HERBAL
MEDICINAL
PLANT
---------------------------------------
WITCH
HAZEL
Hamamelis virginiana L. (Hamamelidaceae)
BY
RETTODWIKART
THENU
WITCH
HAZEL
(wich
hayz’uhl)
Hamamelis
virginiana L. (Hamamelidaceae)
SUMMARY AND PHARMACEUTICAL COMMENT
Witch hazel is characterised by its tannin constituents and astringent
properties. The documented herbal uses are related to these astringent
properties. There is limited evidence from clinical studies to indicate that
witch hazel used topically is effective in the treatment of haemorrhoids, but
its use in the treatment of eczema and dermatitis is more controversial. There
are no known problems associated with the use of topical preparations of witch
hazel during pregnancy and lactation.
SPECIES (FAMILY)
Hamamelis virginiana L. (Hamamelidaceae)
SYNONYM(S)
Hamamelis, Virginian Witch Hazel, Witchazel
OTHER COMMON NAMES
Snapping hazel, spotted alder,
tobacco wood, Winterbloom
ORIGIN
Witch
Hazel originated in the deciduous forests of Atlantic North America.
The
tree is common in European gardens and parks, and is also cultivated in
subtropical countries.
Figure 1. Hamamelis virginiana L.
DESCRIPTION
MEDICINAL PARTS: The medicinal
parts are the plant's hamamelis water, which is distilled from various plant
parts; the bark; the fresh and dried leaves; the fresh bark of the roots and
branches; and the dried bark of the trunk and branches.
FLOWER AND FRUIT: The androgynous
and unisexual flowers grow in light to golden yellow, short-stemmed clusters on
the trees before the leaves come out. The inflorescence is a small, head-like
spike in the axils of the dropping leaves, with 5 to 8 flowers. The 4 sepals
are ovate or triangular, curved outward, yellow-brown to brown on the inside.
The petals are bright yellow, long, narrow-linear, rolled to a spiral in the
bud and crushed like tissue paper when open. The ovary is villous, bivalvular
with 2 anatropic ovules. Fertilization takes place during the spring that
follows 5 to 7 months after pollination. The fruit capsule is woody, ovate, sectioned
and divided, hazelnut-like, 12 to 15 mm long and thickly pubescent. It bursts
so dramatically in autumn that the 2 dark seeds are projected up to 4 m away
from the plant.
LEAVES, STEM AND ROOT: The plant is a
tree-like deciduous bush that typically grows 2 to 3 m high (but sometimes reaches
heights up to 10 m) with a trunk diameter of 40 cm. The bark is thin, brown on
the outside, reddish on the inside. The older branches are bushy, divided and
silver-gray to gray-brown. The younger branches are yellowish-brown with hairs.
The alternate leaves have stipules. The leaf margin is roughly crenate, bluntly
indented to irregularly sweeping.
PRODUCTION: Witch Hazel leaf
is obtained from the leaves of Hamamelis virginiana, which are collected in autumn
and dried rapidly. Witch Hazel bark is the dried bark of the trunk and branches
of Hamamelis virginiana.
NOT TO BE CONFUSED WITH: Witch Hazel is
sometimes confused with Hazelnut bark, to which it bears a resemblance. Confusion
can arise between Witch Hazel leaves and the leaves of Corylus avellana
(hazelnut leaves), which are sometimes substituted as an adulteration.
OTHER NAMES: Hamamelis. Hazel
Nut, Snapping Hazel, Spotted Alder, Striped Alder, Tobacco Wood, Winterbloom
PHARMACOPOEIAL AND OTHER MONOGRAPHS
BHP 1996(G9)
BP 2007(G84)
Complete German Commission E(G3)
ESCOP 2003(G76)
Martindale 35th edition(G85)
Ph Eur 2007(G81)
USP29/NF24(G86)
LEGAL CATEGORY (LICENSED PRODUCTS)
GSL(G37)
CONSTITUENTS
The
following is compiled from several sources, including Reference 1 and General
References G2 and G52.
Flavonoids
(leaf) Flavonols (e.g. kaempferol, quercetin) and their glycosides including
astragalin, quercitrin, afzelin and myricitrin.
