Herbs & Botanicals · Herbs · Shrub used on the skin, with low-certainty evidence and a few cautions
Witch hazel
Hamamelis virginiana L. · also called Witch hazel, witch hazel water, hamamelis
Witch hazel is a shrub of North America. Its bark and leaf are used in traditional medicine, and its twigs are steamed to make witch hazel water, a common ingredient in toners, pads and creams. The bark and leaf are rich in tannins, but the distillate has very little.
General information, not medical advice. Last substantive update · Not medically reviewed. A named clinician has not signed off on this page. How this page is made
About Witch hazel
Witch hazel (Hamamelis virginiana) is a North American shrub whose bark, leaf and steam-distilled twigs are used on skin, in hemorrhoid products and in mouth rinses. Human evidence is small and low in certainty, while allergy and alcohol content are the practical cautions.
What it is
Witch hazel is a shrub in the Hamamelidaceae family. Three different things are sold under the name: witch hazel water (a steam distillate of twigs, with alcohol added), bark or leaf extracts rich in tannins, and purified compounds like hamamelitannin.
The distillate has very little tannin (the US standard limit is 0.03 mg tannic acid per mL), while bark holds 8-12% tannins and leaf 3-10% (EMA report).
Traditional and current uses
In the US, witch hazel water has been official since 1882 and is used as a cooling application. In the EU, bark is a traditional-use herbal medicine for minor skin inflammation and dryness, itching and burning with hemorrhoids, and as a mouthwash. These are traditional uses and are not proof of benefit.
Today it is sold as toners, pads, wipes, creams, suppositories and mouth rinses, often with other ingredients.
What the research shows
The best human studies are small experiments on healthy volunteers with UV-induced redness and one eczema trial. Effects were small or absent compared with plain creams, and hydrocortisone did better. Hemorrhoid, childbirth and mouth uses have no direct trials. Most cosmetic claims come from cells and ex vivo skin, and some of that work was funded by or linked to companies that sell hamamelis products.
At a glance
Traditional uses history, not proof
- Europe and North America: witch hazel water as a cooling, astringent skin application; US Pharmacopoeia entry since 1882 (EMA report).
- EU traditional use of bark: minor skin inflammation and dryness, itching and burning with hemorrhoids, and as a mouthwash.
- Belgium: oral use as herbal tea authorised in the early 1960s with no clear indication (EMA report).
Studied for research
- Sunburn-type skin redness in UV tests (distillate lotions), low
- Eczema (distillate cream), no better than plain cream in one trial, low
- Diaper rash and minor skin injuries in children, very low
- Skin germs (distillate plus urea), very low
- Hemorrhoids, pain after childbirth and mouth rinses, insufficient
- Cosmetic claims and tannin activity (lab only), insufficient
Main compounds
- Hamamelitannin, a tannin mainly in bark
- Condensed tannins (proanthocyanidins) in bark and leaf
- Catechin and gallic acid
- Trace volatile oil (eugenol and other compounds) in leaf and distillate
- Ethanol, added to many distillates (about 14-15%)
Common forms
- Witch hazel water (distillate), often 14-15% alcohol
- Bark and leaf extracts, tinctures and decoctions
- Creams, ointments, gels and suppositories
- Toners, wipes and cosmetics
- Mixed products with aloe, calendula or horse chestnut
Research links: EMA: Hamamelidis cortex (bark) herbal monograph page · EMA assessment report on Hamamelis (PDF) · Distillate cream vs hydrocortisone in atopic eczema (PubMed) · AGA clinical practice update on hemorrhoids (PubMed) · Witch hazel toner ingestion and alcohol withdrawal, case report (PubMed) · GBIF: Hamamelis virginiana · Research Library · Genes & Biomarkers Library
The plant and its history
- Accepted scientific name
- Hamamelis virginiana
- Naming authority
- L.
- Common names
- Witch hazel (English); Hamamelis Bark / Hamamelis Leaf (EMA names) (English); Hamamelisrinde (German); Hamamelis, corteza de (Spanish)
- Botanical family
- Hamamelidaceae (witch hazel family)
- Classification
- Plantae > Tracheophyta > Magnoliopsida > Saxifragales > Hamamelidaceae > Hamamelis > Hamamelis virginiana
- Native range
- Not verified from a primary source in this build.
- Habitat
- Not verified.
- What the plant looks like
- Roots: Not verified.; Stems: Twigs with buds and leaf scars are the part distilled for witch hazel water (EMA report).; Leaves: Leaf is a herbal substance in the EMA monograph; botany details not verified.; Flowers: Not verified.; Fruit: Woody capsule about 15 mm long that splits to release a black seed, per the EMA report description of the drug.
- Cultivation
- Not verified.
- Harvest and processing
- Witch hazel water is made from recently cut, partly dried dormant twigs, soaked in water for 24 hours and distilled, then about 150 ml alcohol is added per 850 ml distillate (EMA report, USP method).
- Look-alikes and adulterants
- Name: Other Hamamelis species (for example Hamamelis mollis, Chinese witch hazel); Note: The EMA report notes that twig structures differ between species; no adulteration study was found.
- Sustainability and conservation
- Not assessed.
Traditional use and history history, not clinical proof
| Tradition or era | Documented use | Source |
|---|---|---|
| United States Pharmacopoeia | Alcoholic witch hazel water official in the US Pharmacopoeia from 1882 (per the EMA report, citing Millspaugh 1974). Used as a cooling application and traditionally as a haemostatic. | EMA assessment report |
| EU herbal medicine | Traditional use of bark for minor skin inflammation and dryness, itching and burning with hemorrhoids, and as a mouthwash for minor mouth inflammation. | EMA/HMPC monograph (bark) |
| Belgium (national register) | Oral use as herbal tea authorised 1961-1962 with no clear indication (as listed in the EMA report). | EMA assessment report |
| North America (general) | Wikipedia-level claims about Native American use were not verified and are not used. | NOT verified |
Traditional use shows how a plant was used. It does not show that a supplement works or is safe today.
What is inside, and how it may work
What the plant contains and how those compounds act in cells and animals. Laboratory and animal mechanisms are not proven effects in people.
Main compounds
| Compound | Family | Where it is concentrated | Activity studied | Level of evidence |
|---|---|---|---|---|
| Hamamelitannin PubChem 21145076 | Hydrolysable tannin (digalloyl hamamelose) | Bark (1-7% per the EMA report) | Anti-inflammatory and wound-migration effects in skin cells; free radical scavenging in lab tests. 23 20 5 18 | Lab |
| Catechin PubChem 9064 | Flavan-3-ol | Bark and leaf | Reduced DNA damage from a known mutagen in liver cells. 4 18 | Lab |
| Proanthocyanidins (condensed tannins) | Condensed tannins | Bark and leaf Bark tannins 8-12%, leaf 3-10% (EMA report) | Large fractions blocked herpes simplex virus 1 in cells and reduced mouse ear swelling. 8 5 | Lab / animal |
| Gallic acid PubChem 370 | Phenolic acid | Bark and leaf | Present as free acid in bark; no activity studied here. 5 18 | Identity only |
| Eugenol (trace volatile) PubChem 3314 | Phenylpropanoid | Leaf oil and distillate (trace) | Named with carvacrol as a trace component in distillate in a case report; no activity studied. 2 5 18 | Identity only |
| Ellagic acid (formed by skin bacteria) | Phenolic acid | Formed from bark extract by skin bacteria ex vivo | Raised inflammatory messengers in fibroblasts in a lab study. 23 | Lab |
Mechanisms, receptors and pathways
| Target or pathway | Gene or receptor | What was found | Level |
|---|---|---|---|
| NF-kB driven inflammatory messengers in skin cells | NF-kB (IL-6, IL-17C, TSLP, CCL26, MMP-9) | A standardised bark extract lowered these messengers with IC50 below 25 ug/mL. 20 | Laboratory research |
| Skin cell migration and wound closure | Not specified | Bark extract and hamamelitannin helped keratinocytes move into a scratch; hamamelitannin was stronger. 23 | Laboratory research |
| Herpes simplex virus 1 and enzymes | Not specified | Large proanthocyanidins blocked HSV-1 in cells, inhibited alpha-glucosidase and elastase, and reduced mouse ear swelling. 8 | In vitro / animal |
| Protein binding (astringency) | Not applicable | Tannins bind proteins; the EMA report links astringency to the traditional uses. 5 | Pharmacological theory |
| DNA damage protection in liver cells | Not specified | Bark compounds reduced DNA damage from benzo[a]pyrene, by scavenging its reactive metabolite, while two compounds alone raised DNA migration about two-fold. 4 | Laboratory research |
Absorption, metabolism and elimination
- Absorption
- No human absorption data for witch hazel were found in the sources read.
- Distribution
- Not found.
- Metabolism
- Skin bacteria can convert part of the bark extract to ellagic acid in a lab model; human metabolism not found.
- Elimination
- Not found.
- Bioavailability
- Not found.
Isolated compounds versus whole extracts
Witch hazel water (distillate) is mostly water and alcohol with trace volatile oil and almost no tannin, while bark and leaf extracts are rich in tannins. A purified compound like hamamelitannin is different again. The studies in people mostly used the distillate; most lab work used bark extracts or hamamelitannin, so lab results cannot be assumed to apply to toners.
Nutritional composition
Not studied as a nutrient source. Tannins may reduce absorption of minerals and B vitamins if bark or leaf is swallowed (EMA report).
2 low certainty2 very low certainty6 not enough evidence
What was looked at
The 10 benefits and uses checked for Witch hazel, each with how strong the evidence is. Tap one to open it.
- Sunburn-type skin redness (UV erythema test): distillate lotionsLow certainty
- Eczema (atopic dermatitis): distillate creamLow certainty
- Diaper rash and minor skin injuries in children: ointment and creamVery low certainty
- Antiseptic and skin-germ effects (skin)Very low certainty
- Cosmetic and soothing claims for skin care (lab and company studies)Not enough evidence
- Traditional use for minor skin inflammation and dryness (EU)Not enough evidence
- Hemorrhoid symptoms: itching, burning, discomfortNot enough evidence
- Pain after childbirth (perineal trauma): witch hazel water padsNot enough evidence
- Minor mouth and throat inflammation (mouthwash, gargle)Not enough evidence
- Antioxidant, anti-inflammatory and antiviral activity of the tannins (lab and animal only)Not enough evidence
Lab markers tracked in the studies
Skin redness after UV exposure (erythema)Eczema sum score (itching, redness, scaling)Diaper dermatitis severity scoreSkin bacteria and Staphylococcus aureus growthInflammation messengers from skin cells (IL-6, IL-8 and others)Hemorrhoid symptoms (bleeding, itching, pain)Perineal pain after childbirthFree radical output by white blood cells (lab)
What is Witch hazel good for?
The main proposed uses and how strong the human evidence is for each. "Low" means small or inconsistent studies; "insufficient" means little or none in people. Distillate, bark extract and tannins are different things.
Benefits, one by one
Each card is a research question, not a promise. Tap a goal to filter. Open a card to see the studies, doses and limits.
