Rose

Rose (Rosa spp.): A Comprehensive Encyclopedic Reference

1. Identity and Botanical Classification

The genus Rosa, belonging to the family Rosaceae, encompasses more than 200 species and approximately 18,000 cultivars distributed across the temperate and subtropical zones of the world. Rosa damascena Mill. is a hybrid between R. gallica and R. phoenicia and is a member of the Rosaceae family. From a dietary supplement and medicinal standpoint, two principal botanical entities dominate the literature: Rosa damascena Mill. (the Damask rose, also known as the "Bulgarian rose" or "Persian rose") and Rosa canina L. (the dog rose, whose fruit — the rosehip — constitutes a major nutraceutical commodity).

R. damascena is a perennial bushy shrub reaching approximately 1 to 2 meters in height with large, showy and colorful flowers. The leaves are imparipinnate and compound with 5–7 leaflets. Its life span is up to 50 years and its economic period is about 25 years; the gestation period is three years for attaining economic production level.

Among the medically relevant species, additional members of the genus are used regionally:

• In European regions, the main medicinal species were the Gallic rose (Rosa gallica), the dog rose (Rosa canina), the Persian rose (Rosa persica), and the Damask rose (Rosa damascena) from the Middle East, which is now widely cultivated to produce the famous rose oil in Bulgaria.
• In China and India, the predominant species were the Chinese rose (Rosa chinensis/Rosa indica) and the giant rose (Rosa gigantea).
• The cabbage rose (Rosa centifolia), which plays an important role in traditional Indian cuisine and Ayurvedic medicine, was created through crossbreeding of the Damask rose, Gallic rose, and dog rose in Asia Minor and the Caucasus region.

Common Forms and Preparations

Rose is commercially and traditionally available in a wide variety of preparations, each derived from different parts of the plant and serving distinct purposes:

• Rose essential oil (rose otto / attar of rose): Obtained by steam distillation of fresh petals. Rose essential oil is an important industrial product for different applications; its yield from the flower mass is very low (0.3–0.4 ml/kg).
• Rose water (hydrosol): A by-product of essential oil distillation or direct aqueous extraction of petals. In folklore, people use rose as rose water or dried rose petals, but the majority application of R. damascena is producing rose water and rose essential oil for use in religious ceremonies, cooking of some foods, and in high-grade perfumes.
• Rosehip powder: Dried and milled fruits (hips) of Rosa canina and related species, standardized to retain seeds and shells. This is the principal form used in osteoarthritis clinical trials.
• Rosehip extract (tablets/capsules): Standardized liquid or dry extracts of rosehip fruits, used in clinical studies of metabolic and cardiovascular outcomes.
• Dried petals / petal powder: Used internally as tea or capsule preparations and externally as topical agents.
• Gulkand: A sweet preserve of rose petals, traditionally prescribed as a Pitta pacifier to reduce excessive cerebral heat, believed to contribute to irritability, cognitive fatigue, and memory loss.
• Gulanjabin: A preparation of honey and rose flower documented in medieval Persian medicine to treat neurological imbalances and headaches.
• Rose absolute: A solvent-extracted concentrate used primarily in perfumery and cosmetics.

2. Traditional and Historical Use

Iranian/Persian Traditional Medicine

R. damascena has an important position in Iranian traditional medicine. This plant is one of the most used medicinal plants in traditional Iranian medicine; an Iranian manuscript from the tenth century described the febrifuge, obstructive, and cholestatic effects of R. damascena. In Persian medicine, the great physician Avicenna documented it as a cognitive enhancer with calming effects on the mind and heart.

The most therapeutic effects of R. damascena in ancient medicine included treatment of abdominal and chest pain, strengthening the heart, treatment of menstrual bleeding and digestive problems, and reduction of inflammation, especially of the neck. In medieval Persia, rosewater made by distilling petals over low heat was a prized therapeutic agent, used to treat digestive disorders and as a mood elevator.

Ethnobotanical studies in Iran indicate that the people of Raz and Jergalan cities, in the northern and northwestern parts of North Khorasan province, use the decoction and powder of flowers for laxatives, flatulence, sedatives, and heart and blood vessel conditions in oral form. The people of Meshkin Shahr, Ardabil province use the essential oil and powder of the flowers for sedative, laxative, memory enhancement, and skin-softening purposes.