Tannins,
catechins Pharmacopoeial standard, not less than 3%.(G81, G84) Hamamelitannin
(hydrolysable), lesser amounts of condensed tannins (bark). (þ)-catechin, (þ)-gallocatechin,
(_)- epicatechingallate, (_) epigallocatechingallate, proanthocyanidin oligomers
of cyanidin and delphinidin type.
Volatile oils About 0.5%. Hexen-2-ol, hexenol, a-
and b-ionones, eugenol, safrole and sesquiterpenes.
Other constituents Fixed oil (about 0.6%),
resin (hamamelin, hamamamelitannin), wax, saponins, choline, free gallic acid
and free hamamelose.
COMPOUNDS: WITCH
HAZEL BARK
Tannins (up to
12%): including
hamamelitannin, monogalloyl hamameloses
Catechins: including
(+)-catechin, (+)-gallocatechin, (-)-epicatechin gallate(III),
(-)-epigallocatechin gallate(III)
OUgomeric
procyanidins
EFFECTS: WITCH
HAZEL BARK
Witch Hazel bark
is astringent, anti-inflammatory and locally hemostatic.
COMPOUNDS: WITCH
HAZEL LEAF
Tannins ( 5%): including
hamamelitannin
Catechins: including
(+)-catechin, (+)-gallocatechin, (-)-epicatechin gallate(III),
(-)-epigallocatechin gallate(III)
OUgomeric
procyanidins
Volatile oil
(0.01 to 0.5%): steam
distillate, consisting chiefly of aliphatic carbonyl compounds, for example hex-2-en-l-ale,
6-methyl-hepta-3,5-dien-2-one aliphatic alcohols, aliphatic esters
Flavonoids: including
quercitrin, isoquercitrin
EFFECTS: WITCH
HAZEL LEAF
The tannins and
tannin elements have an astringent, antiinflammatory and locally hemostatic
effect.
USES
Traditionally, witch hazel has been used to relieve
hemorrhoidal, vaginal, and analitching; decrease inflammation; and promote the
healing of bruises, varicose veins, and other local infl ammation. It is also
used as a gargle to decrease oral irritation and infl ammation and may be used
as a tea for diarrhea.
FOOD USE
Witch
hazel is listed by the Council of Europe as a
natural source of food flavouring (category N3). This category indicates that there
is insufficient information available for an adequate assessment of potential
toxicity.(G16)
HERBAL USE
Witch
hazel is stated to possess astringent, antihaemorrhagic and anti-inflammatory
properties. Traditionally, it has been used for diarrhoea, mucous colitis,
haemorrhoids, haematemesis, haemoptysis, and externally for external
haemorrhoids, bruises and localised inflamed swellings. The German Commission E
approved use for minor skin injuries, local inflammation of skin and mucous
membranes, haemorrhoids and varicose veins.(G3)
Figure 2. Flower and Leaf; Powder Leaf ; Extrack Powder ; Dried Leaf
ACTIONS
Witch hazel has been evaluated for its antiinfl ammatory,
antiviral, and antiaging actions.
Antiinfl
ammatory Action
One
study evaluated the antiinfl ammatory action of Polygonum
bistorta, Guaiacum
offi cinale, and Hamamelis virginiana in rats. Witch hazel did not act as an antiinfl ammatory
in the acute stages of infl ammation but did show antiinfl ammatory properties
in the chronic phase (Duwiejua et al, 1994). Another study documented the
antiinfl ammatory properties of witch hazel when used as an after-sun lotion (Hughes-Formella
et al, 1998).
Antiviral Action
The
antiviral action of witch hazel was shown against herpes simplex virus type 1 (HSV-1).
Its antioxidative qualities were demonstrated by its radical-scavenging ability
(Erdelmeier et al, 1996).
Antiaging Action
The
active-oxygen scavenging action of witch hazel has been documented. This action
may help to delay aging of the skin (Masaki et al, 1995).
