Bloodroot (Sanguinaria canadensis) is a striking North American woodland plant best known for its red-orange sap and a long, complicated medical history. It has been used traditionally for respiratory complaints, skin conditions, and pain, and modern researchers still study its alkaloids for antimicrobial, anti-inflammatory, and anticancer activity. The most important compounds, especially sanguinarine and chelerythrine, are biologically potent, which explains both the interest and the risks. That balance is the key point: bloodroot is not a gentle kitchen herb, and “natural” does not mean safe. Today, the biggest real-world concern is black salve, a corrosive product often marketed online for skin growths despite serious safety problems. This guide explains what bloodroot contains, what it may and may not help with, how it has been used, why dosing is tricky, and who should avoid it entirely. ([PMC][1])
Bloodroot Quick Overview
- Bloodroot contains potent alkaloids such as sanguinarine and chelerythrine, which show strong lab activity but are not proven safe cancer treatments in people.
- Black salve and bloodroot capsules can cause burns, scarring, infection, and delayed diagnosis of serious disease.
- Historical texts describe doses such as 64.5 to 129 mg every 2 hours for expectorant use, but no modern safe self-treatment dose is established.
- People who are pregnant, breastfeeding, treating an undiagnosed skin lesion, or caring for a child should avoid bloodroot products.
- If bloodroot has already been applied to the skin and tissue damage is starting, stop use and seek medical care promptly.
Table of Contents
- What is bloodroot and what is in it?
- How do bloodroot alkaloids work?
- Does bloodroot help with anything?
- How is bloodroot used today?
- How much bloodroot and when?
- Bloodroot side effects and who should avoid it
- What the evidence and bottom line say
What is bloodroot and what is in it?
Bloodroot is a perennial flowering plant native to eastern North America. It grows in shaded woodlands and is most recognizable in early spring, when a white flower appears and the cut rhizome releases a vivid red sap. The rhizome is the part historically used in medicine, and it is the part that contains the highest concentration of the plant’s most active chemicals.
Those chemicals are mainly isoquinoline alkaloids, and this is where bloodroot becomes medically important. Bloodroot is not a mild herb with broad culinary use. It is a pharmacologically active plant with a narrow line between “interesting” and “harmful.”
The major compounds commonly discussed are:
- Sanguinarine
- Chelerythrine
- Protopine
- Allocryptopine
A detailed review also notes additional related alkaloids in the rhizome, including sanguilutine, chelilutine, sanguirubine, and chelirubine. In other words, bloodroot products are rarely a single-ingredient chemical exposure. They are a variable mixture of multiple alkaloids, and that variability is one reason effects can be unpredictable.
Another practical point is that alkaloid content can change based on:
- Wild vs cultivated plants
- Season of harvest
- Plant population and genetics
- Growing conditions such as latitude, elevation, and shade
That matters for safety. Two “bloodroot” products can look similar yet deliver very different alkaloid levels. This is one reason self-dosing with raw plant material, homemade tinctures, or black salve recipes is especially risky.
Historically, bloodroot was used by Native American communities and later by Western practitioners for a wide range of conditions, from coughs and sore throats to topical applications. Some of those uses help explain why the plant remains popular in folk medicine circles. But historical use is not the same as proven modern efficacy, and some historical uses also document poisoning, tissue destruction, and reproductive risks.
The key takeaway for readers: bloodroot is best understood as a potent botanical source of active alkaloids, not as a general wellness herb. If you treat it like chamomile or peppermint, you are likely underestimating its risk profile. ([PMC][1])
How do bloodroot alkaloids work?
Bloodroot’s medicinal reputation comes from how its alkaloids interact with cells, enzymes, membranes, and signaling pathways. The most studied compounds are sanguinarine and chelerythrine, and both are highly bioactive. Researchers have documented actions that help explain why bloodroot has been described as antimicrobial, anti-inflammatory, and cytotoxic.
At a broad level, bloodroot alkaloids can:
- Interfere with cell growth and survival pathways
- Affect inflammatory signaling
- Bind to biological targets involved in DNA and protein regulation
- Alter ion channel activity in cardiac and smooth muscle models
- Damage tissue at higher or concentrated exposures
This “multi-target” behavior is scientifically interesting, but it is also a warning sign. Plants with strong multi-pathway activity often produce both promising lab results and significant toxicity.