Sunburn-type skin redness (UV erythema test): distillate lotions
Low certaintyIn lab-style tests on healthy volunteers, lotions with 10% witch hazel distillate lowered UV-induced redness a little, but plain lotion bases also helped and hydrocortisone worked better.
5 studiesDistillate (witch hazel water) in lotions and creams under a patch fo…
Studies, doses and limits
What the trials found
Hughes-Formella 1998 (30 volunteers) found redness fell about 20% to 27% with an aftersun lotion with 10% hamamelis distillate, against 11% to 15% with other lotions. Hughes-Formella 2002 (40 volunteers) tested three 10% distillate lotions: only one beat the lotion bases, at one UV dose, and hydrocortisone was best. Korting 1993 (24 volunteers per test) found a low-dose distillate cream with phosphatidylcholine reduced UV redness, but a fourfold stronger one did no better. Beikert 2013 (40 volunteers) tested seven plant formulations; only aloe vera was significant and hamamelis was not reported as effective.
Results
Mixed and small. Some effect over the cream base in some experiments, none in others. Hydrocortisone beat hamamelis wherever it was compared.
Effect sizes as reported
Redness suppression about 20% at 7 hours and 27% at 48 hours with one aftersun lotion (Hughes-Formella 1998); no pooled numbers.
Why this rating
Four small tests in healthy volunteers, results mixed, effects small, redness model rather than real sunburn, two studies used commercial lotions and funding is not stated.
Form and dose studied
Distillate (witch hazel water) in lotions and creams under a patch for 48 hours. Results depend on the cream base. This page gives no advice on amounts.
Who was studied
Healthy adult volunteers, Germany.
Limits
Experimental redness, not a skin disease. No trial in people with real sunburn. Bases alone reduced redness too.
Why researchers looked
Researchers use UV-induced redness on the back as a standard model to test mild skin anti-inflammatory products.
Traditional use
Witch hazel water has long been used on irritated skin (per the EMA assessment report). This is traditional use, not proof.
Proposed mechanism Laboratory research
Lab studies report that bark tannins and hamamelitannin lower inflammatory messengers and mop up free radicals in cells. This has not been shown to explain the volunteer results.
A proposed mechanism does not show that the effect happens in people.
Skin allergy to witch hazel is possible. See the Safety tab.
Eczema (atopic dermatitis): distillate cream
Low certaintyOne two-week trial of 72 adults with eczema found witch hazel distillate cream worked no better than the plain cream base, and a weak hydrocortisone cream worked better.
3 studiesHamamelis distillate cream in the trial (5.35 g distillate per 100 g)…
Studies, doses and limits
What the trials found
Korting 1995 randomized 72 adults with moderately severe atopic eczema to hamamelis distillate cream, plain base cream or 0.5% hydrocortisone cream for 14 days. All three reduced itching, redness and scaling. Hydrocortisone was better than hamamelis. Hamamelis did not differ from the plain base. A systematic review of herbal treatments for skin problems in children (Kloter 2023, 17 studies) did not report a hamamelis benefit in its abstract.
Results
Negative for benefit beyond the base cream in the one trial found.
Effect sizes as reported
Score falls as reported: hydrocortisone 2.7 vs hamamelis 1.6; hamamelis 1.8 vs plain base 2.0.
Why this rating
One 14-day trial, adults only, distillate cream only. It is negative for benefit beyond the base. The cell study was done by authors linked to a company that sells hamamelis products.
Form and dose studied
Hamamelis distillate cream in the trial (5.35 g distillate per 100 g). Other forms and bark extracts were not tested in people for eczema.
Who was studied
Adults with moderately severe atopic eczema, Germany.
Limits
Short, single trial, one product; no trial of other forms; funding not stated.
Why researchers looked
Witch hazel is traditionally used for itchy, inflamed skin, so it was tested in eczema.
Traditional use
Traditional use for skin inflammation. Traditional use is not proof of benefit.
Proposed mechanism Laboratory research
In cell tests, a standardised bark extract and hamamelitannin lowered release of eczema-related inflammatory messengers from skin cells by partly blocking NF-kB. Cells in a dish, not people.
A proposed mechanism does not show that the effect happens in people.
Skin reactions in six people were all on vehicle-treated areas. Contact allergy is possible.
Diaper rash and minor skin injuries in children: ointment and cream
Very low certaintyAn observational study in 309 children found skin scores improved with witch hazel ointment, about as much as with dexpanthenol ointment. A small trial of a witch hazel cream versus breast milk cannot tell whether the cream works.
4 studiesHamamelis ointment and a 12 mg per 100 g cream. Not the same product.
Studies, doses and limits
What the trials found
Wolff 2007 treated 309 children aged 27 days to 11 years (231 with hamamelis ointment, 78 with dexpanthenol). Scores fell for both in minor skin injuries, diaper dermatitis and local inflammation, and the two were similar; tolerability was rated excellent or good by 99.1% of physicians and 98.2% of parents for hamamelis. There was no placebo group. Sevimli Guler 2026 randomized 60 infants to breast milk or a witch hazel cream (12 mg per 100 g). The cream group improved (2.83 to 1.53 on the scale) but the breast milk group started much more severe and improved more, so the abstract says the comparison is limited.
Results
Improved with ointment in an uncontrolled comparison; the randomized trial uses witch hazel as the comparison arm and cannot judge it.
Effect sizes as reported
Wolff 2007: tolerability good or excellent in 99.1% (physicians) and 98.2% (parents). Sevimli Guler 2026: cream group score 2.83 to 1.53.
Why this rating
No placebo, children get better on their own, groups not randomized in one study and unequal at the start in the other. Funding not stated.
Form and dose studied
Hamamelis ointment and a 12 mg per 100 g cream. Not the same product.
Who was studied
Children from 27 days to 11 years (Wolff) and infants 0-6 months (Sevimli Guler), Germany and Turkey.
Limits
No placebo-controlled trial in children. The EMA monograph does not recommend skin use under 12 years for lack of data.
Why researchers looked
Mild witch hazel products are sold for nappy rash and small skin injuries, so researchers checked how children do.
Traditional use
Used traditionally for minor skin irritation (EMA assessment report). Not proof of benefit.
Proposed mechanism Laboratory research
Not established. Lab work on bark tannins suggests anti-inflammatory and astringent effects.
A proposed mechanism does not show that the effect happens in people.
Allergic contact dermatitis has been reported. See the Safety tab.
Antiseptic and skin-germ effects (skin)
Very low certaintyA distillate plus urea product cut skin bacteria a little, but far less than standard antiseptics.
2 studiesDistillate 90% with 5% urea product; bark extract in the lab study.
Studies, doses and limits
What the trials found
Gloor 2002 tested a product with 90% distillate and 5% urea in 15 healthy volunteers and in lab dishes: there was a significant effect in one of two skin tests and growth blocking of Staphylococcus aureus and Candida albicans in dishes. The authors call the activity relatively weak compared with chlorhexidine.
Results
Weak and not tested as a treatment of infection.
Effect sizes as reported
Significant in the expanded flora test; weak against chlorhexidine.
Why this rating
Fifteen healthy volunteers, a mixed urea product, lab tests with high concentrations, no infection treated.
Form and dose studied
Distillate 90% with 5% urea product; bark extract in the lab study.
Who was studied
Healthy volunteers and lab.
Limits
Healthy skin only, no infection outcomes.
Why researchers looked
Skin germs play a part in eczema and skin folds, so a mild antimicrobial effect might help.
Traditional use
Witch hazel water is traditionally applied to irritated skin. No source says it was used as an antiseptic.
Proposed mechanism Laboratory research
Tannins can slow bacteria in lab dishes. A 2025 lab study found a bark extract needed 0.5 mg/mL to slow Staphylococcus aureus, and that skin bacteria changed part of the extract into ellagic acid, which raised inflammatory messengers in skin cells.
A proposed mechanism does not show that the effect happens in people.
None reported in the abstract.
Cosmetic and soothing claims for skin care (lab and company studies)
Not enough evidenceReviews and lab studies describe soothing, antioxidant and wound-healing effects in cells. No human trial shows these in skin care use.
5 studiesBark extract, hamamelitannin and a company formula. Distillate toners…
Studies, doses and limits
What the trials found
A 2025 review (Wojciak) says lab and animal work and limited clinical trials show antimicrobial, anti-inflammatory, antioxidant and wound-healing activity. The 2025 L'Oreal-funded ex vivo study tested a company formula. No human trial is described for these claims in the abstracts.
Results
Lab only.
Effect sizes as reported
No numbers in the abstracts.
Why this rating
Cells and ex vivo skin, concentrations may not apply to a toner on the skin, one study funded by a cosmetics company, and a second linked to a company selling hamamelis products.
Form and dose studied
Bark extract, hamamelitannin and a company formula. Distillate toners were not the subject.
Who was studied
Cells and ex vivo skin.
Limits
No human evidence for these claims.
Why researchers looked
Witch hazel bark and leaf extracts are common in toners, wipes and creams, so researchers study the active compounds.
Traditional use
Used for centuries as a skin astringent (per the EMA assessment report).
Proposed mechanism Laboratory research
Bark extract and hamamelitannin lowered inflammatory messengers and helped skin cells migrate in a scratch test. A cosmetic formula lowered IL-6 and IL-8 and oxidation markers in ex vivo skin. A bark fraction blocked herpes simplex virus 1 in cells.
A proposed mechanism does not show that the effect happens in people.
Skin bacteria may change the extract into ellagic acid, which raised inflammatory messengers in a lab study.
Traditional use for minor skin inflammation and dryness (EU)
Not enough evidenceThe EU herbal committee accepts witch hazel bark for minor skin inflammation and dry skin as a traditional-use medicine only, based on long use rather than trials.
2 studiesBark tincture, dry extract and decoction in the monograph; distillate…
Studies, doses and limits
What the trials found
The EMA monograph (2019 version, first adopted 2009-2010) lists traditional use for relief of minor skin inflammation and dryness, itching and burning with hemorrhoids, and as a mouthwash. It is not a finding that the products work. It says use in children under 12 years is not recommended for lack of data and that a doctor should be seen if symptoms last over one week.
Results
Regulatory label based on long-standing use.
Why this rating
Traditional use does not need proof of effect. The 2025 EMA review notice shows the monograph is being reviewed again.
Form and dose studied
Bark tincture, dry extract and decoction in the monograph; distillate is covered in the assessment report.
Who was studied
Adolescents, adults and elderly (skin).
Limits
No clinical trials relied on.
Why researchers looked
Regulators decide whether a herbal product can carry a traditional-use label.
Traditional use
Traditional use in Europe and North America, including witch hazel water in the US Pharmacopoeia since 1882 (per the EMA report).
Proposed mechanism Pharmacological theory
Not required for a traditional-use monograph.
A proposed mechanism does not show that the effect happens in people.
Hypersensitivity is the only contraindication; allergic contact dermatitis reported.
Hemorrhoid symptoms: itching, burning, discomfort
Not enough evidenceGuidelines list witch hazel as an astringent that can be considered for hemorrhoids, but say there is little data to support it. No trial of witch hazel alone was found.