PHARMACOLOGICAL ACTIONS
IN VITRO AND ANIMAL STUDIES
Witch
hazel is known to possess astringent and haemostatic properties, which have
been attributed to the tannin constituents. Vasoconstriction was reduced in the
hindquarters of rabbits when arteries were perfused with aqueous or ethanolic
extracts of witch hazel leaf. A 70% ethanolic extract of leaf (1 : 5, 200 mg/kg,
administered orally) significantly inhibited the chronic phase of carrageenan-induced
rat paw oedema over a period of 19 days, compared with control (p < 0.05).(2)
An aqueous ethanolic extract of witch hazel bark yielded a fraction rich in
polymeric proanthocyanins after ultracentrifugation.(3) This fraction was significantly
active against herpes simplex virus type 1 (HSV-1). It also showed radical
scavenging properties, inhibited b-glucosidase and human leukocyte elastase
activity, and was active in the croton oil ear oedema test in mice. In other
studies, 3-Ogalloylepicatechin-(4b,8)-catechin, a catechin oligomer and
hamamelitannin isolated from witch hazel bark had IC50 values of 6.6, 8.8 and
1.0 mmol/L, respectively, for inhibition of 5-lipoxygenase.(4) The oligomer was
active in the microsomal lyso-PAF:acetyl-CoAacetyltransferase inhibition assay,
with an IC50 value of 9.4 mmol/ L, whereas hamamelitannin was inactive.(4)
CLINICAL STUDIES
Robust clinical research assessing the effects of witch hazel is
limited and rigorous randomised clinical trials are required. A double-blind,
controlled trial involving 90 patients with haemorrhoids compared the effects
of witch hazel bark salve with those of other salves. Witch hazel was reported
to be superior in relief of symptoms.(G50)
In a study involving 30 volunteers who received topical applications
of a hydroglycolic extract of witch hazel leaf, skin temperature was
significantly reduced, compared with baseline values. This was interpreted as a
possible vasoconstrictor effect of witch hazel.(G52) The effects of an after-sun
lotion containing 10% hamamelis distillate were assessed in 30 healthy
volunteers using a modified UV-B erythema test for inflammation.(5) It was
reported that erythema suppression ranged from 20% at seven hours to 27% at 48
hours.
In a two-week, randomised, double-blind trial, 72 patients with moderately
severe eczema were treated with either a hamamelis distillate cream (5.35 g
distillate with 0.64 g ketone/100 g), hydrocortisone cream 0.5%, or drug-free
cream.(6) All three treatments significantly reduced itching, erythema and
scaling after one week. Hydrocortisone cream was more effective than hamamelis
cream.
Several clinical studies of witch hazel in the treatment of
eczema have been reviewed.(G50) A double-blind, placebo-controlled trial of
witch hazel salve (25% water distillate from leaf) involving 80 patients with
toxic and degenerative eczema and 31 patients with endogenous eczema found that
atopic dermatitis responded to the treatment to a greater extent than to
placebo, but that there was no significant effect on primary irritant contact
dermatitis. An uncontrolled study involving 22 patients with atopic eczema who were
treated with witch hazel (4 g leaf provided 25 mL distillate/ 100 g salve)
applied to affected arms over a three-week period reported improvements in symptoms,
compared with baseline values.(G50) Uncontrolled studies provide preliminary
data only and the observed effects cannot be attributed definitively to witch hazel.
An uncontrolled study involving 37 patients treated with a witch hazel leaf
cream twice daily for two weeks reported improvements in eczema and
neurodermatitis.
ACTIVITIES
Alterative (f; CRC); Analgesic (1; DEM; MAB);
Antiaging (1; MAB); Antiaggregant (1; MAB); Antiedemic (1; MAB); Antierythemic
(1; MAB; SHT); Antihemorrhagic (3; CAN; KOM); Antiherpetic (1; MAB);
Antiinflammatory (2; CAN; KOM; PH2); Antileukotriene (1; MAB); Antimutagenic
(1; MAB); Antioxidant (1; MAB); Antiphlebitic (1; BGB); Antipyretic (1; APA;
CRC); Antiseptic (f; CRC); Anti-UV (1; MAB); Antiviral (1; MAB); Antiwrinkle
(1; MAB); Aperitif (f; DEM); Aphrodisiac (f; MIC); Astringent (1; APA; CRC;
FAD; PH2; SHT); Carcinogen (1; CRC); Collyrium (f; CRC); Depurative (f; DEM);
Hemostat (2; FAD; KOM; PH2; SHT); Panacea (f; DEM); Sedative (f; CRC);
Sunscreen (1; MAB); Tonic (1; CRC; MAB); Vasoconstrictor (1; APA; MAB; SHT).
