Drugs A - Z
Witch hazel (Hamamelis virginiana)
Generic Name: Hawthorn
CategoryHerbs & Supplements
Aldehydes, aliphatic alcohols, catechins, epicatechin, epigallocatechin, flavone aglycones, gallate, gallic acid, gallocatechin, galloylhamameloses, Hamamelidaceae (family), Hamamelis japonica, Hamamelis mollis, hamamelis ointment, Hamamelis vernalis, Hamamelis virginiana, hamamelitannin, hamamelose, kaempferol, monoterpenoids, phenolic acids, phenylpropanoids, polymeric proanthocyanidins, polysaccharides, proanthocyanidin fractions, proanthocyanidins, Prrikweg® gel, quercetin, safrole, sesquiterpenoids, snapping hazel, snapping tobacco wood, spotted elder, tannin, tincture of witch hazel, volatile fractions, winter bloom, winterbloom, witchazel, witch hazel distillate, witch hazel extract.
Witch hazel (Hamamelis virginiana) is a flowering shrub, native to Eastern North America although other related species exist in North America, Asia, and Europe. Witch hazel has traditionally been used as a facial cleanser/toner and for the treatment of skin irritations, bruises, hemmorrhoids, and to stop bleeding.
Early research has shown that the leaves, stems, and bark of witch hazel contain compounds which may have astringent, anti-irritant, antioxidant, and antiinflammatory properties.
Although witch hazel is widely available and has been used for a variety of medical conditions, there is currently little human evidence supporting how effective witch hazel is in treatment of many of these conditions.
EvidenceDISCLAIMER: These uses have been tested in humans or animals. Safety and effectiveness have not always been proven. Some of these conditions are potentially serious, and should be evaluated by a qualified healthcare provider.
Based on human study, witch hazel was less effective than hydrocortisone cream, and no more effective than placebo in relieving inflammation associated with atopic eczema. Additional studies are needed to confirm these results.
Witch hazel is a common ingredient in over-the-counter hemorrhoid preparations for the skin; however, human study evaluating the effectiveness for this indication is currently lacking.
A homeopathic formulation containing an extract of witch hazel and tinctures of other botanicals was studied for its effects in relieving redness and itching associated with mosquito bites. According to study results, the formulation did not provide effective relief from mosquito bite symptoms. However, because information about the strength or concentration of the witch hazel extract used was not available, and witch hazel was not evaluated alone, conclusions about the effects of witch hazel on insect bite symptoms cannot be made. Additional research is needed in this area.
Perineal discomfort after childbirth:
Witch hazel has a long history of use for treating inflammation and hemorrhage when applied to the skin. Its use to reduce perineal discomfort associated with childbirth requires well-designed human study before recommendations can be made.
Skin irritation (minor/pediatric patients):
Although witch hazel has been commonly used to relieve minor skin irritations, there are few human studies evaluating its use for this purpose, especially in children. Witch hazel as an oil based formulation may be safe and well tolerated when applied to the skin in children with minor skin irritations. High quality human study is needed for a conclusion to be made.
Ultraviolet light skin damage protection:
Witch hazel has a long history of use for treating skin irritations. Human study evaluating the effects of witch hazel formulations applied to the skin have demonstrated some antiinflammatory effects. Until better quality studies are conducted, the efficacy of witch hazel for this indication cannot be determined.
Witch hazel has been studied for the treatment of varicose veins and improving venous tone. Additional study is needed in this area.
TraditionWARNING: DISCLAIMER: The below uses are based on tradition, scientific theories, or limited research. They often have not been thoroughly tested in humans, and safety and effectiveness have not always been proven. Some of these conditions are potentially serious, and should be evaluated by a qualified healthcare provider. There may be other proposed uses that are not listed below.