4 studiesDistillate, creams, pads and bark extract suppositories are sold. No …
Studies, doses and limits
What the trials found
The 2026 American Gastroenterological Association expert review (Qureshi) says astringents (witch hazel) can be considered for symptomatic hemorrhoids, but there is little data to support efficacy; fibre and avoiding straining are first-line. A 2025 narrative review (Admuthe) says witch hazel, horse chestnut and triphala have shown benefit for pain, bleeding and swelling, but also says clinical validation is lacking. An Italian uncontrolled report (Gaj 2009, 40 patients after anal surgery) used a cream with aloe, hamamelis, calendula, horse chestnut and other ingredients and reported 84% favourable healing, but a combination without a control group cannot show a witch hazel effect.
Results
No controlled trial of witch hazel alone for hemorrhoids was found in this search. Guidance is based on expert opinion and tradition.
Effect sizes as reported
Not available. Gaj 2009: 84% favourable healing with a mixed cream, no control.
Why this rating
Expert guidance says there is little data. A review and an uncontrolled combination study do not show a witch hazel effect.
Form and dose studied
Distillate, creams, pads and bark extract suppositories are sold. No trial compares them. Ask a doctor or pharmacist about amounts.
Who was studied
Adults with symptomatic hemorrhoids; the EMA monograph does not recommend anorectal use under 18.
Limits
Expert review without systematic search; narrative review; uncontrolled combination study with a branded product.
Why researchers looked
Witch hazel is one of the best-known home remedies for hemorrhoids, usually as pads, creams or the distillate.
Traditional use
The EMA lists traditional use for itching and burning associated with hemorrhoids (bark preparations, anorectal use). Traditional use, not proof.
Proposed mechanism Pharmacological theory
Tannins make tissue tighten (astringent). In the lab bark extracts lowered inflammatory messengers. Not shown to explain hemorrhoid relief.
A proposed mechanism does not show that the effect happens in people.
Rectal bleeding needs a doctor to check the cause (AGA, EMA). Topical steroids should not be used for more than 2 weeks (AGA).
Pain after childbirth (perineal trauma): witch hazel water pads
Not enough evidenceA Cochrane review compared cooling treatments after childbirth and lists witch hazel water as one comparison, but its abstract does not give a witch hazel result.
2 studiesHamamelis water (distillate). Pads and gels are marketed. This page g…
Studies, doses and limits
What the trials found
The 2012 Cochrane review (East; 10 randomized trials, 1825 women) found ice packs gave better pain relief 24-72 hours after birth than no treatment (RR 0.61, 95% CI 0.41 to 0.91). Hamamelis water was a comparison treatment in one included trial but the abstract gives no result for it. A 2020 update exists and was not read. The authors conclude the evidence for local cooling treatments is limited.
Results
No witch hazel result can be reported from the abstract.
Effect sizes as reported
Ice packs vs no treatment RR 0.61 (0.41 to 0.91). No witch hazel numbers.
Why this rating
The witch hazel result was not in the abstract read, so no rating beyond insufficient is possible.
Form and dose studied
Hamamelis water (distillate). Pads and gels are marketed. This page gives no advice on amounts.
Who was studied
Women after childbirth.
Limits
Abstract only; newer update unread.
Why researchers looked
Witch hazel pads are used to ease pain and swelling after childbirth.
Traditional use
Witch hazel water is used for general soothing (EMA report). This is not proof.
Proposed mechanism Pharmacological theory
Not established.
A proposed mechanism does not show that the effect happens in people.
Distillate contains alcohol (see Safety tab); the EMA monograph does not recommend use in pregnancy or breastfeeding, and gives no data on postpartum skin use.
Minor mouth and throat inflammation (mouthwash, gargle)
Not enough evidenceThe EU committee accepts bark decoction or diluted tincture as a traditional mouthwash for minor inflammation of the mouth lining. No trial result was found.
1 studiesBark decoction or diluted tincture per the monograph (the tincture co…
Studies, doses and limits
What the trials found
The EMA monograph lists a mouthwash and gargle indication based on long-standing use only. No clinical trial of witch hazel in the mouth was identified in this search.
Results
No human trial found.
Why this rating
Traditional-use label only; no study read.
Form and dose studied
Bark decoction or diluted tincture per the monograph (the tincture contains ethanol). No dosing advice here.
Who was studied
Adolescents, adults and elderly per the monograph; not recommended under 12.
Limits
Regulatory text, no trial.
Why researchers looked
The tannins are astringent and have been used in mouth rinses.
Traditional use
EMA traditional use for minor inflammation of the oral mucosa (bark).
Proposed mechanism Pharmacological theory
Astringent effect of tannins (pharmacological theory in the EMA report).
A proposed mechanism does not show that the effect happens in people.
Tincture contains alcohol; do not swallow a distillate or tincture meant for the mouth or skin.
Antioxidant, anti-inflammatory and antiviral activity of the tannins (lab and animal only)
Not enough evidenceIn cells and mice, witch hazel bark tannins fight free radicals, calm inflammation messengers and block herpes simplex virus 1. None of this has been shown in people.
4 studiesBark extracts, fractions and pure compounds, not distillate (which ha…
Studies, doses and limits
What the trials found
No human trial. Lab studies: Erdelmeier 1996 (bark fractions), Skowronska 2025 (bark extract, neutrophils), Dauer 2003 (HepG2 liver cells).
Results
Lab only.
Effect sizes as reported
No numbers relevant to people.
Why this rating
Cells and mice only; compounds and doses may not match any product.
Form and dose studied
Bark extracts, fractions and pure compounds, not distillate (which has almost no tannins; the USP limit is 0.03 mg tannic acid per mL per the EMA report).
Who was studied
Lab.
Limits
Tannin-rich bark extracts cannot be assumed to behave like distillate (witch hazel water).
Why researchers looked
Hamamelitannin and the large proanthocyanidins are the main active compounds in bark.
Traditional use
Not part of traditional use.
Proposed mechanism Laboratory research
Bark proanthocyanidins blocked HSV-1 in cells, inhibited two enzymes and reduced mouse ear swelling. Hamamelitannin and a proanthocyanidin fraction about doubled DNA migration in liver cells at up to 166 ug/mL, while all tested compounds protected cells from benzo[a]pyrene DNA damage.
A proposed mechanism does not show that the effect happens in people.
The DNA-damage signal in liver cells is a lab finding only; see the Safety tab.
Connections to the rest of health
How Witch hazel connects to the rest of our health knowledge graph. Every link says what kind of connection it is. A safety link (for example to the liver) is a warning, not a benefit. A study that merely mentions a topic never creates a benefit link.
Explore every connection: goals, body systems, organs, symptoms, genes
A. Wellness goals
| Connected to | Kind of connection | Evidence status | Context | Studies |
|---|---|---|---|---|
| Inflammation Balance | Potential benefit | Low certainty | Sunburn-type skin redness (UV erythema test): distillate lotions: In lab-style tests on healthy volunteers, lotions with 10% witch hazel distillate lowered UV-induced redness a little, but plain lotion bases also helped and hydrocortisone worked better. Eczema (atopic dermatitis): distillate cream: One two-week trial of 72 adults with eczema found witch hazel distillate cream worked no better than the plain cream base, and a weak hydrocortisone cream worked better. | 12 13 15 3 25 16 20 14 |
| Healthy Skin | Potential benefit | Low certainty | Sunburn-type skin redness (UV erythema test): distillate lotions: In lab-style tests on healthy volunteers, lotions with 10% witch hazel distillate lowered UV-induced redness a little, but plain lotion bases also helped and hydrocortisone worked better. Eczema (atopic dermatitis): distillate cream: One two-week trial of 72 adults with eczema found witch hazel distillate cream worked no better than the plain cream base, and a weak hydrocortisone cream worked better. | 12 13 15 3 25 16 20 14 24 22 6 10 23 |
| Healthy Skin | Preliminary mechanism | Not enough evidence | Cosmetic and soothing claims for skin care (lab and company studies): Reviews and lab studies describe soothing, antioxidant and wound-healing effects in cells. No human trial shows these in skin care use. | 25 17 23 8 20 |
| Healthy Aging | Preliminary mechanism | Not enough evidence | Cosmetic and soothing claims for skin care (lab and company studies): Reviews and lab studies describe soothing, antioxidant and wound-healing effects in cells. No human trial shows these in skin care use. Antioxidant, anti-inflammatory and antiviral activity of the tannins (lab and animal only): In cells and mice, witch hazel bark tannins fight free radicals, calm inflammation messengers and block herpes simplex virus 1. None of this has been shown in people. | 25 17 23 8 20 4 5 |
| Healthy Skin | Traditional use | Not enough evidence | Traditional use for minor skin inflammation and dryness (EU): The EU herbal committee accepts witch hazel bark for minor skin inflammation and dry skin as a traditional-use medicine only, based on long use rather than trials. | 6 5 |
| Inflammation Balance | Traditional use | Not enough evidence | Traditional use for minor skin inflammation and dryness (EU): The EU herbal committee accepts witch hazel bark for minor skin inflammation and dry skin as a traditional-use medicine only, based on long use rather than trials. Hemorrhoid symptoms: itching, burning, discomfort: Guidelines list witch hazel as an astringent that can be considered for hemorrhoids, but say there is little data to support it. No trial of witch hazel alone was found. | 6 5 21 1 9 |
| Digestive Support | Traditional use | Not enough evidence | Hemorrhoid symptoms: itching, burning, discomfort: Guidelines list witch hazel as an astringent that can be considered for hemorrhoids, but say there is little data to support it. No trial of witch hazel alone was found. Minor mouth and throat inflammation (mouthwash, gargle): The EU committee accepts bark decoction or diluted tincture as a traditional mouthwash for minor inflammation of the mouth lining. No trial result was found. | 21 1 9 6 |
| Womens Wellness | Potential benefit | Not enough evidence | Pain after childbirth (perineal trauma): witch hazel water pads: A Cochrane review compared cooling treatments after childbirth and lists witch hazel water as one comparison, but its abstract does not give a witch hazel result. | 7 5 |
| Immune Support | Preliminary mechanism | Not enough evidence | Antioxidant, anti-inflammatory and antiviral activity of the tannins (lab and animal only): In cells and mice, witch hazel bark tannins fight free radicals, calm inflammation messengers and block herpes simplex virus 1. None of this has been shown in people. | 8 23 4 5 |
B. Body systems
| Connected to | Kind of connection | Evidence status | Context | Studies |
|---|---|---|---|---|