INDICATIONS
Abortion, impending (f; MAD); Abrasion (1; MAB);
Anorexia (f; DEM); Arthrosis (1; DEM; MAB); Asthma (1; DEM; FAD; MAB); Backache
(f; CRC); Bite (f; CRC; DEM); Bleeding (3; BGB; CAN; CRC; FAD; KOM; PH2; SHT);
Boil (f; MAD); Bruise (1; BGB; FAD; MAD); Bug Bite (1; APA); Burn (2; CRC; PHR;
PH2; WAF); Cancer (1; CRC; MAB); Cancer, eye (f; JLH); Chest Cold (f; DEM);
Childbirth (f; DEM); Cholera (1; DEM; FAD); Cold (1; CRC; DEM; FAD); Colitis
(f; CAN; PH2); Congestion (f; CRC); Conjunctivosis (f; CRC); Cough (f; DEM;
FAD); Crohn’s Disease (1; MAB); CVI (2; PHR; PH2); Cystosis (f; MAD);
Dermatosis (2; KOM; PIP; PHR; PH2); Diarrhea (1; APA; CRC; HHB; PH2; SHT); Dysentery
(f; CRC; HHB); Dysmenorrhea (1; APA; CRC; PH2); Eczema (1; BGB; MAB; SKY); Edema
(1; MAB); Enterosis (1; APA; PH2); Enterorrhagia (1; APA); Epistaxis (1; MAD); Erythema
(1; BGB; SHT); Fever (1; APA; CRC); Gingivosis (1; APA; BGB; FNF); Gleet (f; CRC);
Goiter (f; MAD); Gonorrhea (f; MAD); Headache (f; MAD; MIC); Hematemesis (1; CAN;
PH2); Hemoptysis (1; CAN; PHR; PH2); Hemorrhoid (2; CRC; FAD; KOM; PH2; PIP); Herpes
(1; MAB); Inflammation (2; BGB; CAN; KOM; MAB; PH2); Insomnia (f; CRC); Itch (1;
FAD; MAD); Lameness (f; FAD); Leukorrhea (f; MAD); Lumbago (f; MAD);
Menorrhagia (1; HHB); Metrorrhagia (1; FAD); Mucososis (2; APA; KOM; PH2; PIP);
Myosis (f; APA; CRC; FAD); Nervousness (f; CRC); Neuralgia (f; MAD);
Neurodermatosis (1; BGB; MAB); Ophthalmia (f; APA; CRC; FAD; WAF); Orchosis (f;
MAD); Pain (1; DEM; MAB); Pharyngosis (2; KOM; PHR; PH2); Phlebitis (f; BGB;
CRC; HHB); Phthisis (f; CRC); Poison Ivy (f; WAF); Pulmonosis (f; DEM; FAD);
Rash (f; MIC); Rheumatism (f; CRC); Sore (1; HHB; SKY); Sore Throat (1; APA;
CRC; FAD); Sprain (f; BGB; CRC); Stomatosis (2; APA; BGB; KOM; PHR; PH2);
Sunburn (f; BGB; WAF); Swelling (1; CAN; CRC; MAB; MAD); Tuberculosis (f; CRC; DEM);
Tumor (f; BGB; CRC); Ulcer (f; CRC; HHB); Varicocele (f; MAD); Varicosis (2;
KOM; PNC; PHR; PH2; SHT); VD (f; DEM; MAD); Virus (1; MAB); Wound (2; KOM; PHR;
PH2; SKY); Wrinkle (1; MAB).
