Bloodroot (Sanguinaria canadensis) is a perennial wildflower native to eastern North America, named for the vivid reddish-orange sap that seeps from its underground stem when cut or broken. It belongs to the poppy family and grows wild in shaded woodlands from Nova Scotia to Florida and as far west as Nebraska. The plant has a long history in Native American medicine and contains potent alkaloids that are both biologically active and potentially dangerous.
How to Identify Bloodroot
Bloodroot is one of the first wildflowers to appear in spring, blooming before most trees have leafed out. Each plant sends up a single flower stalk wrapped in a tightly clasped leaf. The flower is brilliant white (occasionally light pink), up to 2 inches across, with eight delicate petals arranged symmetrically around a cluster of yellow stamens. Four petals are large and four are smaller. Double-flowered varieties can have up to sixteen petals.
The leaf unfurls as the flower opens. It’s pale green to bluish-green, palmate (shaped like an open hand), with five to nine deeply scalloped lobes. After the flower fades, the leaf continues expanding to its full size of up to 9 inches across, and the stalk stretches to 12 to 15 inches tall. The underside of the leaf has a whitish-green color with conspicuous veins that create a net-like pattern.
Underground, the plant grows from a shallow, branching rhizome about half an inch thick and up to four inches long. This rhizome is covered in fibrous roots and has the distinctive orange-red color that gives the plant its name. Snap it, and it bleeds a bright reddish-orange sap. Over time, the rhizome branches and the plant can form large colonies across a forest floor.
Where It Grows
Bloodroot thrives in undisturbed woodlands, on floodplains, and along slopes near streams or ponds. It prefers moist, well-drained soil that’s rich in organic matter, slightly acidic (pH 5.5 to 6.5), and shaded 70% to 80% of the time. In the wild, it typically occupies the same niche as trilliums and other spring ephemerals, taking advantage of the sunlight that reaches the forest floor before the canopy fills in. It grows across USDA hardiness zones 3 through 8, making it well suited to woodland gardens throughout most of the eastern half of the continent.
Native American Uses
Indigenous peoples, particularly those of the Algonquian, Iroquois, and Siouan language groups, called the plant “puccoon” and developed a wide range of uses for it. Several tribes brewed bloodroot tea or inhaled its powder to treat colds and congestion. The Ojibwe of Wisconsin mixed it with maple sugar to create a lozenge for sore throats.
Topically, it was even more versatile. Rhizomes were boiled in water, cooled, and applied to axe wounds as a coagulant. Poultices made from the root were placed on wounds, and the Meskwaki would chew the root and apply the softened material to burns for pain relief. Tribes also recognized its antibacterial properties and used it on wound infections and gangrene. The dry, powdered rhizome served as an escharotic, a substance that destroys tissue and was used to burn away abnormal growths.
Internally, dosing was critical. Small amounts were used to stop vomiting, while larger doses were used to induce it. It was combined with blue cohosh for abdominal cramps, and Native American women used it for menstrual difficulties. Larger doses were understood to be poisonous, and preparations for serious conditions like hemorrhagic tuberculosis called for only a small piece of the root mixed into larger formulations.
The Active Chemical: Sanguinarine
The compound responsible for most of bloodroot’s biological effects is sanguinarine, an alkaloid with a complex ring structure. Sanguinarine interferes with a cellular pump that maintains the balance of sodium and potassium in cells, which disrupts normal cell function. It also triggers a cascade of events inside cells that promotes programmed cell death, increasing proteins that push cells toward self-destruction while decreasing the ones that protect against it.
In laboratory studies, sanguinarine has shown the ability to kill several types of cancer cells, including melanoma, leukemia, and oral cancer cells. One study found that bloodroot extracts and their alkaloids were more potent against human melanoma cells in lab dishes than some conventional anticancer drugs. Sanguinarine appears to be more toxic to cancer cells than to healthy ones, though high doses can damage DNA in any cell. These results are strictly from lab experiments. No clinical trials have established bloodroot or sanguinarine as a safe or effective cancer treatment in people.
Black Salve and Tissue Destruction
The most controversial modern use of bloodroot is in “black salve,” a paste that typically combines bloodroot extract with zinc chloride, a synthetic corrosive agent. The combination destroys tissue on contact, killing skin cells and forming a thick, dark scab called an eschar. Promoters sell it as a natural treatment for skin cancer, claiming it selectively targets cancerous tissue. It does not.
Black salve destroys whatever tissue it touches. When the eschar eventually falls away, it can leave behind deep, permanent damage. Documented consequences include indented scars on soft skin, loss of the nostrils when applied near the nose, and in one case, a hole through the abdominal wall. Common adverse effects include burning pain, abnormal skin pigmentation, ulceration, and secondary infection. Microscopic analysis of affected skin shows extensive ulceration, tissue death, and deep scarring throughout the dermis.
The FDA has prohibited black salve from being marketed as a topical cancer treatment due to these serious risks. It remains available through alternative health channels online, but there is no evidence it can treat cancer, and the tissue damage it causes can make proper treatment of an actual skin cancer more difficult.
Bloodroot in Dental Products
In the 1980s and 1990s, sanguinarine appeared as an ingredient in some toothpastes and mouthwashes, marketed for its antibacterial properties as a way to reduce plaque and gum inflammation. A six-month, double-blind clinical trial testing a toothpaste containing sanguinarine extract found no long-term reduction in either plaque or gingival inflammation. The ingredient has largely disappeared from mainstream oral care products.
Growing Bloodroot in a Garden
Bloodroot is a popular choice for shade gardens and woodland plantings. It naturalizes well in the right conditions: rich, humus-heavy soil, consistent moisture, and partial to full shade. The flowers are short-lived, often lasting only a day or two, but they appear in early spring when little else is blooming. The foliage remains attractive through late spring and into summer before the plant goes dormant. Because the rhizome grows slowly, new colonies take several years to establish, but once settled, bloodroot spreads reliably and requires little maintenance.