Ayurvedic and Indian Traditional Medicine

In Ayurveda, the Damask rose is known as Shatapatri ("the hundred-petaled one"), valued for its capacity to balance the body and mind. In Ayurveda, the rose is classified as a coolant (Sita), used to balance the Pitta dosha, which regulates heat and metabolism; its preparations relieve internal burning sensations, hyperacidity, and digestive inflammation.

Unani Medicine

Unani medicine, an Indo-Persian system, uses Gul-e-Surkh (Rosa damascena) as an astringent and tonic, often prescribed for palpitations and to strengthen the heart and liver; dried petal powder is also applied to wounds for healing.

North American Indigenous Use

North American Indian tribes used a decoction of the root of R. damascena as a cough remedy to ease children's cough.

Rose Hip in European Folk Medicine

Rosa spp., commonly known as rosehips, are wild plants that have traditionally been employed as herbal remedies for the treatment of a wide range of disorders. Traditionally, rosehip is used as a substitute for vitamin C to treat colds and flu-like infections. The fruit of the genus Rosa, commonly known as "rose hip," has been traditionally used in medicine to address various health issues, including kidney stones, gastrointestinal problems, and hypertension. Rose hips are known as a traditional remedy against hemorrhoids and for the treatment of diabetes mellitus.

Spiritual and Ceremonial Use

In Iran, the plant is known as "Mohammadi flower" and people believe that Mohammadi flower reminds them of the Prophet Muhammad (PBUH). In ancient times, rose oil and rose water were used to strengthen the vital spirit (Rooh), a concept closely aligned with contemporary descriptions of mood disturbances such as depression and anxiety.

3. Key Constituents and Active Compounds

Rosa damascena — Flower Constituents

Rosa damascena is rich in phytochemicals like anthocyanins, flavonoids, and essential oils and demonstrates a wide range of therapeutic properties.

Essential oil composition: The main ingredients of R. damascena essential oil responsible for pharmacological activity are geraniol and citronellol. Rosa damascena is a rich source of bioactive ingredients including flavonoids, anthocyanins, and terpenoids (like citronellol at 30–40% and geraniol at 20–30%). In another study, the composition of rose was phenylethyl alcohol (72.73–73.80%), citronellol (10.62–11.26%), nerol (2.42–2.47%), and geranial (5.58–5.65%). Hydrosol was also found to contain four constituents; geraniol was the major compound (30.74%) followed by citronellol (29.44%), phenylethyl alcohol (23.74%), and nerol (16.12%).

Flavonoids: Identified flavonoids include quercetin, kaempferol, kaempferol 3-O-β-D-glucopyranoside, kaempferol 3-O-α-L-arabinofuranoside, and several glycosidic forms isolated from the marc of Rosa damascena flowers after industrial distillation of essential oil.

Rosa canina — Rosehip Constituents

Chemical compound groups with health-promoting effects found in rose hip include flavonoids, triterpenes, tannins, polysaccharides, phenolic acids, fatty acids, organic acids, carotenoids, and vitamins.

Vitamin C (ascorbic acid): Among wild edible fruits, rosehips (Rosa canina) are characterized by the highest vitamin C content, with 1252.3 mg/100 g fresh weight, compared with elderberries (Sambucus nigra L.) with 116.7 mg/100 g FW. Furthermore, rosehips are characterized by the highest phenolics content (3217.2 mg/100 g) and antioxidant activities.

GOPO (galactolipid): Larsen, Kharazmi, Christensen LP, and Christensen SB (2003) first isolated an anti-inflammatory agent with inhibitory effects on chemotaxis of human peripheral blood neutrophils in vitro from dried and milled fruits of Rosa canina. This anti-inflammatory agent is a single compound identified as (2S)-1,2-di-O-[(9Z,12Z,15Z)-octadeca-9,12,15-trienoyl]-3-O-β-D-galactopyranosyl glycerol (GOPO), which may be responsible for the anti-inflammatory properties of rosehip powder.

Carotenoids: Beyond vitamin C, rosehips contain lycopene, beta-carotene, and lutein among the carotenoids.

Polyphenols: Polyphenol content includes quercetin, catechins, and tiliroside, a glycoside that has received particular research attention. Rosa canina's phytochemistry also contains gallic acid, vanillic acid, protocatechuic acid, syringic acid, ellagic acid, rutin, and catechin.