INDICATIONS AND USAGE
Approved by
Commission E:
·
Hemorrhoids
·
Inflammation
of the mouth and pharynx (leaf only)
·
Inflammation
of the skin
·
Venous
conditions
·
Wounds
and bums
Unproven Uses: Witch Hazel leaf
and bark arc used internally in folk medicine for non-specific diarrheic
ailments (such as inflammation of the mucous membrane of the large intestine
and colon), hematemesis, hemoptysis and also for menstrual complaints. Efficacy
in the treatment of diarrhea seems plausible because of the tannin content. Witch
Hazel is used externally for minor injuries of the skin, localized inflamed
swelling of the skin and mucous membranes, hemorrhoids and varicose veins. It
is also used in folk medicine for inflammation of the mucosa of the colon, hematemesis
and hemoptysis.
Homeopathic Use:
Applications
for use of Witch Hazel bark in homeopathy include hemorrhoids, varicose veins,
skin inflammation and bleeding of the mucous membranes.
PRECAUTIONS
AND ADVERSE REACTIONS
Health risks
following the proper administration of designated therapeutic dosages are not
recorded. If taken internally, the tannin content of the drug can lead to
digestive complaints. Liver damage is conceivable following longterm administration,
but rare.
PRODUCT AVAILABILITY
Cream, dried leaves, fl uid
extract, pads, rectal suppositories, vaginal suppositories, witch hazel water
PLANT
PARTS USED: Bark, leaves
DOSAGES
Dosages
for oral (unless otherwise stated) administration (adults) for traditional uses
recommended in older and contemporary standard herbal and pharmaceutical
reference texts are given below. While
doses for oral administration are given in older literature, modern use of
witch hazel is by topical application.
·
Dried leaves 2 g as an infusion three times
daily.(G6)
·
Hamamelis Liquid Extract (BPC 1973) 2–4mL (1 : 1 in 45% alcohol) three times daily.(G6)
·
Hamamelis Water (BPC 1973) for local application,
undiluted or 1 : 3 dilution for external use.(G3)
·
Decoction 5–10
g in 250 mL water for compresses.(G3)
DOSAGES
·
Adult PO dried leaf gargle: 2 g
tid
·
Adult PO fl uid extract: 2-4 ml
tid (1:1 dilution in 45% alcohol)
·
Adult topical witch hazel
water: apply to affected area tid-qid prn
Dosages
·
Adult PO dried leaves: 3-6 g tid
·
Adult PO fl uid extract: 2-3 ml
tid (1:1 dilution in 25% alcohol)
·
Adult PO tincture: 0.5 ml
bid-tid (1:5 dilution in 45% alcohol)
DOSAGES
·
2 g dry leaf, or in tea, 3 ×/day (CAN); 2 g leaf or bark 3 ×/day
(MAB); 7–14 ml/day fluid leaf extract (1:2) (MAB); 2–4 tsp (1–2 g) leaf
decoction 1–3 ×/day (APA); 1 tsp (2–3 g) bark decoction 1–3 ×/day (APA);
·
2–4 ml liquid bark extract (1:1 in 45% ethanol) 3 ×/day (CAN); 10–15 drops liquid bark extract 3 ×/day (MAD);
·
2–4 ml bark tincture (APA; PNC). Few sources seem to stress
topical use only. Even the Herbal PDR (PH2) says that witch hazel bark is
available as a comminuted drug or as an extract for internal and external uses
(PH2).
DOSAGES
WITCH HAZEL BARK
MODE OF ADMINISTRATION: Witch Hazel Bark
is available as comminuted drug or extract for internal and external use as galenic
preparations. A steam distillate of the fresh leaves and bark is used for
internal and external application.
HOW SUPPLIED: Forms of commercial
pharmaceutical preparations include: cream; gel; ointment; suppositories.
PREPARATION: Various formulations
of Witch Hazel are prepared as follows:
EXTERNAL—aqueous steam distillate (Witch Hazel
water) undiluted, or diluted 1:3 with water.
FOR POULTICES—20
to 30% in semi-solid preparations.
EXTRACT PREPARATIONS—semi-solid
and liquid preparations, corresponding to 5 to 10% drug.
COMPRESSES AND
RINSES—decoctions of 5 to 10 g of
herb per cup (250 ml) of water.
OINTMENT/Gel—5
g Witch Hazel extract in 100 g ointment base.
SUPPOSITORIES—Use 0.1 to 1 g drug.
DAILY DOSAGE: Suppositories
can be used 1 to 3 times a day.