A useful way to think about bloodroot is this: its compounds are chemically active enough to matter, but not selective enough to assume safety. For example, bloodroot’s escharotic effect (tissue destruction) is exactly why black salve can remove tissue and leave scarring. The problem is that the damage is not reliably limited to abnormal cells.
A recent laboratory study on bloodroot extracts and melanoma cell lines adds more detail. It found high levels of sanguinarine and chelerythrine in tested extracts and very low inhibitory concentrations in vitro, including strong cytotoxicity against melanoma cells. These numbers support the idea that bloodroot compounds are biologically powerful. They do not prove bloodroot is a safe or effective treatment in people, because cell culture results do not account for dosing control, tissue selectivity, wound healing, or systemic toxicity in real patients.
The older phytochemical review adds an important nuance: bloodroot alkaloids can show actions that look promising in one context and harmful in another. The same literature discusses antimicrobial and anti-inflammatory findings while also raising concerns about genotoxicity, tissue necrosis, and adverse clinical outcomes in human use.
So, when people ask whether bloodroot has “medicinal properties,” the accurate answer is yes, in the sense that it has real pharmacologic activity. But pharmacologic activity is not the same thing as a validated therapy. For bloodroot, the gap between mechanism and safe clinical use is still large. ([PMC][1])
Does bloodroot help with anything?
This is the question most people actually care about, and the honest answer is: it depends on what you mean by “help,” and the evidence is uneven.
What bloodroot may help explain in traditional use
Historical and ethnobotanical records describe bloodroot being used for:
- Colds and congestion
- Sore throat
- Respiratory complaints
- Rheumatic pain
- Topical wound care
- Skin lesions and growths
Those records are valuable because they show long-standing human exposure and patterns of use. They also show something else that often gets overlooked: traditional users recognized that dose mattered, and larger amounts could cause poisoning.
What modern lab research suggests
Modern studies support the idea that bloodroot alkaloids have:
- Cytotoxic activity (can kill or inhibit cells in lab settings)
- Antimicrobial activity
- Anti-inflammatory signaling effects
- Other biological effects that may have drug-development relevance
This helps explain why bloodroot remains a research topic. In a lab, some bloodroot compounds perform strongly, especially against certain cell lines.
What is not established
For everyday readers, the most important limitation is this: there is no strong clinical evidence that bloodroot products safely treat serious conditions such as skin cancer. In fact, dermatology literature repeatedly describes poor outcomes from self-treatment with bloodroot-containing black salves, including disfiguring tissue injury and delayed appropriate care.
Bloodroot is a good example of a plant that can look promising in a Petri dish and still be a poor choice for home treatment. That is not unusual in medicine. A compound can be active but too corrosive, too unpredictable, or too unsafe in the form people actually buy online.
Practical interpretation
If your goal is general wellness, respiratory comfort, or skin healing, bloodroot is usually not the safest first option because:
- Its active compounds are potent and variable.
- Human dosing standards are not well established.
- Topical misuse can cause irreversible injury.
- There are safer, better-studied alternatives for most common symptoms.
So yes, bloodroot has biological activity and a real medicinal history. But when translated into modern self-care, its risks often outweigh its likely benefits. ([PMC][1])
How is bloodroot used today?
Bloodroot is still used today, but not in one standard way. The problem is that the modern marketplace mixes very different products under the same plant name, and they do not have the same risk profile.
Common forms you may see
- Black salve or escharotic pastes (often marketed for moles, skin tags, or skin cancer)
- Capsules or powders marketed as “natural” internal cleansers or immune products
- Tinctures and extracts sold by herbal vendors
- Homeopathic products labeled as Sanguinaria (very dilute, different from crude herb)
- Topical formulas in alternative skin-care markets
The most concerning category is black salve. Case reports and dermatology reviews describe these products as corrosive, variable in composition, and capable of causing significant tissue destruction. A common ingredient combination is bloodroot plus zinc chloride. That combination can burn healthy tissue along with diseased tissue and may leave deep scars.
A case report from 2022 illustrates how quickly things can go wrong: a patient left a black salve ointment on a neck cyst for seven days and developed tissue breakdown, infection, and a concave scar after healing. This is not a rare “allergy” story. It reflects the expected corrosive action of escharotic products.