Organic acids and other nutrients: Organic acids including malic acid and citric acid contribute to the characteristic tart flavor; essential fatty acids are present in the seeds, though these are not typically extracted into an infusion tea.

Mechanisms of Action

Anti-inflammatory mechanisms: Potent antioxidant radical scavenging effects are well documented for numerous rose hip constituents besides vitamin C; anti-inflammatory activities include the reduction of pro-inflammatory cytokines and chemokines, reduction of NF-κB signaling, inhibition of pro-inflammatory enzymes including COX1/2, 5-LOX and iNOS, reduction of C-reactive protein levels, reduction of chemotaxis and chemoluminescence of PMNs, and an inhibition of pro-inflammatory metalloproteases.

GOPO mechanism: Specific compounds within rose hips, particularly a galactolipid known as GOPO, have been investigated for their anti-inflammatory properties. Research suggests that GOPO may inhibit the chemotaxis of neutrophils and reduce the expression of pro-inflammatory cytokines. The mechanism involves modulating inflammatory cell and signaling pathways, distinct from the action of traditional nonsteroidal anti-inflammatory drugs (NSAIDs).

Neuropsychological mechanisms (Rose damascena): Proposed mechanisms for the neuropsychological effects of R. damascena include a decrease in sympathetic nervous system activity, induction of neurotransmitters, and induction of nerve growth factors by neurogenesis and synaptogenesis mechanisms.

Collagen synthesis (Rosehip vitamin C): Vitamin C not only hydroxylates the collagen molecule to stabilize it but also triggers fibroblasts to produce collagen mRNA. Vitamin C also plays an important role in the regeneration of collagen in the joint cartilage and is necessary to keep bones and supporting tissue healthy.

Anti-obesity (tiliroside): Ninomiya et al. showed that an 80% aqueous acetone extract of the whole fruit of R. canina L. significantly suppressed body weight gain and prevented increases in the visceral fat in nonobese mice without any changes in diet intake; they also reported that tiliroside upregulated the expression of peroxisome proliferator-activated receptor α (PPARα) messenger RNA in the liver.

4. Scientific Evidence by Area of Use

4.1 Osteoarthritis and Joint Pain (Rosa canina — Rosehip)

This is the most extensively studied clinical application of rose-derived supplements. The evidence base is built primarily on randomized controlled trials (RCTs) using standardized rosehip powder preparations.

Meta-analysis: A meta-analysis of randomized controlled trials examined a hip powder of Rosa canina (rosehip) preparation for symptomatic treatment of osteoarthritis (OA), with the primary outcome being reduction in pain calculated as effect size (ES), defined as the standardized mean difference (SMD). The three studies (287 patients and a median trial duration of 3 months) — all supported by the manufacturer (Hyben-Vital International) — showed a reduction in pain scores by rosehip powder (145 patients) compared to placebo (142 patients). The authors concluded that although based on a sparse amount of data, rosehip powder does reduce pain and may be of interest as a nutraceutical, but results on the safety and efficacy of rose hip for pain reduction in the treatment of patients with osteoarthritis needed to be substantiated in a large well-conducted RCT of at least six months duration.

Systematic review conclusion: Moderate evidence exists for the use of a powder of the seeds and husks of a Rosa canina subspecies in patients suffering from osteoarthritis.

Standardized preparation evidence: A meta-analysis of three randomised controlled trials involving 287 patients with a median treatment period of 3 months reported that treatment with standardised rosehip powder consistently reduced pain scores; a standardised rosehip powder has been developed to maximise the retention of phytochemicals, and this powder has demonstrated antioxidant and anti-inflammatory activity as well as clinical benefits in conditions such as osteoarthritis, rheumatoid arthritis, and inflammatory bowel disease.

Dosage in trials: Winther et al. (2005) indicated that consuming 5 g of rosehip powder (RHP) daily can significantly reduce WOMAC (Western Ontario and McMaster Universities Osteoarthritis Index) pain.

Limitations: Most trials included in the meta-analyses were funded by the same manufacturer, sample sizes were small, and trial durations were short (median 3 months). Independent, large-scale replication has been called for repeatedly in the literature.