| Integumentary System | Biological association | Low certainty | Studied for: Sunburn-type skin redness (UV erythema test): distillate lotions Studied for: Eczema (atopic dermatitis): distillate cream | 12 13 15 3 25 16 20 14 24 22 6 10 23 17 8 5 |
| Immune System | Biological association | Low certainty | Studied for: Eczema (atopic dermatitis): distillate cream Studied for: Antioxidant, anti-inflammatory and antiviral activity of the tannins (lab and animal only) | 16 20 14 8 23 4 5 |
| Digestive System | Biological association | Not enough evidence | Studied for: Hemorrhoid symptoms: itching, burning, discomfort Studied for: Minor mouth and throat inflammation (mouthwash, gargle) | 21 1 9 6 |
| Cardiovascular System | Biological association | Not enough evidence | Studied for: Hemorrhoid symptoms: itching, burning, discomfort | 21 1 9 6 |
| Reproductive System | Biological association | Not enough evidence | Studied for: Pain after childbirth (perineal trauma): witch hazel water pads | 7 5 |
C. Body parts and organs
| Connected to | Kind of connection | Evidence status | Context | Studies |
|---|---|---|---|---|
| Skin | Adverse effect or risk | Low certainty | Allergic contact dermatitis reported; frequency not known. Preparation or compound: Distillate, bark extract and cosmetic products on skin |
6 5 11 |
| Liver | Adverse effect or risk | Not enough evidence | Rare liver damage mentioned in secondary sources; no case report found. Rare liver damage mentioned in secondary sources; no case found. Preparation or compound: Swallowed tannin-rich products |
5 |
| Gut | Adverse effect or risk | Not enough evidence | Stomach irritation mentioned in secondary sources. Preparation or compound: Swallowed bark or leaf products |
5 |
| Skin | Potential benefit | Low certainty | Small reduction of UV-induced redness in healthy volunteers; no benefit over base cream in eczema. Preparation or compound: Hamamelis distillate lotions and creams |
12 16 |
| Gut | Traditional use | Not enough evidence | Traditional use for hemorrhoid itching and burning; little data. Preparation or compound: Bark preparations anorectal use |
21 6 |
I. Biomarkers
| Connected to | Kind of connection | Evidence status | Context | Studies |
|---|---|---|---|---|
| Skin redness after UV exposure (erythema) | Biological association | Low certainty | Measured in trials: mixed. A lab change is not the same as a health benefit. | 12 13 15 3 |
| Eczema sum score (itching, redness, scaling) | Biological association | Low certainty | Measured in trials: no-change. A lab change is not the same as a health benefit. | 16 |
| Diaper dermatitis severity score | Biological association | Very low certainty | Measured in trials: lowered. A lab change is not the same as a health benefit. | 22 24 |
| Skin bacteria and Staphylococcus aureus growth | Biological association | Very low certainty | Measured in trials: lowered. A lab change is not the same as a health benefit. | 10 23 |
| Inflammation messengers from skin cells (IL-6, IL-8 and others) | Biological association | Not enough evidence | Measured in trials: lowered. A lab change is not the same as a health benefit. | 20 17 |
| Hemorrhoid symptoms (bleeding, itching, pain) | Biological association | Not enough evidence | Measured in trials: no-change. A lab change is not the same as a health benefit. | 21 9 |
| Perineal pain after childbirth | Biological association | Not enough evidence | Measured in trials: no-change. A lab change is not the same as a health benefit. | 7 |
| Free radical output by white blood cells (lab) | Biological association | Not enough evidence | Measured in trials: lowered. A lab change is not the same as a health benefit. | 23 |
J. Genes, receptors and enzymes
K. Biological pathways
| Connected to | Kind of connection | Evidence status | Context | Studies |
|---|---|---|---|---|
| NF-kB signalling | Preliminary mechanism | In vitro | Blocked by a bark extract in skin cells | 20 |
L. Active compounds
| Connected to | Kind of connection | Evidence status | Context | Studies |
|---|---|---|---|---|
| Hamamelitannin | Biological association | Lab | Anti-inflammatory and wound-migration effects in skin cells; free radical scavenging in lab tests. Preparation or compound: Bark (1-7% per the EMA report) |
23 20 5 18 |
| Catechin | Biological association | Lab | Reduced DNA damage from a known mutagen in liver cells. Preparation or compound: Bark and leaf |
4 18 |
| Proanthocyanidins (condensed tannins) | Biological association | Lab / animal | Large fractions blocked herpes simplex virus 1 in cells and reduced mouse ear swelling. Preparation or compound: Bark and leaf |
8 5 |
| Gallic acid | Biological association | Identity only | Present as free acid in bark; no activity studied here. Preparation or compound: Bark and leaf |
5 18 |
| Eugenol (trace volatile) | Biological association | Identity only | Named with carvacrol as a trace component in distillate in a case report; no activity studied. Preparation or compound: Leaf oil and distillate (trace) |
2 5 18 |
| Ellagic acid (formed by skin bacteria) | Biological association | Lab | Raised inflammatory messengers in fibroblasts in a lab study. Preparation or compound: Formed from bark extract by skin bacteria ex vivo |
23 |
Each connection is stored with the ingredient, the connected record, the kind of connection, the evidence status, the supporting studies, the preparation or compound involved, and a review date (last reviewed October 25, 2026).
Evidence at a glance: what changed in 8 lab markers
Tap a number to show only those markers. Counts are markers, not people.
The evidence
The research centre for Witch hazel. Every record here was checked against PubMed or the publisher's page; we never list a study we have not verified.
Evidence by outcome
Bars show how many studies we found for each outcome, not how well it works. People are added up across trials only (reviews are not added, to avoid double counting).
How we rate evidence
High certainty
Several well-run trials or reviews agree; further research is unlikely to change the picture much.
Moderate certainty
Good trials point the same way, but some doubt remains.
Low certainty
Small, short or inconsistent trials. The finding could change with better research.
Very low certainty
Very little or very weak human data. Treat as a possibility only.
Mixed findings
Trials or reviews disagree with each other.
Not enough evidence
Not enough human research to say either way.
Evidence against
Good research found no benefit, or found harm.
We take the reviewers' own risk-of-bias and GRADE statements where they exist, and otherwise judge from study size, design, consistency, directness and whether a product matches what is sold. Many publications do not make evidence high. Method note: We searched PubMed, read the EMA/HMPC bark monograph and the full EMA assessment report, and checked the plant name in GBIF and NCBI Taxonomy and compounds in PubChem. Nearly all studies were read as abstracts; three records (the contact allergy case report and an allergen article) have no abstract on PubMed. Not verified: LiverTox and LactMed (no record found by search), FDA and Commission E (not checked), and the EMA leaf monograph document (only its web page). The NCCIH has no witch hazel page (404). The liver-damage and stomach statements come from secondary citations in the EMA report. Certainty ratings are the compiler's own reading, not formal grades. No study is cited that we could not verify.
Study library: every study we checked 25
| Study | Design | People | Product, dose, length | Result |
|---|---|---|---|---|
| Admuthe 2025 Natural Products in Hemorrhoid Management: A Comprehensive Literature Review of Traditional Herbal Remedies and Evidence-Based Therapies. Cureus · PMID 40458338 · DOI |
Narrative review mixed |
Review of herbal remedies for hemorrhoids | Witch hazel, horse chestnut, triphala and others varied Varied Varied · vs Varied |
Says witch hazel, horse chestnut and triphala have shown benefit for pain, bleeding and swelling, but lists problems with standardisation, quality control and clinical validation and says more research is needed. No numbers in the abstract. Methods, limits and fundingOutcomes: Overview of herbal hemorrhoid remedies Limitations: Narrative review in a low-selectivity journal; the abstract does not say which witch hazel studies support its claim. Funding and conflicts: Authors declare no financial relationships. Read: abstract |
| Anderson 2024 A case of a patient requiring medically supervised withdrawal after ingestion of witch hazel toner as a surrogate alcohol. Clin Case Rep · PMID 38799527 · DOI |
Case report |
1 Adult with alcohol use disorder who drank witch hazel toner |
Witch hazel toner (steam-distilled, 13-15% ethanol per the authors) distillate Drunk daily as an alcohol substitute Routine use |
The patient needed medically supervised alcohol withdrawal treatment (phenobarbital taper) and was discharged stable. Authors note the toner is not FDA regulated, is made for skin use and contains 13-15% ethanol with small amounts of carvacrol and eugenol. 1 patient. Methods, limits and fundingOutcomes: Alcohol withdrawal Limitations: One case; does not give a rate of harm. Funding and conflicts: Authors declare no conflicts of interest. Read: abstract |
| Beikert 2013 [Antiinflammatory potential of seven plant extracts in the ultraviolet erythema test. A randomized, placebo-controlled study]. Hautarzt · PMID 23337964 · DOI |
Controlled trial |
40 40 healthy volunteers, UVB-induced redness |
Hamamelis virginiana formulation (one of seven plant formulations) unspecified Under occlusion 48 hours · vs Hydrocortisone acetate 1%, betamethasone valerate 0.1%, vehicle (unguentum leniens), UV-only control |
Aloe vera, chamomile, lemon balm, tea tree and coriander showed an anti-inflammatory trend; only aloe vera was statistically significant. Hamamelis was not among the formulations reported to show an effect. All were well tolerated. No significant effect reported for hamamelis. Methods, limits and fundingOutcomes: Photometric redness at 24 and 48 hours Limitations: Healthy volunteers, experimental redness, abstract gives no hamamelis numbers. Funding and conflicts: Funding not stated in the abstract. Read: abstract |
| Dauer 2003 Genotoxic and antigenotoxic effects of catechin and tannins from the bark of Hamamelis virginiana L. in metabolically competent, human hepatoma cells (Hep G2) using single cell gel electrophoresis. Phytochemistry · PMID 12711142 · DOI |
Laboratory research in-vitro |
Human liver cancer cell line (HepG2) comet assay | Catechin, hamamelitannin and two proanthocyanidin fractions from Hamamelis virginiana bark bark 2-166 ug/mL Cell experiment · vs Untreated cells; benzo[a]pyrene challenge |
Hamamelitannin and the large proanthocyanidin fraction about doubled DNA migration at up to 166 ug/mL, while all compounds reduced DNA damage from benzo[a]pyrene (a known mutagen). About 2-fold increase in DNA migration with hamamelitannin and the large fraction. Methods, limits and fundingOutcomes: DNA damage (comet assay) Limitations: Cells in a dish; high concentrations; not known to apply to people or to products on skin. Read: abstract |
| EMA Committee on Herbal Medicinal Products (HMPC) 2010 Assessment report on Hamamelis virginiana L., cortex, folium, folium et cortex aut ramunculus destillatum (EMA/HMPC/114585/2008) European Medicines Agency · Source |
Authoritative guidance |