Why bloodroot remains popular despite the risks
People are often drawn to bloodroot products because they are marketed as:
- Natural
- Affordable
- “Surgery-free”
- Private (self-use at home)
- Useful for cancer or chronic skin problems
That marketing is powerful, especially when someone is anxious about a biopsy or worried about cost. But this is exactly where bloodroot becomes dangerous: a skin lesion can look small and still be serious, and destroying the surface can delay diagnosis while the disease continues underneath.
A safer way to think about “uses”
If you are considering bloodroot for a skin growth, the safest modern use is usually not using it at all and getting a medical skin exam first. If a lesion is benign, you avoid unnecessary scarring. If it is cancerous, you avoid delaying proper treatment.
If you already have a bloodroot product at home, treat it like a high-risk agent, not a routine herbal remedy. Do not apply it to:
- The face
- Genitals
- Mucous membranes
- Large areas
- Any lesion that has not been diagnosed
Bloodroot’s modern “uses” are real, but many of them are driven by online claims rather than strong clinical evidence. That is why regulators and clinicians continue to warn against self-treatment with bloodroot salves and capsules. ([PMC][2])
How much bloodroot and when?
This is the hardest part of any bloodroot guide, because there is no well-established modern self-care dose for crude bloodroot that can be confidently recommended as both effective and safe.
The most important dosing fact
For modern home use, the safest “dose guide” is:
- Do not self-dose bloodroot internally
- Do not self-apply black salve to skin lesions
That may sound unsatisfying, but it is the most accurate advice based on the evidence and current safety concerns.
Historical doses you may see quoted online
Older medical and herbal texts (summarized in modern reviews) describe bloodroot doses such as:
- 1 to 2 grains as an expectorant, repeated every second hour
(about 64.5 to 129 mg per dose) - 20 grains as an emetic
(about 1.29 g)
These are historical references, not current safe recommendations. They come from eras with very different standards for toxicity monitoring, drug quality control, and informed consent. In practice, those older doses may help explain why bloodroot can cause nausea, vomiting, and poisoning at higher exposures.
Why modern dosing is unreliable
Even if a label gives a milligram amount, the actual biologic effect can still vary because:
- Bloodroot products are not standardized the same way prescription drugs are
- Alkaloid content changes by harvest season and source
- Black salve formulas vary and may include zinc chloride or other corrosive substances
- Topical “dose” depends on concentration, skin location, occlusion, and contact time
That last point is critical. With bloodroot salves, “when” and “how long” matter as much as “how much.” The 2022 case report involved prolonged contact over seven days, and the result was tissue necrosis and infection.
If you are trying to use bloodroot for a symptom
If the goal is cough relief, sore throat, or a skin issue, the better question is not “how much bloodroot?” but “what safer, evidence-based option fits this problem?” Bloodroot is not the herb to experiment with casually.
If a clinician trained in herbal medicine, pharmacy, or dermatology is involved, they can help you interpret:
- Product type (crude herb vs homeopathic dilution)
- Concentration and ingredient list
- Intended route (oral vs topical)
- Duration and stop points
- When urgent evaluation is needed
Without that supervision, bloodroot dosing is more guesswork than guidance, and that is not a good setup for a plant this potent. ([PMC][1])
Bloodroot side effects and who should avoid it
Bloodroot side effects are not limited to mild stomach upset. Depending on the product and route, they can include serious tissue injury and delayed diagnosis of major disease.
Common and serious side effects
Topical bloodroot (especially black salve) can cause:
- Burning and severe irritation
- Tissue necrosis (skin destruction)
- Ulceration
- Infection
- Swelling
- Pain
- Permanent scarring and disfigurement
Oral or internal exposure may cause:
- Nausea and vomiting (historically, bloodroot was used as an emetic)
- GI irritation
- Neurologic symptoms at higher exposure (historical reports include tremor, headache, torpor)
- Unpredictable toxicity from variable alkaloid content
The literature also raises a specific oral safety concern: sanguinaria-containing mouth products have been associated with leukoplakia, a premalignant oral condition. That does not mean every exposure causes cancer, but it is a strong reason not to treat bloodroot as a routine oral health ingredient.