4.2 Anxiety, Depression, and Mood (Rosa damascena)

Clinical research indicates that Rosa damascena (RD) aromatherapy effectively alleviates anxiety and depressive moods in healthy individuals or those experiencing stressors related to childbirth, surgery, burns, and severe illnesses, while also improving sleep quality.

A systematic review aimed to identify animal preclinical studies and randomized controlled trials examining the effects of R. damascena in any form on different mental diseases; databases including PubMed, Scopus, Embase, Web of Science, and Cochrane trials were searched up to September 2021. The review included 10 animal studies, of which all but one confirmed positive effects on mental disorders, and a total of 38 studies met the criteria for inclusion, involving individuals with anxiety, sleep disturbance, and depressive disorder; R. damascena essential oil, essence, extract, and dried plant were used in both aromatherapy and oral administration.

Thirteen clinical trials (772 participants) were included in a comprehensive review; rose oil was administered via inhalation or used topically, and most of the studies (five trials) evaluated the analgesic effect of rose oil. Anti-depressant, psychological relaxation, improving sexual dysfunction, and anti-anxiety effects were the other clinical properties reported for rose oil.

Quality of evidence: Most RCTs had a fair methodological quality based on the Cochrane risk of bias assessment tool; the quality of evidence ranged from very low to moderate according to the GRADE approach; further high-quality RCTs are needed to draw reliable conclusions regarding the use of R. damascena for treating adults' anxiety, depression, and stress.

Numerous studies on the pharmacological properties of rose oil have been done in animals, but studies in humans are few; in the reviewed studies, it was observed that rose oil had physiological and psychological relaxation, analgesic, and anti-anxiety effects; to obtain conclusive results on the efficacy and safety of rose oil, further clinical trials with larger sample size and better designation are required.

4.3 Dysmenorrhea (Primary Menstrual Pain)

Two clinical trials are most cited in this area:

Rose tea RCT (Taiwan, 2005): To determine the effectiveness of drinking rose tea as an intervention for reducing pain and psychophysiologic distress in adolescents with primary dysmenorrhea, 130 female adolescents were randomly assigned to an experimental (n = 70) and a control (n = 60) group; preintervention and postintervention data were gathered at 1 month, 3 months, and 6 months; the results showed that the experimental group perceived less menstrual pain, distress, and anxiety. In this six-month RCT, 2 cups of rosehip tea daily (each 300 ml), consumed 1 week before and 5 days after commencing menstruation, reduced perception of menstrual pain, distress, and anxiety, and the experimental group reported greater psychophysiological well-being compared to placebo.

Rosa damascena extract cross-over trial (Iran): This study was performed in Iran on 92 single 18–24-year-old students with BMI 19–25 and a pain intensity score of 5–8 on the Visual Analogue Scale, who were randomly classified into two groups of 46 persons; participants received two capsules of mefenamic acid and Rosa damascena with similar physical properties in two consecutive cycles per 6 hours for 3 days in a cross-over form. Bani et al. in this cross-over study in two groups of 46 persons suggested that Rosa damascena extract and mefenamic acid had similar effects on pain intensity of primary dysmenorrhea.

These results are promising but both trials have methodological limitations including small samples and single-center designs. Independent replication in larger populations is needed.

4.4 Cardiovascular Health and Metabolic Markers (Rosa canina)

A systematic review published in 2023 (Cureus) evaluated the effects of daily intake of rosehip extract on LDL cholesterol and blood glucose levels, synthesizing findings from randomized clinical trials focusing on cardiovascular and metabolic health outcomes; the review included studies employing various forms of rosehip supplementation, assessing primary outcomes such as LDL-C, HDL-C, total cholesterol, triglycerides, fasting blood glucose (FBG), and glycated hemoglobin (HbA1c).

This systematic review analysed four randomised clinical trials that studied the impact of rosehips on lipid profiles and blood glucose levels; dosages varied between 40 g powder to 100 mg to 750 mg in tablets, taken once or twice daily for between 6–12 weeks; results showed significant reductions in LDL cholesterol, fasting blood glucose and HbA1c; secondary measures included reductions in body weight, systolic blood pressure, abdominal fat and cardiovascular risk scores; rosehip was well tolerated with limited adverse effects.

Andersson et al. reported that rosehip juice decreased the systolic blood pressure and plasma cholesterol levels in obese subjects. The study concludes that rosehip powder can significantly reduce the risk of cardiovascular disease in obese people through the lowering of systolic blood pressure and plasma cholesterol levels.

