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Witch Hazel - How Witch Hazel Works? - Side Effects of Use

Taxonomic Class

Hamamelidaceae

Common Trade Names

Witch Doctor, Witch Hazel Cream, Witch Hazel Liquid, Witch Hazel Lotion, Witch Hazel Pads, Witch Hazel Soap, Witch Stik.

Common Forms

Available as dried bark, cream, dried leaves, liquid extract, lotion, medicated pads, soap, and witch hazel water (milder form of extract).

Source

The active components are derived from the leaves and bark of Hamamelis virginiana, a shrub that is native to North America. Witch hazel is prepared by distilling twigs of the plant and adding alcohol to the distillate. Commercial sources originate in western Virginia, North Carolina, and Tennessee. Witch hazel water distillate is prepared from wintergreen twigs and contains 13% to 15% alcohol in water with a trace of volatile oil.

Chemical Components

Witch hazel contains tannins, flavonoids (kaempferol, quercetin, and others), traces of volatile oil (eugenol, safrole, sesquiterpenes), a bitter principle, calcium oxalate, fixed oil, resin, wax, saponins, and gallic acid.

Actions

Witch hazel is reported to exert astringent, antihemorrhagic, and anti­inflammatory effects. Some studies have shown that witch hazel distillate reduces swelling and inflammation of skin after exposure to ultraviolet B radiation another study failed to show this effect. Other components from witch hazel bark have demonstrated antimutagenic properties.

Reported Uses

Witch hazel has long been used to relieve anal and vaginal itching and irritation, hemorrhoids, and postepisiotomy or posthemorrhoidectomy discomfort. It is also claimed to be useful for treating bruises, local swelling, and varicose veins. Witch hazel has been used as a gargle to decrease inflammation of mucous membranes of the mouth, gums, and throat.

Dosage

Dried leaves: 2 g as a tea t.i.d. or a gargle.

Liquid extract (1:1 in 45% alcohol): 2 to 4 ml P.O. t.i.d.

Witch hazel water: apply topically t.i.d. or q.i.d.

Adverse Reactions

GI: constipation (more than 1,000 mg), nausea, vomiting.

Hepatic: hepatotoxicity (tannin component), increased risk of liver cancer (controversial; related to safrole component.

Skin: contact dermatitis.

Interactions

None interactions are reported for witch hazel.

Contraindications and Precautions

Avoid using witch hazel in pregnant or breast-feeding women; effects are unknown.

Special Considerations

• Caution the patient not to ingest witch hazel.

• Advise the patient to consult a primary health care provider if his condition worsens or does not improve after a few days of topical use of witch hazel.

• Caution the patient to keep witch hazel out of the reach of children.

Commentary

Witch hazel products are known to be effective astringents and produce hemostatic effects. Although they are apparently safe for external use, they are not for internal use.