witch hazel

Witch hazel, or Hamamelis virginiana, is a tree native to North America. Indigenous Americans have used witch hazel for various conditions including hemorrhoids, sore muscles, insect bites, cuts, rashes, sunburn, and bruises.

Witch hazel extracts and witch hazel water, also known as hamamelis water, are distilled from the dried leaves, bark, and twigs of the witch hazel tree, and are available over the counter (OTC).

Witch hazel is primarily used for relieving pain, itching, burning and irritation caused by hemorrhoids or difficult bowel movements. The therapeutic effect of witch hazel comes from the chemicals it contains, including flavonoids and tannins which have anti-inflammatory, antioxidant, skin-tightening (astringent) and vasoconstrictive properties. The alcohol content in witch hazel extract preparations likely provides antibacterial effects.

Witch hazel promotes wound healing by inhibiting elastase and collagenase, the enzymes which break down elastin and collagen that keep the skin intact, flexible and strong. Witch hazel reduces tissue damage from free radicals and by constricting the blood vessels locally, it reduces swelling and itching caused by inflammation.

Suggested topical uses of witch hazel include:

• Irritation from hemorrhoids
• Anorectal irritation and cleansing
• Skin and mucous membrane inflammation and irritation
• Vaginal irritation

People also take witch hazel orally for various conditions including diarrhea, mucous colitis, vomiting blood, coughing up blood, tuberculosis, colds, eye inflammation, varicose veins, fevers, tumors, and cancer. Witch hazel is likely effective for its topical uses, however, there is little scientific evidence to support any of the other uses.

• Do not use witch hazel if you are hypersensitive to any of the components in the formulation.
• Witch hazel is for external use only, avoid oral ingestion. Avoid applying in or near the eyes.

Common side effects of witch hazel include:

Topical

• Mild skin dryness
• Minor skin irritation

Oral ingestion

• Nausea
• Vomiting
• Stomach upset
• Liver damage
• Kidney damage

Call your doctor immediately if you experience any of the following symptoms or serious side effects while using this drug:

• Serious heart symptoms include fast or pounding heartbeats, fluttering in your chest, shortness of breath, and sudden dizziness;
• Severe headache, confusion, slurred speech, severe weakness, vomiting, loss of coordination, feeling unsteady;
• Severe nervous system reaction with very stiff muscles, high fever, sweating, confusion, fast or uneven heartbeats, tremors, and feeling like you might pass out; or
• Serious eye symptoms include blurred vision, tunnel vision, eye pain or swelling, or seeing halos around lights.

This is not a complete list of all side effects or adverse reactions that may occur from the use of this drug. Call your doctor for medical advice about serious side effects or adverse reactions. You may also report side effects or health problems to the FDA at 1-800-FDA-1088.

Liquid, External

• Generic: (500 mL, 4000 mL, 20000 mL)

Solution, External

• Generic: 86% (473 mL)

Pad, External

Administration

Topical

• Apply as needed
• For external use only; do not use in or around eyes
• When practical, cleanse the affected area with mild soap and warm water and rinse thoroughly

Rectal products

• Apply rectal wipes by gently wiping, patting, and blotting the affected area
• Do not put the product into the rectum using fingers or any mechanical device or applicator

• With appropriate topical application there is no risk of overdose of witch hazel.
• Oral overdose of witch hazel can cause nausea and vomiting, and kidney or liver damage. If overdose symptoms do not resolve with discontinuation of witch hazel, seek medical help or report to Poison Control.

Inform your doctor of all medications you are currently taking, who can advise you on any possible drug interactions. Never begin taking, suddenly discontinue, or change the dosage of any medication without your doctor’s recommendation.

• Witch hazel has no known interactions with other drugs.

The drug interactions listed above are not all of the possible interactions or adverse effects. For more information on drug interactions, visit the RxList Drug Interaction Checker.

It is important to always tell your doctor, pharmacist, or health care provider of all prescription and over-the-counter medications you use, as well as the dosage for each, and keep a list of the information. Check with your doctor or health care provider if you have any questions about the medication.

• There isn’t enough information on the safety of witch hazel use in pregnant or breastfeeding women. Topical application and use of rectal wipes are possibly safe. Do not take witch hazel orally if you are pregnant or breastfeeding.
• Never use any herbal product if you are pregnant or breastfeeding, without first checking with your healthcare provider.

• Witch hazel is possibly safe for most adults when used for topical application.
• Use witch hazel exactly as per label instructions. Do not apply in or around the eyes.
• If you self-medicate with witch hazel, discontinue use and contact your healthcare provider if:
  • Condition worsens
  • Does not improve within 7 days
  • Bleeding occurs
• Witch hazel is marketed as an herbal supplement and is not regulated by the FDA. Products may differ in formulations and strengths, and labels may not always match contents; exercise caution in choosing your product.
• Store safely out of reach of children.