J. Cosmet. Sci., 71, 439–454 (November/December 2020) 439 Effi cacy and Safety of Centella Asiatica (L.) Urb. on Wrinkles: A Systematic Review of Published Data and Network Meta-Analysis CHUENJID KONGKAEW, PEERAPONG MEESOMPERM, C. NORMAN SCHOLFIELD, NARTTAYA CHAIWIANG, and NETI WARANUCH , Department of Pharmacy Practice, Faculty of Pharmaceutical Sciences, Naresuan University, Phitsanulok 65000, Thailand (C.K., C.N.S. ), Department of Pharmacy Practice, Research Centre for Safety and Quality in Health, Faculty of Pharmaceutical Sciences, Naresuan University, Phitsanulok 65000, Thailand (C.K., P.M., C.N.S.), Research Department of Practice and Policy, UCL School of Pharmacy, London WC1N 1AX, United Kingdom (C.K. ), Medical Division of General Support Offi ce, Armed Force Development Command, Bangkok, Thailand 10210 (P.M.), Faculty of Optometry, Ramkhamhaeng University, Bangkok 10240, Thailand (N.C.), Department of Pharmaceutical Technology, Cosmetics and Natural Products Research Center, Faculty of Pharmaceutical Sciences and Center of Excellence for Innovation in Chemistry, Naresuan University, Phitsanulok, 65000, Thailand (N.W.) Accepted for publication May 22, 2020. Synopsis Centella asiatica has many applications in cosmetics, including wrinkle treatments, but its effectiveness remains to be clarifi ed. This systematic review study aimed to demonstrate the effi cacy and safety of C. asiatica for reducing facial wrinkles. PubMed, Excerpta Medica dataBASE (EMBASE), Cochrane Central Register of clinical trials, Allied and Complementary Medicine Database, Cumulative Index to Nursing and Allied Health Literature (CINAHL), Thai Library Integrated System, and Thai university database/journals were searched until May 2019. Five double-blinded randomised controlled trials, including 172 Asian females, were included. Endpoints were wrinkling measured by visual score, image analysis, and participant satisfaction. Two placebo-controlled studies applied gel/creams containing C. asiatica or asiaticoside for 12 w to periorbital skin. Two studies applied tretinoin or Pueraria mirifi ca contralaterally and by network meta- analysis C. asiatica appeared more effective than P. mirifi ca but possibly less than tretinoin. Asiaticoside applied as a lipstick for 8 w reduced lip wrinkling. Skin hydration was markedly raised by C. asiatica but not tretinoin. One study reported 10 adverse events for C. asiatica and 35 for tretinoin. Cochrane risk of bias was generally low, reporting was weak, and lack of C. asiatica standardization prevents general application. From the reported data, it is possible to conclude that C. asiatica improved lip and periocular wrinkles, and may replace retinoids if its long-term safety is established and C. asiatica is standardized. Address all correspondence to Chuenjid Kongkaew at chuenjidk@nu.ac.th or chuenjid@googlemail.com.