Regulatory assessment of bark, leaf and distillate preparations | Describes witch hazel water as a steam distillate of twigs with about 14-15% ethanol (USP) and tannins at or below 0.03 mg/mL; bark contains 8-12% tannins and leaf 3-10%. Safety section: no serious events known; stomach irritation in a small number; rare contact allergy; conjunctivitis reported with eye drops; tannins may inhibit absorption of minerals and B vitamins; in rare cases tannins may cause liver damage (secondary source cited by the EMA: McGuffin 1997, not read); no drug interactions reported; safety in pregnancy and lactation not established. Safrole is noted at below 0.2% in leaf oil. Distillate was negative in Salmonella and mouse lymphoma tests. See text. Methods, limits and fundingOutcomes: Composition, regulatory status, clinical data and safety Limitations: Regulatory summary of secondary and older sources; liver and stomach statements are secondary citations whose originals were not read. Read: full-text | |
| EMA Committee on Herbal Medicinal Products (HMPC) 2019 Community herbal monograph on Hamamelis virginiana L., cortex (EMA/HMPC/114583/2008 Corr.1) European Medicines Agency · Source |
Authoritative guidance |
Traditional-use herbal medicinal product, bark | Traditional use only (not well-established use): minor skin inflammation and dryness; itching and burning with hemorrhoids; mouthwash for minor mouth inflammation. Contraindication: hypersensitivity. Not recommended under 12 (skin, mouth) or under 18 (anorectal) for lack of data. Pregnancy and breastfeeding: not recommended, no data. Interactions: none reported. Side effect: allergic contact dermatitis, frequency not known. No overdose cases. Reproductive toxicity, genotoxicity and carcinogenicity tests not performed. See text. Methods, limits and fundingOutcomes: Indications, warnings, interactions, pregnancy, adverse effects Limitations: Traditional use rests on long-standing use, not on trials. A leaf monograph (Hamamelidis folium, EMA/HMPC/114586/2008) is listed on the EMA site; only its web page was checked, not the document. Read: full-text | |
| East 2012 Local cooling for relieving pain from perineal trauma sustained during childbirth. Cochrane Database Syst Rev · PMID 22592710 · DOI |
Systematic review |
1825 Women with perineal pain after childbirth, 10 randomized trials |
Local cooling treatments; hamamelis water (witch hazel) was one of the comparison treatments in an included trial distillate Varied · vs No treatment or other treatments |
Ice packs gave better pain relief 24-72 hours after birth than no treatment (RR 0.61, 95% CI 0.41 to 0.91; n = 208). The abstract names hamamelis water as a comparator but gives no result for it. Conclusion: limited evidence for cooling treatments. This 2012 version has a newer 2020 update that was not read. Ice packs vs no treatment RR 0.61 (0.41-0.91). (0.41 to 0.91 (ice packs vs no treatment)) Methods, limits and fundingOutcomes: Perineal pain relief Limitations: Witch hazel result not given in the abstract; superseded by a 2020 update. Read: abstract |
| Erdelmeier 1996 Antiviral and antiphlogistic activities of Hamamelis virginiana bark. Planta Med · PMID 8693037 · DOI |
Laboratory research in-vitro |
Cell and mouse-ear experiments | Hydroalcoholic extract of Hamamelis virginiana bark, fractions bark Lab doses Lab experiment · vs Unfractionated extract and lower-weight fraction |
A fraction of large proanthocyanidins blocked herpes simplex virus 1 in cells, mopped up free radicals, inhibited two enzymes and reduced mouse ear swelling. No numbers in the abstract. Methods, limits and fundingOutcomes: Herpes simplex virus 1 activity, enzyme inhibition, mouse ear swelling Limitations: Lab and mouse only; a fraction, not a product. Read: abstract |
| Gaj 2009 [Proctological surgery: advantages derived from the use of an innovative detergent in the post-operative period]. Clin Ter · PMID 19756323 |
Case series |
40 40 patients after anal surgery (30 with grade III-IV hemorrhoids, 10 fissures), Italy |
Detergent cream containing aloe, hamamelis, calendula, horse chestnut, zinc oxide and other ingredients (combination) unspecified Twice daily At least 12 days |
The authors report 84% of patients had normal re-epithelialisation with less burning and itching and no irritation or allergy. Not specific to witch hazel. 84% favourable healing reported. Methods, limits and fundingOutcomes: Healing, discomfort, infection Limitations: Uncontrolled, many ingredients, abstract only; cannot tell what witch hazel did. Study of a commercial product. Funding and conflicts: Funding not stated in the abstract; a branded product (Anonet) was tested, so an industry link is possible and not confirmed. Read: abstract |
| Gloor 2002 Antiseptic effect of a topical dermatological formulation that contains Hamamelis distillate and urea. Forsch Komplementarmed Klass Naturheilkd · PMID 12119511 · DOI |
Clinical study |
15 15 healthy volunteers plus lab tests |
Topical product with 90% hamamelis distillate and 5% urea distillate (twig) Product applied under occlusion · vs Compared with earlier chlorhexidine and fuchsine data |
The product reduced skin bacteria in one of two tests and inhibited Staphylococcus aureus and Candida albicans in the lab. Authors say the antimicrobial activity of the distillate and urea was relatively weak compared with chlorhexidine. Significant effect in the expanded flora test; weak against chlorhexidine. Methods, limits and fundingOutcomes: Skin bacteria counts and agar growth inhibition Limitations: Small, product mixed with urea, short, healthy skin. Funding and conflicts: Funding not stated in the abstract. Read: abstract |
| Granlund 1994 Contact allergy to witch hazel. Contact Dermatitis · PMID 7821023 · DOI |
Case report |
1 31-year-old woman with leg dermatitis (as summarised by the EMA) |
Eye gel containing hamamelis distillate and cucumber extract distillate Eye gel About one week to first swelling |
Per the EMA assessment report, swelling spread from the eyes to face and neck and became eczema; patch tests were positive to the gel, hamamelis distillate and cucumber extract. The PubMed record has no abstract, so details come from the EMA summary. 1 patient. Methods, limits and fundingOutcomes: Contact allergy Limitations: Title-only on PubMed; details from the EMA report, not read in the original. Read: title-only |
| Hughes-Formella 1998 Anti-inflammatory effect of hamamelis lotion in a UVB erythema test. Dermatology · PMID 9621139 · DOI |
Controlled trial |
30 30 healthy volunteers, UVB-induced redness on the back |
Aftersun lotion with 10% hamamelis distillate (Eucerin pH5 product) distillate (twig) 10% distillate in lotion, applied under a patch 48 hours · vs Lotion vehicle and a previous aftersun lotion; untreated irradiated area |
Redness fell about 20% at 7 hours and 27% at 48 hours in the hamamelis fields, against 11-15% with the other lotions. Differences from the other lotions were statistically significant. Redness suppression about 20% (7 h) to 27% (48 h) with hamamelis vs 11-15% with comparison lotions. Methods, limits and fundingOutcomes: Skin redness (chromameter and visual score) at 7, 24 and 48 hours Limitations: Healthy volunteers, small, 48 hours, one commercial lotion, an experimental redness model not a sunburn or skin disease. No hydrocortisone comparison in this trial. Funding and conflicts: Funding not stated in the abstract. The tested product was a branded commercial lotion; an industry link is possible and not confirmed. Read: abstract |
| Hughes-Formella 2002 Anti-inflammatory efficacy of topical preparations with 10% hamamelis distillate in a UV erythema test. Skin Pharmacol Appl Skin Physiol · PMID 11867970 · DOI |
Controlled trial |
40 40 healthy volunteers, UV-induced redness |
Three lotions with 10% hamamelis distillate from different suppliers distillate (twig) 10% distillate in lotion, under a patch 48 hours · vs Two vehicles, dimethindene 0.1% gel, hydrocortisone 1% cream and 0.25% lotion |
Hydrocortisone was most effective. All three hamamelis lotions and the vehicles showed some anti-inflammatory effect; only one hamamelis lotion beat the vehicles significantly, at the 1.4 MED dose. Dimethindene was no better than hamamelis or vehicles. Only one of three hamamelis lotions beat vehicle, at one UV dose; hydrocortisone best. Methods, limits and fundingOutcomes: Redness (chromameter and visual) at 24, 48 and 72 hours Limitations: Healthy volunteers, short, differences between hamamelis lotions were slight, vehicles alone also reduced redness. Funding and conflicts: Funding not stated in the abstract; the study compares commercial distillates from suppliers, so an industry link is possible and not confirmed. Read: abstract |
| Kloter 2023 Phytotherapy in paediatric skin disorders - A systematic literature review. Complement Ther Med · PMID 36958415 · DOI |
Systematic review |
2358 17 clinical studies of herbal treatments in children with atopic dermatitis, diaper dermatitis and skin wounds |
Many herbal products including hamamelis varied Varied Varied · vs Varied |
Hamamelis was one of 13 herbs in the studies. Reviewers found some sign that evening primrose oil may help atopic dermatitis in children and that comfrey may help wounds. The abstract gives no hamamelis conclusion. Eight of 17 studies were of low quality. No pooled numbers in the abstract. Methods, limits and fundingOutcomes: Effects on child skin conditions Limitations: Few and often low-quality studies; no hamamelis-specific result in the abstract. Read: abstract |
| Korting 1993 Anti-inflammatory activity of hamamelis distillate applied topically to the skin. Influence of vehicle and dose. Eur J Clin Pharmacol · PMID 8513841 · DOI |
Controlled trial |
24 24 healthy volunteers per test; UV-induced redness and tape-stripping irritation |
Hamamelis distillate cream, 0.64 and 2.56 mg hamamelis ketone per 100 g, with or without phosphatidylcholine distillate (twig) Two strengths in oil-in-water creams Single experiment, effects read at 24 h and 4-8 h · vs Chamomile cream, hydrocortisone 1% cream, four base creams, untreated skin |
UV redness at 24 h was reduced by low-dose hamamelis cream with phosphatidylcholine and by hydrocortisone; hydrocortisone was better than the other hamamelis cream without phosphatidylcholine and than chamomile. After tape-stripping, low-dose hamamelis cream with phosphatidylcholine and chamomile cream reduced inflammation, less than hydrocortisone. A fourfold higher strength did not work better. Activity depended on the cream base; four times the strength gave no extra effect. Methods, limits and fundingOutcomes: Skin redness by visual score and chromameter Limitations: Healthy volunteers, experimental redness, no numbers in the abstract, depends on the cream base. Funding and conflicts: Funding not stated in the abstract. Read: abstract |
| Korting 1995 Comparative efficacy of hamamelis distillate and hydrocortisone cream in atopic eczema. Eur J Clin Pharmacol · PMID 8582464 · DOI |
Controlled trial |
72 72 adults with moderately severe atopic eczema |
Hamamelis distillate cream (5.35 g distillate with 0.64 mg ketone per 100 g) distillate (twig) Cream on test areas 14 days · vs Drug-free vehicle cream and 0.5% hydrocortisone cream |