Diabetes/blood glucose: One study observed the effects of rosehip on glycemia and lipid profile in humans with type 2 diabetes aged 35–60 years with fasting blood glucose levels between 130 and 200 mg/dL and HbA1c between 7 and 9%; two groups of patients were formed, one receiving 750 mg rosehip fruit extract and the other receiving 750 mg toast powder as placebo twice daily for three months; when compared to the baseline, the fasting blood glucose level in the rosehip group decreased significantly after 3 months.

The cardiovascular and metabolic evidence base is preliminary. The available trials are small and of short duration; findings warrant confirmation in larger, independent RCTs.

4.5 Obesity / Visceral Fat Reduction (Rosa canina)

A randomized, double-blind, placebo-controlled clinical trial found that rosehip extract may be a good candidate food material for preventing obesity. Tiliroside, a polyphenolic compound in rosehip, has shown fat metabolism and weight management effects in several studies; a 2015 randomized trial found that rosehip extract reduced visceral and total abdominal fat in overweight adults over twelve weeks compared to placebo; the mechanism appears to involve enhanced fat oxidation and reduced lipid accumulation.

4.6 Skin Health

Vitamin C is a powerful water-soluble antioxidant employed in multiple types of skincare products aimed to protect and restore photo-aged skin; skin benefits associated with this treatment include fading of post-acne scarring and hyperpigmentation, brightening dull skin, restoring skin complexion, and reducing fine lines and wrinkles. According to clinical research, applying vitamin C topically to human skin of any age enhances the formation of collagen. Studies on rosehips have shown the potential role in collagen synthesis and cell membrane longevity.

The skin-health evidence for rose preparations is largely based on the well-established science of topical vitamin C combined with in vitro studies of rose polyphenols. Direct large-scale RCTs using rose-specific preparations for skin conditions in human subjects remain limited.

4.7 Antimicrobial Activity

The antimicrobial, antioxidant, analgesic, anti-inflammatory, anti-diabetic, and anti-depressant properties of R. damascena have been confirmed. The in vitro antibacterial activities of essential oil from R. damascena were shown by disk diffusion testing against E. coli, Staph. aureus, and Ps. aeruginosa. These findings are based on in vitro studies; clinical antimicrobial evidence in humans is absent.

4.8 Anti-inflammatory and Analgesic Effects (Rosa damascena)

Antimicrobial, anti-inflammatory, antioxidant, anticancer, and protective neuronal, cardiac, gastrointestinal, and hepatic effects have been shown in 30 in vitro and 21 animal studies of R. damascena. Rosa damascena has a wide spectrum of bio-pharmacological activity including antidepressant, hypoglycaemic, anti-inflammatory, analgesic, antioxidant, and antimicrobial properties.

4.9 Ophthalmic Uses

R. damascena effects were confirmed in patients with conjunctivitis, dry eye, acute dacryocystitis, pterygium, or pinguecula disorders. This evidence appears to be based on limited observational and small clinical data rather than large RCTs.

5. Body Systems Associated with Rose

• Musculoskeletal system: Rosehip (Rosa canina) and its GOPO content are most strongly associated with osteoarthritis pain relief and joint health, supported by multiple RCTs and meta-analyses.
• Nervous system / Mental health: R. damascena has been studied in individuals with anxiety, sleep disturbance, and depressive disorder.
• Cardiovascular system: Rosehips have been shown to reduce LDL cholesterol, lower blood pressure, and reduce the risk of cardiovascular disease.
• Metabolic system: Rosehip extract has shown reductions in fasting blood glucose and HbA1c in clinical trials of type 2 diabetic patients.
• Reproductive / Gynecological system: Rose tea and R. damascena extract have been studied for primary dysmenorrhea with positive clinical outcomes.
• Integumentary system (skin): Rose preparations are used topically and systemically for collagen synthesis, anti-aging, and wound healing.
• Immune system: Due to the high levels of antioxidants, vitamin C, and nutritive compounds in rosehip, it is used by herbalists to support and strengthen the immune system; it is also an immunomodulator, which is one of the ways by which it helps to lower the inflammatory effects of autoimmune conditions such as rheumatoid arthritis.
• Gastrointestinal system: R. damascena is prescribed in traditional medicine for the management of chest and abdominal pain, constipation, and digestive disorders.