Interactions and medication cautions
Formal human interaction studies are limited, but caution is sensible because bloodroot alkaloids affect multiple biologic systems. Ask a clinician or pharmacist before use if you take medicines for:
- Heart rhythm or heart failure
- Blood thinning or clotting
- Blood pressure
- Sedation
- Chronic pain
- Skin conditions requiring prescription treatment
Bloodroot’s alkaloids have documented effects in cardiovascular and inflammatory pathways in experimental research, so combination use with other active agents should not be assumed safe.
Who should avoid bloodroot
Avoid bloodroot completely if you are:
- Pregnant or trying to conceive (historical use includes abortifacient and menstrual effects)
- Breastfeeding
- Giving herbal remedies to a child
- Treating an undiagnosed skin lesion
- Trying to self-treat suspected skin cancer
- Using it on the face or near eyes, mouth, or genitals
- Immunocompromised or healing poorly
Red flags that need urgent care
Get medical help quickly if bloodroot use is followed by:
- Rapidly worsening pain
- Spreading redness or swelling
- Pus or foul odor
- Fever
- Bleeding
- A deep or blackening wound
- A lesion that “falls off” but leaves a crater
Bloodroot injuries can look dramatic and can worsen beneath the surface. Early wound care and medical assessment reduce the chance of lasting damage. ([PMC][2])
What the evidence and bottom line say
Bloodroot has a strong traditional history and clear laboratory activity, but the clinical evidence is not strong enough to support most of the high-stakes claims made online.
What the evidence supports
- Bloodroot contains potent alkaloids with measurable biologic effects.
- Sanguinarine and chelerythrine show strong cytotoxic activity in lab studies.
- Bloodroot and black salve products can cause real harm, especially on skin.
- Product variability makes effects hard to predict.
What the evidence does not support
- Safe, evidence-based self-treatment of skin cancer with black salve
- A standardized oral bloodroot dose for common home use
- Reliable benefit that outweighs risk for most everyday symptoms
This gap matters. In vitro studies are useful for drug discovery, but they are an early step. They do not prove a crude herb product is safe, selective, or effective in humans. Dermatology reviews and case reports consistently show that real-world self-treatment often ends with scarring, delayed diagnosis, or both.
Regulatory messaging has also become more direct. Recent enforcement and public safety statements in Australia specifically warn consumers against black salve and bloodroot capsules, cite lack of credible evidence for serious disease claims, and emphasize the risk of corrosive injury and delayed conventional treatment.
A practical bottom line for readers
If you are researching bloodroot because you saw a skin lesion, a “natural cancer salve,” or a social media testimonial, the safest next step is a proper medical evaluation, not a home trial.
If you are interested in bloodroot for herbal medicine history or phytochemistry, it is a fascinating plant. If you are thinking about using it therapeutically, it is a high-risk herb that requires much more caution than most supplement labels suggest.
Bloodroot is a good reminder that some herbs are powerful enough to act like drugs and corrosives at the same time. In those cases, respect for the plant means respecting its limits. ([PMC][3])
References
- Sanguinaria canadensis: Traditional Medicine, Phytochemical Composition, Biological Activities and Current Uses – PMC 2016 (Review)
- Dermatologic uses of bloodroot: a review and reappraisal – PubMed 2021 (Review)
- Determination of Cytotoxic Activity of Sanguinaria canadensis Extracts against Human Melanoma Cells and Comparison of Their Cytotoxicity with Cytotoxicity of Some Anticancer Drugs – PMC 2021 (In Vitro Study)
- Black salve: risky escharotic – PMC 2022 (Case Report)
- Conviction for unlawful supply and advertising of black salve products | Therapeutic Goods Administration (TGA) 2026 (Regulatory Safety Update)
Disclaimer
This article is for educational purposes only and is not medical advice, diagnosis, or treatment. Bloodroot is a high-risk botanical with potentially corrosive and toxic effects, especially in black salve products and concentrated extracts. Do not use it to self-treat skin cancer, suspicious skin lesions, or any serious condition. If you are pregnant, breastfeeding, taking prescription medicines, or treating a child, avoid bloodroot unless a qualified clinician specifically advises otherwise. If you have already used a bloodroot product and notice burning, tissue breakdown, infection, or worsening pain, seek medical care promptly.
If you found this guide useful, please share it on Facebook, X (formerly Twitter), or any platform you prefer.
