Frankincense – The Ancient Resin Rediscovered by Modern Research

Frankincense is far more than incense. The resin of the Boswellia tree is one of the oldest documented remedies in human history – and one of the few plant-derived substances that continues to hold up under the scrutiny of modern science. At its centre is a group of triterpenic acids, most notably AKBA (acetyl-11-keto-β-boswellic acid), which shows remarkable properties in laboratory and clinical studies. What lies behind this resin, how it works, and what current research tells us – we explain it all in this article.

Where does frankincense come from – and what does it have to do with medicine?

Frankincense is obtained from the dried resin of various Boswellia tree species native to the arid regions of North Africa, the Arabian Peninsula, and India. The best-known and most thoroughly researched species is Boswellia serrata – Indian frankincense, also known as Salai guggal or Shallaki.

The use of frankincense stretches back thousands of years. In the Ayurvedic medicine of the Indian subcontinent, Boswellia serrata has been used for centuries in the treatment of joint complaints, respiratory conditions, and inflammation. In ancient Egypt, in Greek antiquity, and in Christian liturgy, frankincense carried both ritual and medicinal significance.

This long tradition has contributed to Boswellia serrata being the only frankincense species listed in the European Pharmacopoeia today – a recognition of the particular standing this resin holds in scientific pharmacobotany.

The active compounds in frankincense – what is actually in the resin?

The resin of Boswellia serrata contains a complex mixture of essential oils, polysaccharides, and – most significant from a pharmacological perspective – boswellic acids. This group of pentacyclic triterpenic acids includes, among others:

• β-Boswellic acid (β-BA)
• 11-Keto-β-boswellic acid (KBA)
• Acetyl-11-keto-β-boswellic acid (AKBA) – the most potent and most extensively researched compound

AKBA is considered the lead substance of frankincense extract. It selectively inhibits the enzyme 5-lipoxygenase (5-LOX), which plays a central role in the production of leukotrienes – pro-inflammatory signalling molecules that are elevated in a range of chronic conditions. AKBA also influences other inflammatory mediators, including NF-κB, various interleukins (IL-1, IL-2, IL-4, IL-6), and tumour necrosis factor TNF-α.

Standardised extracts are today calibrated to their boswellic acid content. Quality products clearly state this content – a value that is decisive for efficacy and comparability between preparations.

What the research shows about frankincense

For a plant-derived substance, the body of evidence on Boswellia serrata is exceptionally well documented. Multiple controlled studies and systematic reviews are now available, particularly for the area of joint health.

Joints and osteoarthritis

A systematic review and meta-analysis (BMC Complementary Medicine and Therapies, 2020) evaluated seven randomised controlled trials involving 545 patients. The analysis found that Boswellia extracts statistically significantly improved pain and stiffness scores in osteoarthritis compared to placebo – a result that is by no means a given in plant-based joint research.

A more recent systematic review and network meta-analysis (Complementary Therapies in Medicine, 2025, literature search through March 2025, 20 RCTs, 1,633 participants) examined the effects of Boswellia serrata and Curcuma longa – both individually and in combination – in knee osteoarthritis. Results point to positive effects for both substances; evidence for the combined formulation is still emerging.

A further systematic review (Journal of Dietary Supplements, 2024) focusing specifically on standardised Boswellia serrata extracts in osteoarthritis provides detailed subgroup analyses – with positive signals for pain reduction and joint function.

Bioavailability and absorption

A pharmacokinetic study published in Phytomedicine in 2024 by the Medical University of Graz investigated how effectively different Boswellia formulations are absorbed by the body. The results show that the bioavailability of AKBA can vary considerably depending on the preparation – an important consideration when choosing a product. Both formulations studied also reduced the release of TNF-α, a key inflammatory marker.

Other areas of research

Research into frankincense extends beyond joints. Laboratory studies and smaller clinical investigations are also examining potential effects on chronic inflammatory bowel conditions (Crohn's disease, ulcerative colitis), the respiratory tract, and – at a preclinical level – certain tumour models. In these areas, the preclinical data is interesting, but robust human evidence is still largely lacking. No clinical conclusions can currently be drawn.

What to look for when choosing a frankincense extract

Standardisation to boswellic acids – the single most important quality indicator is a clearly stated total boswellic acid content. Products without this information cannot be meaningfully compared and provide no basis for assessing actual active ingredient levels.

Frankincense is generally well tolerated when taken orally. Occasional mild gastrointestinal discomfort has been reported as a possible side effect. Adequate safety data for pregnant or breastfeeding individuals is not yet available; those taking prescription medication should consult a physician before use.

Conclusion

Frankincense is a rare example: a traditional remedy with thousands of years of documented use that also holds up under the conditions of modern clinical research. The evidence for Boswellia serrata – particularly in the area of joint health – is exceptionally well documented among plant-derived substances. Its most potent compound, AKBA, selectively inhibits the 5-LOX inflammatory pathway and remains an active subject of research. For other applications, the evidence is still developing. Anyone wishing to supplement with frankincense should look for an extract clearly standardised to boswellic acids – and verified product quality.

This article is intended for general informational purposes only and does not replace medical advice. Dietary supplements are not a substitute for a balanced and varied diet.