All three creams cut itching, redness and scaling after one week. Hydrocortisone was better than hamamelis (basic-criteria scores fell by 2.7 and 1.6 respectively). Hamamelis cream did not differ from the plain vehicle (mean falls of 1.8 and 2.0 respectively). All creams were well tolerated; skin reactions in six people were all in vehicle-treated areas. Score falls as reported: hydrocortisone 2.7 vs hamamelis 1.6; hamamelis 1.8 vs vehicle 2.0 (no significant difference from vehicle). Methods, limits and fundingOutcomes: Itching, redness and scaling sum scores Limitations: Two weeks, one trial, paired test-area design, distillate cream only. Negative for hamamelis beyond the base cream. Funding and conflicts: Funding not stated in the abstract. Read: abstract |
| Liu 2025 Revealing the Therapeutic Potential: Investigating the Impact of a Novel Witch Hazel Formula on Anti-Inflammation and Antioxidation. J Cosmet Dermatol · PMID 39575475 · DOI |
Laboratory research in-vitro |
Ex vivo skin models and cells | Novel witch hazel extract formula (cosmetic) unspecified Lab experiment · vs Inflamed or UV-stressed model without formula |
The formula lowered IL-6 and IL-8 and oxidation markers and improved barrier markers in the models. No numbers in the abstract. Methods, limits and fundingOutcomes: Cytokines IL-6 and IL-8, barrier markers, UV oxidation markers Limitations: Lab and ex vivo skin only; a cosmetic formula; not tested in people. Funded by a cosmetics company. Funding and conflicts: Fully funded by L'Oreal Research and Innovation; one author is a paid L'Oreal consultant. Read: abstract |
| NCBI PubChem 2026 PubChem compound records: hamamelitannin, catechin, gallic acid, eugenol PubChem PUG REST · Source |
Database |
Compound records | Hamamelitannin CID 21145076 (C20H20O14); catechin CID 9064 (C15H14O6); gallic acid CID 370 (C7H6O5); eugenol CID 3314 (C10H12O2). Found. Methods, limits and fundingOutcomes: CIDs and formulas Limitations: Identity only. Read: api | |
| NCCIH 2026 NCCIH Herbs at a Glance: no witch hazel page nccih.nih.gov · Source |
Database |
Regulator page check | https://www.nccih.nih.gov/health/witch-hazel returned 404 and the Herbs at a Glance list had no witch hazel entry in the page text checked. Not found. Methods, limits and fundingOutcomes: Whether NCCIH has a witch hazel page Limitations: Absence of a page does not mean the herb is unsafe or safe. Read: page-check | |
| Piazza 2022 Unveiling the Ability of Witch Hazel (Hamamelis virginiana L.) Bark Extract to Impair Keratinocyte Inflammatory Cascade Typical of Atopic Eczema. Int J Mol Sci · PMID 36012541 · DOI |
Laboratory research in-vitro |
Human keratinocyte cell line (HaCaT) stimulated with an eczema-like cytokine mix | Standardised Hamamelis virginiana bark extract (HVE) and hamamelitannin bark 0.5-125 ug/mL extract; 0.5-5 ug/mL hamamelitannin Cell experiment · vs Untreated stimulated cells |
The extract lowered release of these messengers in a concentration-dependent way (IC50 below 25 ug/mL), partly by blocking NF-kB, and recovered a skin differentiation marker. IC50 < 25 ug/mL for several messengers. Methods, limits and fundingOutcomes: Release of inflammatory messengers (IL-6, IL-17C, TSLP, CCL26, MMP-9) Limitations: Cells in a dish only, not people. Two authors work for a company that sells cosmetics and devices containing hamamelis extracts. Funding and conflicts: Authors state two are linked to Istituto Ganassini S.p.A., which sells products with Hamamelis extracts; they say the funders had no role. Read: abstract |
| Qureshi 2026 AGA Clinical Practice Update on Diagnosis and Treatment of Hemorrhoids: Expert Review. Clin Gastroenterol Hepatol · PMID 42067175 · DOI |
Guideline |
Adults with symptomatic hemorrhoids | Topical astringents including witch hazel (as one option) unspecified |
Topical treatments including anesthetics, astringents (witch hazel), corticosteroids and vasoactive agents can be considered for symptomatic hemorrhoids, but there is little data to support efficacy. Fibre and avoiding straining are first-line. Topical steroids should not be used more than 2 weeks at a time. In pregnancy, conservative care including topical ointments is advised. Rectal bleeding needs proper diagnosis. Not applicable. Methods, limits and fundingOutcomes: Best-practice advice for hemorrhoids Limitations: Expert review without systematic search or formal evidence ratings. Funding and conflicts: Not stated in the abstract. Read: abstract |
| Sevimli Güler 2026 Comparison of the Effects of Breast Milk and Hamamelis virginiana (Witch Hazel) on the Healing of Diaper Dermatitis in Infants: A Randomized Trial. Breastfeed Med · PMID 41468068 · DOI |
Controlled trial |
60 60 infants aged 0-6 months with uncomplicated diaper dermatitis, Turkey |
Diaper rash cream containing Hamamelis virginiana (12 mg per 100 g) as the comparison arm unspecified Cream; dose not stated · vs Breast milk applied to the skin |
Scores fell from 2.83 to 1.53 in the witch hazel cream group (the comparison group) and from 5.17 to 0.03 in the breast milk group. The groups differed at the start, so the abstract says direct comparison of treatments is limited. Witch hazel cream group mean score 2.83 (before) to 1.53 (after). Methods, limits and fundingOutcomes: Diaper dermatitis severity scale score Limitations: Single-blind, groups unequal at baseline, witch hazel cream was the comparison arm, small. Does not show witch hazel works or fails. Funding and conflicts: Funding not stated in the abstract. Read: abstract |
| Skowrońska 2025 Chemical composition, skin microbiota metabolism, antimicrobial potential and anti-inflammatory properties of witch hazel bark (Hamamelis virginiana L.). J Ethnopharmacol · PMID 40819781 · DOI |
Laboratory research in-vitro |
Human neutrophils, skin cells and Staphylococcus aureus in lab tests | Aqueous Hamamelidis cortex (bark) extract and hamamelitannin bark Lab concentrations; S. aureus MIC 0.5 mg/mL extract Lab experiment · vs Untreated stimulated cells |
The extract and hamamelitannin lowered inflammation messengers and helped skin cells migrate in a scratch test. Skin bacteria turned part of the extract into ellagic acid, which raised inflammatory messengers in fibroblasts. Minimum growth-blocking concentration for S. aureus was 0.5 mg/mL (extract). S. aureus MIC 0.5 mg/mL (extract), 0.5 mM (hamamelitannin). Methods, limits and fundingOutcomes: Cytokines, reactive oxygen species, keratinocyte migration, S. aureus growth Limitations: Lab only. Authors warn that skin bacteria can change the extract in ways that may have undesirable effects. Funding and conflicts: Authors declare no competing interests. Read: abstract |
| Wolff 2007 Hamamelis in children with skin disorders and skin injuries: results of an observational study. Eur J Pediatr · PMID 17177071 · DOI |
Observational study |
309 309 children aged 27 days to 11 years with minor skin injuries, diaper dermatitis or localized skin inflammation |
Hamamelis ointment (231 children) vs dexpanthenol ointment (78 children) unspecified · vs Dexpanthenol ointment (not randomized, 3:1 groups) |
Scores fell significantly from baseline in all three diagnosis groups for both ointments (p < 0.0001 each). Results were similar for hamamelis and dexpanthenol. Tolerability was rated excellent or good in 99.1% (physicians) and 98.2% (parents) for hamamelis. Tolerability good or excellent in 98-99% (hamamelis). Methods, limits and fundingOutcomes: Sign and symptom scores, physician and parent global ratings Limitations: Observational, no placebo, mixed conditions, improvement could be natural healing, groups not randomized. Funding and conflicts: Funding not stated in the abstract; an industry link is possible and not confirmed. Read: abstract |
| Wójciak 2025 Hamamelis virginiana L. in Skin Care: A Review of Its Pharmacological Properties and Cosmetological Applications. Molecules · PMID 40649262 · DOI |
Narrative review mixed |
Review of lab, animal and limited clinical studies of Hamamelis virginiana in skin care | Hamamelis virginiana bark and leaf extracts bark+leaf Varied Varied · vs Varied |
Reports antimicrobial, anti-inflammatory, antioxidant and wound-healing activity from lab and animal studies and limited clinical trials, and calls the results encouraging for skin use. Not a systematic review. No numbers in the abstract. Methods, limits and fundingOutcomes: Pharmacology and cosmetic use Limitations: Narrative review, not systematic; mostly lab and animal evidence; no safety conclusions in the abstract. Funding and conflicts: Authors declare no conflicts of interest. Read: abstract |
What we do not know yet
- What the evidence supports: nothing about witch hazel is above low certainty. UV-induced redness and eczema (distillate) are low; children are very low; skin germs are very low; hemorrhoids, childbirth pain, mouth rinses, cosmetics and tannin activity are insufficient.
- What is uncertain: tests were small and short, in healthy volunteers, often with commercial lotions whose funding is not stated; plain bases also helped; the Cochrane review abstract gave no witch hazel result.
- What is not known: how often contact allergy happens, whether liver harm occurs from swallowed bark or leaf, drug interactions, safety in pregnancy and breastfeeding, and product quality (no heavy-metal or adulteration study).
How new research is added
New studies are found by a saved PubMed search and are placed in a review queue. A person reads each one before it changes any evidence rating or safety wording. New publications never change ratings automatically.
Lab markers
What changed in blood or saliva tests during trials. A changed number is not the same as feeling or being healthier, and we give no "normal ranges".
Other 8
Skin redness after UV exposure (erythema)
Mixed results in trials
Skin redness measured by a colour meter (chromameter) and by a person scoring it.
Low certaintyResults and what it means
Why it was measured
The standard measure in UV test models of skin inflammation.
Statistical vs. clinical meaning
Statistically significant in some tests, small in size; a lab redness model.
Safety implication
Not a safety measure.
| Study | Result | People | Product |
|---|---|---|---|
| 12 | Redness suppression about 20% at 7 h and 27% at 48 h with 10% distillate lotion vs 11-15% with other lotions. | 30 healthy volunteers | Aftersun lotion with 10% hamamelis distillate, 48 h |
| 13 | Only 1 of 3 distillate lotions beat the lotion bases (at 1.4 MED); hydrocortisone best. | 40 healthy volunteers | Three 10% distillate lotions, 48 h |
| 3 | Hamamelis not among the formulations reported to have an effect; only aloe vera significant. | 40 healthy volunteers | Hamamelis formulation under occlusion |
Eczema sum score (itching, redness, scaling)
No clear change in trials
A doctor adds up scores for itching, redness and scaling in a test area.
Low certaintyResults and what it means
Why it was measured
Used in trials of eczema creams.
Statistical vs. clinical meaning
One two-week trial; no advantage over the base cream.
Safety implication
Skin reactions occurred only in vehicle-treated areas.
| Study | Result | People | Product |
|---|---|---|---|
| 16 | All creams lowered scores; hamamelis did not differ from plain base cream and hydrocortisone was better. | 72 adults with atopic eczema | Hamamelis distillate cream, 14 days |
Diaper dermatitis severity score
Lowered in trials
A scale scoring how severe nappy rash looks.
Very low certaintyResults and what it means
Why it was measured
Tracks rash healing in infants.
Statistical vs. clinical meaning
Scores fall in both groups but no placebo; babies often heal anyway.