Abnormal menstrual bleeding, acne, anti-aging, anti-inflammatory, antibacterial, antioxidant, anxiety, athlete's foot, bruising, burns, cancer prevention, circulatory disorders, colds, colitis, cosmetic uses, dermatitis, diarrhea, edema, eye disorders, fevers, headache, hemmorhage, herpes simplex virus, high blood sugar/glucose intolerance, itching, pain, gum disease, poison ivy, psoriasis, seborrheic dermatitis, skin rash, tuberculosis, vaginal dryness, venereal disease, vomiting, wrinkle prevention.
Adults (18 years and older)
Witch hazel has been used on the skin as an astringent, for first aid, facial cleansing, and inflammatory topical conditions in the following forms: compress, steam distillate (undiluted or diluted with water), poultice, gargle or mouthwash, salve, tincture, and fluid extract. Witch hazel suppositories, prepared with leaves or bark of witch hazel in combination with cocoa butter, have been used rectally or vaginally. Witch hazel can also be applied to toilet paper to wipe the anal area.
For the treatment of moderately severe atopic eczema, 5.35 grams of hamamelis distillate with 0.64 milligrams of ketone per 100 grams was used for 14 days.
For the treatment of ultraviolet light skin damage protection, the following single doses were used: 0.64 milligrams or 2.56 milligrams of witch hazel with ketone per 100 grams; pH5 Eucerin( Aftersun Lotion with 10% witch hazel; and 10% witch hazel distillate.
Children (under 18 years old)
For minor skin injuries/irritation, an oil based witch hazel preparation was applied to the skin in a thin layer several times daily.
SafetyDISCLAIMER: Many complementary techniques are practiced by healthcare professionals with formal training, in accordance with the standards of national organizations. However, this is not universally the case, and adverse effects are possible. Due to limited research, in some cases only limited safety information is available.
Avoid with a known allergy or sensitivity to witch hazel.
Side Effects and Warnings
Witch hazel is recommended for use on the skin only. If redness or burning of the skin after use of witch hazel occurs, it is recommended to dilute with water. A healthcare provider should be contacted if symptoms of diarrhea or constipation persist while using witch hazel.
Use with caution in patients with liver or kidney disorders as witch hazel may potentially cause damage to these organs when taken by mouth in large doses.
Witch hazel may lower blood sugar levels. Caution is advised in patients with diabetes or hypoglycemia, and in those taking drugs, herbs, or supplements that affect blood sugar. Blood glucose levels may need to be monitored by a qualified healthcare professional, including a pharmacist, and medication adjustments may be necessary.
Use with caution in children, due to limited evidence of safety. In a study of children 27 months to 11 years of age with minor skin irritations, treatment with an oil based witch hazel preparation was well tolerated.
Pregnancy and Breastfeeding
Interactions with Drugs
Witch hazel may lower blood sugar levels. Caution is advised when using medications that may also lower blood sugar. Patients taking drugs for diabetes by mouth or insulin should be monitored closely by a qualified healthcare professional, including a pharmacist. Medication adjustments may be necessary.
Interactions with Herbs and Dietary Supplements
Witch hazel may lower blood sugar levels. Caution is advised when using herbs or supplements that may also lower blood sugar. Blood glucose levels may require monitoring, and doses may need adjustment.
Witch hazel may add to the effects of anti-inflammatory, antibacterial, antifungal, antiviral, antioxidant, antiulcer, or tannin containing herbs and supplements.
This information is based on a systematic review of scientific literature, and was peer-reviewed and edited by contributors to the Natural Standard Research Collaboration (www.naturalstandard.com): Dilys Burke, BA (Natural Standard Research Collaboration); Julie Conquer, PhD (RGB Consulting); Dawn Costa, BA, BS (Natural Standard Research Collaboration); Catherine Ulbricht, PharmD (Massachusetts General Hospital); Minney Varghese, BA (Northeastern University); Wendy Weissner, BA (Natural Standard Research Collaboration); Jen Woods, BS (Natural Standard Research Collaboration).
