Shikonboreito
Quick Facts
- What it is: A Ministry-approved Japanese Kampo formula, Lithospermum and Oyster Shell Decoction, used by mouth for stubborn skin sores and swellings.
- Main uses: Long-lasting skin sores and ulcers, Boils and deep skin abscesses, Swollen lymph glands, Hard lumps under the skin
- Best for: Chronic skin sores under Kampo guidance, Short courses, not daily long-term use
- Active ingredients: Shikonin and acetylshikonin (Lithospermum), Sennosides, rhein and emodin (rhubarb root), Glycyrrhizin (licorice root), Paeoniflorin (peony root), Calcium carbonate (oyster shell)
- Forms: Dry extract granules in sachets, Powder or tablets, Traditional decoction from raw herbs
- Time to effect: Bowel effect within hours; any skin change takes weeks.
- Side effects: Loose stools and cramps are common; long use can lower potassium and raise blood pressure.
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What is Shikonboreito?
Shikonboreito is a Japanese Kampo herbal formula taken by mouth. Its name means Lithospermum and Oyster Shell Decoction (herbs boiled in water). It is a Ministry-approved Kampo formula in Japan and is sold mainly as extract granules.
In Kampo practice it is used for long-lasting skin sores, boils and hard swollen lumps. Some practitioners also use it for swollen, tender lymph glands and for painful breast inflammation. It is swallowed, not rubbed on the skin.
Here is the evidence verdict up front. Traditional use in Kampo is long-standing, but we found no controlled human trials of the whole formula. Long traditional use is not proof that a remedy works.
This formula is not a mild tonic. It contains rhubarb root (daio), a stimulant laxative, and licorice root (kanzo). Those two herbs drive most of its risks, and they are covered below.
How does Shikonboreito work?
The honest answer first: how Shikonboreito works in people has not been shown.
Kampo theory describes it as cooling heat, moving blood and draining the bowel. That is a traditional model of the body. It is not a laboratory finding.
Some single herbs in it do have lab data. In test tubes, shikonin from Lithospermum slows some bacteria and lowers markers of inflammation. Whether that happens in your skin after you swallow the herb is unknown.
One effect is clear in people. The sennosides in rhubarb root act on the gut wall and bring on a bowel movement. This is a real drug-like effect, and it is why the formula can cause cramps and diarrhoea.
Licorice root also acts in people, and not in a helpful way here. Its glycyrrhizin can raise blood pressure and lower potassium in the blood. Oyster shell is mostly calcium carbonate (chalk), and it has no proven effect on skin sores.
What forms does Shikonboreito come in?
Most people meet it as dry extract granules in single-dose sachets. This is the standard Kampo form in Japan.
Other forms you may see:
Fine powder or tablets made from the same extract.
A traditional decoction, where raw sliced herbs are simmered in water and the liquid is drunk.
Strength differs between makers and between granules and home-made decoctions. Always follow the label on the product you actually have.
Where it comes from:
Shikonboreito comes from Japanese Kampo, with roots in older Chinese surgical writing. It was used by Edo-period Japanese doctors who treated sores, abscesses and hard swellings.
It has stayed in use because Kampo prescribers kept it for stubborn skin lesions and swollen glands. It remains an approved Kampo formula in Japan today.
That is a strong traditional record within one tradition. It is not, on its own, clinical evidence.
Who should avoid Shikonboreito?
- Do not use if you are pregnant or think you might be. The rhubarb root in it can stimulate the womb.
- Do not use if you are breastfeeding. Rhein from the rhubarb passes into breast milk and can give your baby diarrhoea.
- Do not use if you have a blocked bowel, or a bowel that has stopped moving (ileus), or belly pain with no known cause.
- Do not use if you have low potassium in your blood (hypokalaemia), or if a blood test has shown it recently.
- Do not use if you have high blood pressure that is not controlled, heart failure, or a heart-rhythm problem.
- Do not use if you have kidney disease or liver disease, unless your doctor agrees.
- Do not use if you take digoxin, water tablets (diuretics), steroid medicines or other licorice-containing Kampo formulas, unless your doctor checks your potassium first.
- Do not use if you have ongoing diarrhoea, or if you are dehydrated or frail.
- Do not use if you have had a rash or other allergic reaction to any herb in the formula.
- Never give it to a child unless a doctor or Kampo practitioner directs it.
- Never use it on a new or growing breast lump instead of getting the lump checked.
When should you see a doctor?
See a doctor promptly if you get muscle weakness, cramps, an uneven or racing heartbeat, or unusual tiredness. These can be signs of low potassium.
See a doctor if your ankles swell, your blood pressure climbs, or you gain weight quickly over a few days.
Get urgent care for severe belly pain, no bowel movement with vomiting, or blood in your stool.
Stop it and call a doctor if your skin or eyes turn yellow, your urine goes dark, or you feel sick and very tired. These can point to liver trouble.
See a doctor if a skin sore spreads, smells bad, or comes with fever. See a doctor too if a lump or swollen gland lasts more than a few weeks.
Evidence grades and traditional-use labels are explained in our methodology. Nothing here is medical advice.
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