Safety implication
Tolerability good or excellent in 98-99% (Wolff 2007).
| Study | Result | People | Product |
|---|---|---|---|
| 22 | Witch hazel cream group score 2.83 to 1.53; breast milk group 5.17 to 0.03. Baseline groups differed. | 60 infants aged 0-6 months | Witch hazel cream vs breast milk |
| 24 | Total sign and symptom scores fell significantly in all three diagnosis groups with hamamelis ointment (p < 0.0001); similar to dexpanthenol. | 309 children | Hamamelis ointment |
Skin bacteria and Staphylococcus aureus growth
Lowered in trials
Germ counts on skin or growth of bacteria in a dish.
Very low certaintyResults and what it means
Why it was measured
Skin germs play a role in eczema and skin folds.
Statistical vs. clinical meaning
Weak effects; not a measure of treating infection.
Safety implication
Skin bacteria may convert part of the bark extract to ellagic acid, which raised inflammatory messengers in lab cells.
Inflammation messengers from skin cells (IL-6, IL-8 and others)
Lowered in trials
Proteins that skin cells release when inflamed.
Not enough evidenceResults and what it means
Why it was measured
Show whether an extract calms inflamed cells in the lab.
Statistical vs. clinical meaning
Lab only; two sources linked to companies; not shown in people.
Safety implication
Not a safety measure.
Hemorrhoid symptoms (bleeding, itching, pain)
No clear change in trials
Patient-reported symptoms of hemorrhoids.
Not enough evidenceResults and what it means
Why it was measured
What matters to patients with hemorrhoids.
Statistical vs. clinical meaning
No controlled witch hazel data found; the combination study is uncontrolled.
Safety implication
Bleeding needs a doctor.
| Study | Result | People | Product |
|---|---|---|---|
| 21 | Guidance says there is little data to support topical astringents (witch hazel); first-line is fibre and avoiding straining. | Adults with symptomatic hemorrhoids | Topical witch hazel (as an option) |
| 9 | 84% favourable healing with a mixed cream containing hamamelis (no control group). | 40 patients after anal surgery | Combination cream |
Perineal pain after childbirth
No clear change in trials
Pain scores in the days after childbirth.
Not enough evidenceResults and what it means
Why it was measured
Main outcome in cooling treatment trials.
Statistical vs. clinical meaning
No witch hazel number available.
Safety implication
None noted.
| Study | Result | People | Product |
|---|---|---|---|
| 7 | Ice packs gave better relief than no treatment (RR 0.61). No witch hazel result in the abstract. | Women after childbirth | Local cooling treatments; witch hazel water a comparator |
Free radical output by white blood cells (lab)
Lowered in trials
How many reactive oxygen molecules lab-grown immune cells release.
Not enough evidenceResults and what it means
Why it was measured
Marks inflammation in lab cells.
Statistical vs. clinical meaning
Lab measurement, not a patient outcome.
Safety implication
Not a safety measure.
| Study | Result | People | Product |
|---|---|---|---|
| 23 | Bark extract and hamamelitannin lowered inflammation messengers and reactive oxygen in human neutrophils tested ex vivo (abstract gives no numbers). | Human neutrophils in a dish | Aqueous bark extract and hamamelitannin |
Safety
What studies and official sources say about side effects, medicines and who should check first. Each point shows what kind of evidence it comes from.
Main points to know 6
- Skin allergy (contact allergy) can happen. Allergic contact dermatitis has been reported with witch hazel. The EMA lists it as an undesirable effect with unknown frequency and calls it rare in its assessment. A case report describes an eye gel with hamamelis distillate that led to swelling and eczema on the face, with positive patch tests. Stop use if the skin becomes red, swollen or itchy, and do not use if you are allergic to witch hazel. Authoritative guidance 6 5 11
- Many witch hazel waters and toners contain alcohol (about 13-15% ethanol). The US Pharmacopoeia style distillate has 14-15% alcohol added (per the EMA report), and a 2024 case report describes a toner with 13-15% ethanol. A man with alcohol use disorder who drank a witch hazel toner needed medically supervised alcohol withdrawal. Products made for the skin are not made for drinking. Keep them away from children and from anyone avoiding alcohol. Case report 2 5
- Swallowed bark and leaf products: stomach upset, and possibly liver harm (weak evidence). The EMA report says long-term oral use needs caution because of tannins; stomach irritation can occur in susceptible people, and in rare cases witch hazel tannins may cause liver damage (a secondary citation to McGuffin 1997 that was not read). No case report of liver injury was found in PubMed. The EMA monograph covers skin, rectal and mouth-rinse uses, not routine swallowing. Authoritative guidance 5
- Pregnancy and breastfeeding: not recommended; no data. The EMA monograph says safety in pregnancy and breastfeeding has not been established and use is not recommended. The assessment report says internal use should not be used without medical advice. The 2026 AGA hemorrhoid guidance says conservative care with topical ointments is generally advised in pregnancy but does not endorse witch hazel specifically. Authoritative guidance 6 5 21
- Children: data are limited. The EMA does not recommend skin or mouth use under 12 years or anorectal use under 18 for lack of data. An observational study of 309 children up to age 11 rated tolerability excellent or good in 98-99% with a hamamelis ointment, but it had no placebo group. Authoritative guidance 6 24
- Rectal bleeding needs a doctor. The EMA says to see a doctor if rectal bleeding occurs, and the AGA says anoscopy should be done to confirm the cause. Hemorrhoid creams should not hide a serious problem. Authoritative guidance 6 21
Side effects 5
| Effect | How often | Severity and recovery | Evidence |
|---|---|---|---|
| Allergic contact dermatitis (redness, swelling, itching, eczema) Frequency not known; the EMA calls reports rare. Witch hazel is also a labelled ingredient in about 1 in 10 facial wipes surveyed, so exposure is common. | Not established | Mild to moderate; one case spread from the eyes to face and neck Not stated; use was stopped | Authoritative guidance 6 5 11 |
| Brief stinging or burning on skin The assessment report mentions short irritation and slight burning in many cases for topical use (a secondary statement). | Not established | Mild Short-lived | Authoritative guidance 5 |
| Conjunctivitis with eye drops containing hamamelis distillate Frequency not known. | Not established | Not stated Not stated | Authoritative guidance 5 |
| Stomach irritation when taken by mouth Occasional, in susceptible people, per secondary sources cited by the EMA. | Not established | Mild Not stated | Authoritative guidance 5 |
| Alcohol effects and withdrawal if a toner or distillate is drunk One case; no rate. | Not established | Withdrawal needed hospital treatment in one case Treated with a phenobarbital taper in the case report | Case report 2 |
Liver
No published case of liver injury from witch hazel was found in PubMed. The EMA assessment report repeats a statement that in rare cases witch hazel tannins may cause liver damage (citing McGuffin 1997, which was not read), and another that oral use may cause stomach irritation and liver damage. No LiverTox chapter for witch hazel or Hamamelis was found. 5
How often. No frequency is given in any source read.
Monitoring. No monitoring protocol was found. See a doctor for yellow skin or eyes, dark urine or severe stomach pain.
This is a safety connection. It is not evidence that Witch hazel supports liver health.
Medicines and supplements 4
| With | Why it matters | Importance | Evidence | What to do |
|---|---|---|---|---|
| Prescription medicines (general) drug | The EMA monograph says no interactions have been reported. No interaction study was found. | Authoritative guidance Not enough evidence 6 5 | Tell a pharmacist about all medicines before use, especially on broken skin or rectally. | |
| Minerals (iron, zinc) and B vitamins when bark or leaf is swallowed nutrient | The EMA report states that tannins inhibit absorption of minerals and B vitamins. | Not measured for witch hazel in people. Distillate has very little tannin (USP limit 0.03 mg tannic acid per mL). | Authoritative guidance Not enough evidence 5 | Not relevant to skin use. If you swallow a tannin-rich product, ask a pharmacist. |
| Medicines or situations where alcohol is a problem (for example some antibiotics and alcohol-sensitive medicines, or alcohol use disorder) drug | Many distillates and tinctures contain ethanol (about 14-15%). | General pharmacology about alcohol, not a finding from a witch hazel study. A case report shows alcohol withdrawal after drinking a toner. No interaction study was found. | Pharmacological theory Not enough evidence 2 5 | Do not swallow a skin product. Ask a pharmacist if you take a medicine that must not be mixed with alcohol. |
| Topical corticosteroids (hydrocortisone) drug | Compared head to head in trials; no interaction study. | Hydrocortisone worked better than hamamelis in the UV redness and eczema trials. Not an interaction; a comparison. AGA says topical steroids should not be used for more than 2 weeks at a time. | Controlled trial Low certainty 16 13 21 | Do not replace a prescribed steroid cream with witch hazel without asking your doctor. |
Who should check first 7
| Situation | Advice | Evidence |
|---|---|---|
| Allergy to witch hazel or its ingredients | Do not use. This is the only contraindication in the EMA monograph. | Authoritative guidance 6 |
| Pregnancy and breastfeeding | Not recommended; no safety data (EMA). | Authoritative guidance 6 5 |
| Children (skin or mouth use under 12; anorectal use under 18) | Not recommended by the EMA for lack of data. Ask a doctor. | Authoritative guidance 6 |
| People avoiding alcohol, alcohol use disorder, and anyone who might swallow a distillate or toner | Many products contain about 13-15% ethanol. Keep out of reach of children and do not drink. | Case report 2 5 |
| Rectal bleeding or hemorrhoid symptoms lasting over 2 weeks | See a doctor (EMA monograph). | Authoritative guidance 6 21 |
| Skin or mouth problems lasting more than one week | See a doctor (EMA monograph). | Authoritative guidance 6 |
| Liver disease (oral use) | Avoid swallowing tannin-rich products without advice; liver harm is mentioned in rare, weakly sourced reports. | Authoritative guidance 5 |
Overdose, product quality and regulators
Summary. Skin use of distillate and bark preparations appears to have a low rate of serious harm in the sources read, but data are old and thin. No serious events are known according to the EMA assessment report.
Animal. Per the EMA report, oral single doses of 10-20 g of a hamamelis preparation caused no toxic effect in mice and rats, and 100 mg/kg daily for three months caused no abnormalities in rats; intravenous extract in dogs caused a marked fall in blood pressure. Primary papers were not read.
Human doses studied. Distillate lotions at 10% in healthy volunteers for 48 hours; distillate cream for 14 days in 72 adults; ointment in 309 children (duration not in abstract). This page gives no dosing advice.
High dose or long term signals. The EMA report cautions about long-term oral use because of tannins. Long-term skin use has not been studied in trials.
Overdose response. No case of overdose has been reported (EMA). One case report describes alcohol withdrawal after drinking a toner.
Genotoxicity. The EMA report says witch hazel water was negative in Salmonella and mouse lymphoma mutation tests. In a liver cell study (Dauer 2003), hamamelitannin and a large proanthocyanidin fraction about doubled DNA migration at up to 166 ug/mL, yet all tested bark compounds reduced DNA damage from benzo[a]pyrene. The EMA monograph says tests on reproductive toxicity, genotoxicity and carcinogenicity have not been performed.
Toxic plant parts. No part is known to be poisonous in skin use. Safrole is noted at below 0.2% in leaf oil and eugenol and carvacrol are reported in small amounts in distillate; no source linked these to harm from witch hazel products. Safrole is not a stated concern in the monograph.
