Awaiting clinical review. This page is built from sourced entries but has not yet been signed off by a pharmacist or clinician.
Natural remedies for headaches
Direct answer
For preventing migraine, butterbur has the best-rated evidence (Moderate, 3) but carries a liver-safety problem: the UK regulator advised against unlicensed products in 2012, and liver injury has been reported even with PA-free extracts. Feverfew is rated Limited (2), with about 0.6 fewer attacks a month than placebo in its best trial; for tension headache, peppermint oil on the skin is Limited (2) on one small trial, and willow bark is Traditional (1). A herb is not a first-line answer here, and any headache that is sudden and extremely painful, follows a head injury, comes with vision changes, weakness, confusion, a stiff neck or fever, or keeps coming back or gets worse needs medical help.
Compare the options
Click a column heading to sort.
| Rated for | Typical form & use | Main caution | |||
|---|---|---|---|---|---|
| Butterbur Petasites hybridus (root, leaf) | Moderate | Migraine prevention | PA-free root extract, 75 mg twice daily | Rare liver injury, even with PA-free products | 4+ weeks |
| Feverfew Tanacetum parthenium (leaf) | Limited | Preventing migraine | Leaf powder 100–600 mg/day | Not for pregnancy; may slow blood clotting | 4+ weeks |
| Peppermint Mentha x piperita (oil, leaf) | Limited | Tension headache (oil applied to forehead and temples) | 10% oil in ethanol, applied to skin | Not on broken skin or on under-2s | 2 weeks |
| Willow bark Salix spp. (bark), e.g. S. alba | Traditional | Minor joint pain, headache and fever with a cold | Ethanol extract, 120–240 mg salicin/day | Salicylate: not with aspirin allergy or under 18 | About a week |
- Rated for
- Migraine prevention
- Form
- PA-free root extract, 75 mg twice daily
- Onset
- 4+ weeks
- Rated for
- Preventing migraine
- Form
- Leaf powder 100–600 mg/day
- Onset
- 4+ weeks
- Rated for
- Tension headache (oil applied to forehead and temples)
- Form
- 10% oil in ethanol, applied to skin
- Onset
- 2 weeks
- Rated for
- Minor joint pain, headache and fever with a cold
- Form
- Ethanol extract, 120–240 mg salicin/day
- Onset
- About a week
Quick picks
Feverfew was well tolerated in trials, with mild digestive upset and mouth sores from chewing fresh leaves the most common problems. Benefit is modest: the Cochrane review rated the evidence low quality, and the best trial showed 0.6 fewer attacks a month than placebo. Avoid it in pregnancy and with blood thinners or daisy-family allergy, and give it about 2 months.
Traditional favouriteWillow barkThe EU regulator recognises willow bark for headache on long-standing use alone, and no trials are cited for that use. Its real evidence is for low back pain, not headache. It is a salicylate related to aspirin, so it is unsuitable for anyone allergic to aspirin, under 18s and those on blood thinners without medical advice.
Talk to a doctor first if…
Who should avoid
Butterbur: avoid any product not labelled PA-free, and avoid it altogether with liver disease or a history of liver problems, in pregnancy and breastfeeding, and beyond about 16 weeks. Feverfew is not for pregnancy, breastfeeding, under 18s, before surgery, or with a daisy-family allergy or clotting disorder. Willow bark is contraindicated with aspirin or NSAID allergy, active stomach ulcer, bleeding disorders and in under-18s (Reye's syndrome risk); peppermint oil should not go on broken skin or on under-2s.
Known interactions
Feverfew may slow blood clotting, so ask a doctor or pharmacist first if you take blood thinners; the EU assessment also lists a theoretical extra risk with NSAID painkillers. Willow bark may increase the effect of anticoagulants, and combining it with aspirin or other NSAIDs is not recommended without medical advice. No interactions are listed for butterbur or topical peppermint oil, which does not mean there are none.
Before you reach for an ingredient
For most headaches the basics come first: fluids, regular meals, rest and finding your triggers. If you get migraines, a diary is also what a doctor will want to see before any preventive, herbal or not.
- The NHS advises drinking plenty of water, trying to relax because stress can make headaches worse, not skipping meals, not oversleeping, avoiding long stretches of eye strain from screens, and avoiding alcohol.3
- The NHS lists dehydration, not eating regular meals, stress, alcohol, bad posture, eyesight problems and taking too many painkillers among common causes, and suggests a headache diary to work out your triggers.3
Questions people ask
Do feverfew or butterbur prevent migraines?
Both may, modestly. Feverfew is rated Limited: the Cochrane review found the evidence low quality, and the best trial found 0.6 fewer attacks a month than placebo. Butterbur is rated Moderate on one 245-person trial of a special extract (48% fewer attacks versus 26% on placebo), but its liver-safety record is why NCCIH and the UK regulator urge caution.
Is butterbur safe for your liver?
Not reliably. Butterbur contains pyrrolizidine alkaloids that can damage the liver, and NCCIH says even products labelled PA-free have been linked to rare liver injury. In January 2012 the MHRA advised against unlicensed butterbur products, and a Medsafe review counted 40 reported liver cases, two needing transplants. See a doctor promptly for yellow skin or eyes, dark urine or persistent tiredness.
Does peppermint oil help a tension headache?
One small 1996 trial in 41 people found 10% peppermint oil in ethanol on the forehead and temples reduced headache intensity versus placebo, similar to 1,000 mg paracetamol. NCCIH describes the evidence as limited, and we have not seen it replicated.
When should I see a doctor about a headache?
See a GP if headaches keep coming back, do not improve with self-care, or are getting worse; feverfew's EU monograph also says migraine should first be confirmed by a doctor. Get urgent help (NHS 111 in the UK) for a headache with vision problems, being sick, or that is worse when coughing or bending. Call 999 or go to A&E if it started suddenly and is extremely painful, follows a head injury, or comes with weakness, confusion, a seizure, a stiff neck or a non-fading rash.
Sources
- Randomised controlled trial Göbel H, Fresenius J, Heinze A, Dworschak M, Soyka D. Effectiveness of Oleum menthae piperitae and paracetamol in therapy of headache of the tension type. Nervenarzt. 1996.
- Regulator/health agency NCCIH. Peppermint Oil: Usefulness and Safety. National Center for Complementary and Integrative Health (last updated May 2025).
- Regulator/health agency NHS. Headaches. National Health Service (page last reviewed 17 April 2024).
- Regulator monograph European Medicines Agency HMPC. European Union herbal monograph on Salix [various species including S. purpurea L., S. daphnoides Vill., S. fragilis L.], cortex (EMA/HMPC/80630/2016 - Corr 1). 2017.
- Cochrane review Wider B, Pittler MH, Ernst E. Feverfew for preventing migraine. Cochrane Database Syst Rev. 2015.
- Regulator/health agency NCCIH. Feverfew. National Center for Complementary and Integrative Health (last updated February 2025).
- Regulator/health agency NCCIH. Butterbur: Usefulness and Safety. National Center for Complementary and Integrative Health.
- Regulator summary Medsafe (New Zealand). Complementary Corner: Butterbur and Liver Toxicity. Prescriber Update, June 2012.
Draft, awaiting clinical review