BibliographyDISCLAIMER: Natural Standard developed the above evidence-based information based on a thorough systematic review of the available scientific articles. For comprehensive information about alternative and complementary therapies on the professional level, go to www.naturalstandard.com. Selected references are listed below.
Deters, A., Dauer, A., Schnetz, E., Fartasch, M., and Hensel, A. High molecular compounds (polysaccharides and proanthocyanidins) from Hamamelis virginiana bark: influence on human skin keratinocyte proliferation and differentiation and influence on irritated skin. Phytochemistry 2001;58(6):949-958.
East, C. E., Begg, L., Henshall, N. E., Marchant, P., and Wallace, K. Local cooling for relieving pain from perineal trauma sustained during childbirth. Cochrane Database Syst Rev 2007;(4):CD006304.
Erdelmeier, C. A., Cinatl, J., Jr., Rabenau, H., Doerr, H. W., Biber, A., and Koch, E. Antiviral and antiphlogistic activities of Hamamelis virginiana bark. Planta Med 1996;62(3):241-245.
Granlund, H. Contact allergy to witch hazel. Contact Dermatitis 1994;31(3):195.
Hill, N., Stam, C., and van Haselen, R. A. The efficacy of Prrrikweg gel in the treatment of insect bites: a double-blind, placebo-controlled clinical trial. Pharm World Sci 1996;18(1):35-41.
Hughes-Formella, B. J., Filbry, A., Gassmueller, J., and Rippke, F. Anti-inflammatory efficacy of topical preparations with 10% hamamelis distillate in a UV erythema test. Skin Pharmacol Appl Skin Physiol 2002;15(2):125-132.
Korting, H. C., Schafer-Korting, M., Hart, H., Laux, P., and Schmid, M. Anti-inflammatory activity of hamamelis distillate applied topically to the skin. Influence of vehicle and dose. Eur J Clin Pharmacol 1993;44(4):315-318.
Korting, H. C., Schafer-Korting, M., Klovekorn, W., Klovekorn, G., Martin, C., and Laux, P. Comparative efficacy of hamamelis distillate and hydrocortisone cream in atopic eczema. Eur J Clin Pharmacol 1995;48(6):461-465.
Lauk, L., Lo Bue, A. M., Milazzo, I., Rapisarda, A., and Blandino, G. Antibacterial activity of medicinal plant extracts against periodontopathic bacteria. Phytother Res 2003;17(6):599-604.
No authors listed. [Drug therapy of hemorrhoids. Proven results of therapy with a hamamelis containing hemorrhoid ointment. Results of a meeting of experts. Dresden, 30 August 1991]. Fortschr Med.Suppl 1991;116:1-11.
Periera, da Silva, Rocha, R., Silva, C. M., Mira, L., Duarte, M. F., and Florencio, M. H. Antioxidants in medicinal plant extracts. A research study of the antioxidant capacity of Crataegus, Hamamelis and Hydrastis. Phytother Res 2000;14(8):612-616.
Wang, H., Provan, G. J., and Helliwell, K. Determination of hamamelitannin, catechins and gallic acid in witch hazel bark, twig and leaf by HPLC. J Pharm Biomed Anal 11-24-2003;33(4):539-544.
Willhite, L. A. and O'Connell, M. B. Urogenital atrophy: prevention and treatment. Pharmacotherapy 2001;21(4):464-480.
Wolff, H. H. and Kieser, M. Hamamelis in children with skin disorders and skin injuries: results of an observational study. Eur J Pediatr 2007;166(9):943-948.
Yang, S., Dennehy, C. E., and Tsourounis, C. Characterizing adverse events reported to the California Poison Control System on herbal remedies and dietary supplements: a pilot study. J Herb Pharmacother 2002;2(3):1-11.
Remember, keep this and all other medicines out of the reach of children, never share your medicines with others, and use this medication only for the indication prescribed.