No study testing witch hazel products for heavy metals, pesticides or adulteration was found. Quality is described by monographs: the Ph. Eur. has a bark monograph and the USP defines witch hazel water (14-15% ethanol, tannin limit 0.03 mg/mL).
Species. Other Hamamelis species (for example Chinese witch hazel) are different plants. No adulteration study was found. 5
Alcohol content varies. The EMA report lists distillates with ethanol 6% to 15% in different registered products. 5
| Body | Action | Date |
|---|---|---|
| European Medicines Agency (EMA/HMPC) (EU) | EU herbal monograph on Hamamelis virginiana L. bark (Hamamelidis cortex; final, last updated 2019) and a leaf monograph (folium), both traditional use only, with an assessment report covering bark, leaf and twig distillate. A periodic review consultation was opened in April 2025. source | 2026-10-25 |
| NCCIH (US National Center for Complementary and Integrative Health) (US) | No witch hazel page: https://www.nccih.nih.gov/health/witch-hazel returned 404 and the Herbs at a Glance list had no witch hazel entry. Not found. source | 2026-10-25 |
When to get medical help
- Swelling of the face or throat, trouble breathing or a spreading rash after using a witch hazel product: get emergency help.
- Someone has swallowed a witch hazel toner or distillate, especially a child: call poison control or emergency services.
- Rectal bleeding, black stools or severe pain: see a doctor, do not self-treat.
- Yellow skin or eyes, dark urine or severe stomach pain after swallowing witch hazel products: see a doctor.
- Skin redness, swelling or weeping after use that gets worse: stop and see a doctor.
- Heavy drinkers who stop suddenly after using alcohol products: shaking, sweating, confusion or seizures need urgent care.
Stop the supplement and contact a clinician or emergency service. In the US, Poison Control is 1-800-222-1222.
General information only, not medical advice. Ask a clinician or pharmacist before use, especially with medicines, in pregnancy or with a health condition. See the Natural Remedy Safety guide.
Frequently asked questions
What is witch hazel?
What is the difference between witch hazel water and bark or leaf extract?
Does witch hazel help eczema?
Not beyond a plain cream, in the one trial found. In 72 adults, a witch hazel distillate cream did no better than its cream base over 14 days. A mild hydrocortisone cream did better.
Does witch hazel calm sunburn or redness?
Does witch hazel help hemorrhoids?
Can witch hazel cause an allergic reaction?
Does witch hazel contain alcohol?
Is it safe to swallow witch hazel?
Is witch hazel safe in pregnancy or breastfeeding?
Is witch hazel safe for children and babies?
Does witch hazel interact with medicines?
Explore by health goal
Healthy SkinInflammation BalanceHealthy AgingDigestive SupportWomens WellnessImmune Support
Editorial transparency
- Written by
- AlternativeMed editorial team. Research compiled with AI assistance, then checked against PubMed records.
- Medical review
- None. This page has not been reviewed by a physician or pharmacist.
- First published
- 2026-10-25
- Last substantive update
- 2026-10-25
- How we research
- We searched PubMed, read the EMA/HMPC bark monograph and the full EMA assessment report, and checked the plant name in GBIF and NCBI Taxonomy and compounds in PubChem. Nearly all studies were read as abstracts; three records (the contact allergy case report and an allergen article) have no abstract on PubMed. Not verified: LiverTox and LactMed (no record found by search), FDA and Commission E (not checked), and the EMA leaf monograph document (only its web page). The NCCIH has no witch hazel page (404). The liver-damage and stomach statements come from secondary citations in the EMA report. Certainty ratings are the compiler's own reading, not formal grades. No study is cited that we could not verify.
- How we rate evidence
- See "How we rate evidence" in the Evidence tab.
- Independence
- No product is promoted on this page. No affiliate links are shown. If one is added later it will be labelled and kept apart from the evidence.
Sources 25
Each source was opened and checked. Where we read only the abstract, it says so. The small numbers in the text point here.
- Admuthe NB, Karajgi S, Uikey J, et al.. Natural Products in Hemorrhoid Management: A Comprehensive Literature Review of Traditional Herbal Remedies and Evidence-Based Therapies.. Cureus. 2025. PMID 40458338. DOI 10.7759/cureus.83397. (abstract)
- Anderson KE, Balasanova AA. A case of a patient requiring medically supervised withdrawal after ingestion of witch hazel toner as a surrogate alcohol.. Clin Case Rep. 2024. PMID 38799527. DOI 10.1002/ccr3.9007. (abstract)
- Beikert FC, Schönfeld BS, Frank U, et al.. [Antiinflammatory potential of seven plant extracts in the ultraviolet erythema test. A randomized, placebo-controlled study].. Hautarzt. 2013. PMID 23337964. DOI 10.1007/s00105-012-2505-x. (abstract)
- Dauer A, Hensel A, Lhoste E, et al.. Genotoxic and antigenotoxic effects of catechin and tannins from the bark of Hamamelis virginiana L. in metabolically competent, human hepatoma cells (Hep G2) using single cell gel electrophoresis.. Phytochemistry. 2003. PMID 12711142. DOI 10.1016/s0031-9422(03)00104-3. (abstract)
- EMA Committee on Herbal Medicinal Products (HMPC). Assessment report on Hamamelis virginiana L., cortex, folium, folium et cortex aut ramunculus destillatum (EMA/HMPC/114585/2008). European Medicines Agency. 2010. (full-text)
- EMA Committee on Herbal Medicinal Products (HMPC). Community herbal monograph on Hamamelis virginiana L., cortex (EMA/HMPC/114583/2008 Corr.1). European Medicines Agency. 2019. (full-text)
- East CE, Begg L, Henshall NE, et al.. Local cooling for relieving pain from perineal trauma sustained during childbirth.. Cochrane Database Syst Rev. 2012. PMID 22592710. DOI 10.1002/14651858.CD006304.pub3. (abstract)
- Erdelmeier CA, Cinatl J Jr, Rabenau H, et al.. Antiviral and antiphlogistic activities of Hamamelis virginiana bark.. Planta Med. 1996. PMID 8693037. DOI 10.1055/s-2006-957868. (abstract)
- Gaj F, Crispino P. [Proctological surgery: advantages derived from the use of an innovative detergent in the post-operative period].. Clin Ter. 2009. PMID 19756323. (abstract)
- Gloor M, Reichling J, Wasik B, et al.. Antiseptic effect of a topical dermatological formulation that contains Hamamelis distillate and urea.. Forsch Komplementarmed Klass Naturheilkd. 2002. PMID 12119511. DOI 10.1159/000064265. (abstract)
- Granlund H. Contact allergy to witch hazel.. Contact Dermatitis. 1994. PMID 7821023. DOI 10.1111/j.1600-0536.1994.tb01972.x. (title-only)
- Hughes-Formella BJ, Bohnsack K, Rippke F, et al.. Anti-inflammatory effect of hamamelis lotion in a UVB erythema test.. Dermatology. 1998. PMID 9621139. DOI 10.1159/000017904. (abstract)
- Hughes-Formella BJ, Filbry A, Gassmueller J, et al.. Anti-inflammatory efficacy of topical preparations with 10% hamamelis distillate in a UV erythema test.. Skin Pharmacol Appl Skin Physiol. 2002. PMID 11867970. DOI 10.1159/000049400. (abstract)
- Kloter E, Albanese F, Schweighoffer R, et al.. Phytotherapy in paediatric skin disorders - A systematic literature review.. Complement Ther Med. 2023. PMID 36958415. DOI 10.1016/j.ctim.2023.102942. (abstract)
- Korting HC, Schäfer-Korting M, Hart H, et al.. Anti-inflammatory activity of hamamelis distillate applied topically to the skin. Influence of vehicle and dose.. Eur J Clin Pharmacol. 1993. PMID 8513841. DOI 10.1007/BF00316465. (abstract)
- Korting HC, Schäfer-Korting M, Klövekorn W, et al.. Comparative efficacy of hamamelis distillate and hydrocortisone cream in atopic eczema.. Eur J Clin Pharmacol. 1995. PMID 8582464. DOI 10.1007/BF00194335. (abstract)
- Liu X, Hage TW, Chen LC, et al.. Revealing the Therapeutic Potential: Investigating the Impact of a Novel Witch Hazel Formula on Anti-Inflammation and Antioxidation.. J Cosmet Dermatol. 2025. PMID 39575475. DOI 10.1111/jocd.16662. (abstract)
- NCBI PubChem. PubChem compound records: hamamelitannin, catechin, gallic acid, eugenol. PubChem PUG REST. 2026. (api)
- NCCIH. NCCIH Herbs at a Glance: no witch hazel page. nccih.nih.gov. 2026. (page-check)
- Piazza S, Martinelli G, Magnavacca A, et al.. Unveiling the Ability of Witch Hazel (Hamamelis virginiana L.) Bark Extract to Impair Keratinocyte Inflammatory Cascade Typical of Atopic Eczema.. Int J Mol Sci. 2022. PMID 36012541. DOI 10.3390/ijms23169279. (abstract)
- Qureshi W, Hoang S, Frye J, et al.. AGA Clinical Practice Update on Diagnosis and Treatment of Hemorrhoids: Expert Review.. Clin Gastroenterol Hepatol. 2026. PMID 42067175. DOI 10.1016/j.cgh.2026.04.008. (abstract)
- Sevimli Güler D, Vural G, Turan Z, et al.. Comparison of the Effects of Breast Milk and Hamamelis virginiana (Witch Hazel) on the Healing of Diaper Dermatitis in Infants: A Randomized Trial.. Breastfeed Med. 2026. PMID 41468068. DOI 10.1177/15568253251406258. (abstract)
- Skowrońska W, Pawłowska KA, Obrębski M, et al.. Chemical composition, skin microbiota metabolism, antimicrobial potential and anti-inflammatory properties of witch hazel bark (Hamamelis virginiana L.).. J Ethnopharmacol. 2025. PMID 40819781. DOI 10.1016/j.jep.2025.120433. (abstract)
- Wolff HH, Kieser M. Hamamelis in children with skin disorders and skin injuries: results of an observational study.. Eur J Pediatr. 2007. PMID 17177071. DOI 10.1007/s00431-006-0363-1. (abstract)
- Wójciak M, Pacuła W, Sowa I, et al.. Hamamelis virginiana L. in Skin Care: A Review of Its Pharmacological Properties and Cosmetological Applications.. Molecules. 2025. PMID 40649262. DOI 10.3390/molecules30132744. (abstract)
Where to buy
Check the label first. Whatever you buy, look for these:
- The plant part and the extract type or ratio on the label
- A standardized amount of the active compounds, where relevant
- A third-party testing mark (USP, NSF or ConsumerLab)
- Interactions: ask a pharmacist if you take medicines, are pregnant or have a medical condition
Talk to a pharmacist or doctor before you start any supplement, especially if you take medicines. See the Safety tab for interactions.
Support our free guides: as an Amazon Associate we earn from qualifying purchases. Full disclosure.
