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Updated 18 February 2013

Witch hazel (Hamamelis virginiana)

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.

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BACKGROUND

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.

EVIDENCE TABLE

Conditions

Uses
disclaimer: 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.
Grade*

Eczema

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.

C

Hemorrhoids

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.

C

Insect bites

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.

C

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.

C

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.

C

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.

C

Varicose veins

Witch hazel has been studied for the treatment of varicose veins and improving venous tone. Additional study is needed in this area.

C

*Key to grades: A: Strong scientific evidence for this use; B: Good scientific evidence for this use; C: Unclear scientific evidence for this use; D: Fair scientific evidence against this use (it may not work); F: Strong scientific evidence against this use (it likely does not work).

TRADITION

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.

DOSING

disclaimer: The below doses are based on scientific research, publications, traditional use, or expert opinion. Many herbs and supplements have not been thoroughly tested, and safety and effectiveness may not be proven. Brands may be made differently, with variable ingredients, even within the same brand. The below doses may not apply to all products. You should read product labels, and discuss doses with a qualified healthcare provider before starting therapy.

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.

SAFETY

disclaimer: The U.S. Food and Drug Administration does not strictly regulate herbs and supplements. There is no guarantee of strength, purity or safety of products, and effects may vary. You should always read product labels. If you have a medical condition, or are taking other drugs, herbs, or supplements, you should speak with a qualified healthcare provider before starting a new therapy. Consult a healthcare provider immediately if you experience side effects.

Allergies

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

Avoid in patients who are pregnant or breastfeeding, due to a lack of safety evidence.

INTERACTIONS

disclaimer: Most herbs and supplements have not been thoroughly tested for interactions with other herbs, supplements, drugs, or foods. The interactions listed below are based on reports in scientific publications, laboratory experiments, or traditional use. You should always read product labels. If you have a medical condition, or are taking other drugs, herbs, or supplements, you should speak with a qualified healthcare provider before starting a new therapy.

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.

Witch hazel may add to the effects of antibiotic, antifungal, antiinflammatory, antiviral, and antiulcer drugs.

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.

ATTRIBUTION

This information is based on a systematic review of scientific literature edited and peer-reviewed by contributors to the Natural Standard Research Collaboration (www.naturalstandard.com).

  • 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. View abstract
  • 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. View abstract
  • 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. View abstract
  • Granlund, H. Contact allergy to witch hazel. Contact Dermatitis 1994;31(3):195. View abstract
  • 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. View abstract
  • 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. View abstract
  • 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. View abstract
  • 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. View abstract
  • 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. View abstract
  • 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. View abstract
  • 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. View abstract
  • 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. View abstract
  • Willhite, L. A. and O'Connell, M. B. Urogenital atrophy: prevention and treatment. Pharmacotherapy 2001;21(4):464-480. View abstract
  • 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. View abstract
  • 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. View abstract
disclaimer: Natural Standard Bottom Line Monograph, Copyright © 2011 (www.naturalstandard.com). Commercial distribution prohibited. This monograph is intended for informational purposes only, and should not be interpreted as specific medical advice. You should consult with a qualified healthcare provider before making decisions about therapies and/or health conditions. disclaimer: While some complementary and alternative techniques have been studied scientifically, high-quality data regarding safety, effectiveness, and mechanism of action are limited or controversial for most therapies. Whenever possible, it is recommended that practitioners be licensed by a recognized professional organization that adheres to clearly published standards. In addition, before starting a new technique or engaging a practitioner, it is recommended that patients speak with their primary healthcare provider(s). Potential benefits, risks (including financial costs), and alternatives should be carefully considered. The below monograph is designed to provide historical background and an overview of clinically-oriented research, and neither advocates for or against the use of a particular therapy. disclaimer: The information in this monograph is intended for informational purposes only, and is meant to help users better understand health concerns. Information is based on review of scientific research data, historical practice patterns, and clinical experience. This information should not be interpreted as specific medical advice. Users should consult with a qualified healthcare provider for specific questions regarding therapies, diagnosis and/or health conditions, prior to making therapeutic decisions.

Copyright © 2011 Natural Standard (www.naturalstandard.com)



Copyright © 2011 Natural Standard (www.naturalstandard.com)
 
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