6. Dosage Forms and Dosages Reported in Studies

The following dosages appear in the peer-reviewed clinical literature cited in this article; they are reported as recorded in the source studies and should not be interpreted as recommended doses:

• Rosehip powder for osteoarthritis: Winther et al. (2005) indicated that consuming 5 g of rosehip powder (RHP) daily can significantly reduce WOMAC pain in osteoarthritis patients.
• Rosehip extract for blood glucose / lipids (type 2 diabetes): One study involved patients with type 2 diabetes aged 35–60 years, with one group receiving 750 mg rosehip fruit extract and the other receiving 750 mg toast powder as placebo, twice daily for three months.
• Rosehip supplementation range across trials (lipid/glucose systematic review): Dosages in the reviewed trials varied between 40 g powder to 100 mg to 750 mg in tablets, taken once or twice daily for between 6–12 weeks.
• Rose tea for dysmenorrhea: Two cups of rosehip tea daily (each 300 ml), consumed 1 week before and 5 days after commencing menstruation, was the protocol in the six-month RCT involving 130 female adolescents.
• Rosa damascena extract for dysmenorrhea (cross-over trial): Participants received two capsules of Rosa damascena preparation per 6 hours for 3 days per cycle in a cross-over design.
• Rose oil aromatherapy: Rose oil was administered via inhalation or topically in the clinical trials reviewed. Specific inhalation durations and concentrations vary widely across studies.

7. Safety Considerations and Notable Interactions

General Tolerability

Findings have shown no nephrotoxic effects in studied populations, with serum creatinine levels remaining unaltered, a safety profile potentially linked to antioxidant constituents like quercetin and ellagic acid. Hydrosols of R. damascena showed low cytotoxic and genotoxic effects at high concentrations (3–20%, 4 h); they also reported a potent cytoprotective and genoprotective effect against the mutagen MNNG, expressed by a more than twofold reduction in chromosomal aberrations and micronuclei.

A study of rose water brands from Tehran markets found that while methanol and ethanol can cause significant complications if present in high concentrations, mean levels were significantly lower than the Maximum Residue Levels, posing no health risk.

Gastrointestinal Side Effects

Human studies have reported hypersensitivity and gastrointestinal side effects such as urticaria, nausea, vomiting, diarrhea, and gastrointestinal discomfort for rose hip. Rosehip is, however, frequently noted to be better tolerated gastrointestinally than conventional NSAIDs used for arthritis.

Allergic / Hypersensitivity Reactions

Damask rose essential oil contains several biochemically allergenic and highly concentrated components such as citronellol, geraniol, and nerol. Although rare, since some fragrances are also flavors, foods that contain Rosa damascena can cause flare-ups of dermatitis in fragrance-sensitive individuals; if diagnosed with oral or lip allergies to fragrances or flavorings, foods prepared with rosa damascena extract should be avoided.

Pregnancy and Pediatric Use

Damask rose essential oil is contraindicated during the first three months of pregnancy; after this period, it is advisable to seek a doctor's opinion before use; it is also not recommended for children under 3 years old.

Rosehip and Anticoagulants / Vitamin C Interactions

Rosehip is a rich source of vitamin C (ascorbic acid). High-dose vitamin C is known in the pharmacological literature to potentially interact with anticoagulant agents such as warfarin by affecting iron absorption and oxidative pathways, though direct clinical interaction data for rosehip supplementation specifically are limited in the available reviewed literature.

Quality Control

Despite strong evidence of the plant's intrinsic safety, quality control of commercial products is paramount. An interesting characteristic of rosehip is that its chemical composition differs depending on the cultivar, growing region, climate, maturity, cultivation practice, and storage conditions. This variability means that standardization of commercial preparations is critical to achieving the outcomes demonstrated in clinical trials.

Research Gaps and Limitations

Further studies on the characterization of chemical constituents and the scientific basis of pharmacological activity of R. damascena should be carried out; large-scale preclinical and clinical trials will be beneficial in investigating the mechanism of the therapeutic potential of R. damascena to explore its uses in pharmaceutical industries. Additional investigations on the pharmacological effects of rose hip as well as evidence from randomized controlled trials are essential to assess the therapeutic value of this natural product.

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