Severity assessment:

Size limit for home treatment: Smaller than palm of hand, but if unsure seek medical assistance

Immediate (0-30 minutes):

  1. COOL immediately: Cool (not ice) running water 10-20 minutes
  2. Do NOT apply ice directly (causes tissue damage)
  3. Remove jewelry, tight clothing from area
  4. Do NOT break blisters (infection risk)

After cooling:

  1. Gently pat dry
  2. Apply aloe vera gel (fresh from plant if possible)
  3. Cover with non-adherent dressing
  4. Take oral pain medication if needed (paracetamol, ibuprofen)

Days 1-7:

  1. Reapply aloe vera 4-6x daily
  2. Keep covered, change dressing daily
  3. Once blisters open (if any): Apply honey or calendula to prevent infection
  4. Monitor for infection signs

Days 7-21:

  1. As epithelialisation completes: Calendula cream for healing
  2. Avoid sun exposure (new skin very sensitive)

Seek medical care if:

Protocol 4: Nosebleed

Management:

Immediate:

  1. Sit upright, lean slightly forward (prevents blood swallowing)
  2. Pinch soft part of nose firmly for 10 minutes (continuous, no peeking!)
  3. Breathe through mouth
  4. Apply ice to bridge of nose (vasoconstriction)

If continues after 10 minutes:

  1. Fresh yarrow: Insert small piece of clean, crushed yarrow leaf into bleeding nostril
  2. Continue pinching 10 more minutes

Or tincture method:

  1. Soak small piece of cotton or gauze in yarrow tincture
  2. Insert gently into nostril
  3. Pinch 10 minutes

After bleeding stops:

  1. Keep yarrow in place 15-30 minutes
  2. Remove gently (moisten first if stuck)
  3. Avoid blowing nose for 12 hours
  4. Use saline spray to keep moist (prevents rebleeding)

Seek medical care if:

Summary: Building Your Evidence-Based First Aid Kit

Core items based on mechanism and evidence:

Tier 1 (Essential):

  1. Calendula salve (wound healing, antimicrobial)
  2. Fresh plantain access (drawing, anti-itch, antimicrobial)
  3. Manuka honey UMF 10+ (infected wounds, burns)
  4. Arnica gel 10% (bruises, soft tissue injury)

Tier 2 (Highly Useful):

  1. Ginger tincture (internal anti-inflammatory)
  2. Yarrow tincture (hemostatic)
  3. Lavender essential oil (burns, stress, headache)

Tier 3 (specialised):

  1. Comfrey cream (fractures, strains – external only)
  2. St. John’s wort oil (nerve pain, burns)
  3. Tea tree oil (antiseptic)

Always include:

Storage:

Remember: Herbal first aid is for MINOR injuries only. Seek professional medical care for serious injuries, persistent symptoms, or any concerning conditions.

References

Bone, K., & Mills, S. (2013). Principles and practice of phytotherapy: Modern herbal medicine (2nd ed.). Churchill Livingstone.

Iannitti, T., Morales-Medina, J. C., Bellavite, P., Rottigni, V., & Palmieri, B. (2016). Effectiveness and safety of arnica montana in post-surgical setting, pain and inflammation. American Journal of Therapeutics, 23(1), e184-e197.

Lyss, G., et al. (1997). Helenalin, an anti-inflammatory sesquiterpene lactone from arnica, selectively inhibits transcription factor NF-κB. Biological Chemistry, 378(9), 951-962.

Majtan, J. (2014). Honey: An immunomodulator in wound healing. Wound Repair and Regeneration, 22(2), 187-192.

Disclaimer: This guide is for educational purposes only and is not medical advice. Herbal first aid supports minor injury care but does not replace emergency medicine or professional medical care. Always seek immediate medical attention for serious injuries, severe symptoms, or any concerning conditions. Use herbs at your own risk and consult qualified healthcare practitioners, especially if pregnant, nursing, taking medications, or having medical conditions.

Note on Pricing: All prices mentioned in this guide are approximate and based on New Zealand suppliers as of December 2025. Prices vary by supplier, season, and market conditions. We recommend checking current prices with your local suppliers.

The Public Herbarium is built on a foundation of scientific integrity, transparency, and care. Research sources are referenced throughout the site wherever possible. Content creation is assisted by AI tools and carefully reviewed for accuracy.