HOMEOPATHIC DOSAGE: 5 drops, 1 tablet
or 10 globules every 30 to 60 minutes (acute) or 1 to 3 times daily (chronic); parenterally:
1 to 2 ml sc acute, 3 times daily; chronic: once a day, suppositories 2 to 3 times
per day and ointment 1 to 2 times daily (acute and chronic); for the external application,
1 dessertspoonful to be mixed with 250 ml water and then used as a wash or
poultice (HAB1).
STORAGE: Store Witch
Hazel bark protected from exposure to light.
WITCH HAZEL
LEAF
MODE OF ADMINISTRATION: Witch hazel leaf
is available as comminuted drug or extract for internal and external use as galenic
preparations. A steam distillate of the fresh leaves and bark is used for
internal and external applications.
HOW SUPPLIED:
LIQUID —1:1 liquid
PREPARATION:
LIQUID Extract—1:1
with 45% ethanol (PF X).
STABILIZED LIQUID
EXTRACT—100 g of leaf powder are
moistened with 45 g 1:2 90% ethanol:water and subsequently percolated with 540
g 1:2 90% ethanol:water. Separation into 85 g forerun and the residue, which is
evaporated until dry. The dried substance is dissolved with 15 g ethanol:water
and is then mixed with the forerun. This solution is kept for 8 days at 2 to 8°
C and then filtered at the same temperature.
TEA: pour 150 ml boiling water over 2 to 3
g drug and strain after 10 minutes.
DAILY DOSAGE:
DECOCTION —
250 ml water with 5 to 10 g drug for washes or poultices; 2 to 3 g to 150
ml water as a gargle solution.
SUPPOSITORIES —
0.1 to 1 g drug/supp. 3 times daily.
TEA —
1 cup 2 to 3 times daily between meals.
LIQUID Extract
— 2 to 4 ml 3 times daily.
STORAGE: Protect Witch
Hazel leaf from light and moisture when stored.
DOSAGE
AND DURATION OF USE
– EXTERNAL Use
• RINSES
AND Compresses: Use a
decoction containing 5–10 g of the herb and 250 mL water.s
• GARGLE:
Mix 2–3 g of the herb with 150
mL water and use several times a day.
– INTERNAL USE: One
suppository 3 times a day; each suppository should contain 0.1–1 g herb.
CONTRAINDICATIONS, INTERACTIONS, AND SIDE
EFFECTS
CLASS 1. TANNINS (AHP).
None known (KOM). “Hazards and/or side effects not
known for proper therapeutic dosages” (PH2). “It is not recommended that these
extracts be taken internally because the toxicity of the tannins has not been
well defined... Doses of 1 g of witch hazel will cause nausea, vomiting, or constipation”
(LRNP, Sep, 1990). In susceptible patients, irritation of
the stomach may occur occasionally. In rare cases, witch hazel tannins may
cause liver damage (BIS). In view of the tannin content, excessive use,
especially during lactation and pregnancy, should be avoided. “There are no
known problems with the use of witch hazel during pregnancy...” (CAN). No contraindications,
drug-drug interactions, or side effects are known (SHT). “May cause minor skin
irritation in some people when applied topically” (SKY). Witch hazel water is
not intended for internal use. Teas can be brewed from leaves and twigs, but
their safety is not defined (LRNP, September 1990). APA lists the
carcinogen safrole, but in minimal quantities (APA). Tannins, many of the same
ones promoted for tea today, explain nearly half of the indications.
CONTRAINDICATIONS
Class 1 herb (bark, leaf).
Until more research is available, witch hazel should
not be used during pregnancy and breastfeeding. Persons who are hypersensitive
to witch hazel should not use it. Witch hazel should not be ingested.
SIDE-EFFECTS, ADVERSE
REACTIONS,
TOXICITY
GI: Nausea, vomiting, anorexia, constipation, hepatotoxicity
INTEG: Hypersensitivity reactions, contact dermatitis
SIDE-EFFECTS, TOXICITY
The
volatile oil contains safrole, a known carcinogen (see Sassafras), but in
amounts too small to cause concern. Stomach irritation may occur in susceptible
patients after oral treatment. Four of 1032 patients tested reacted to an
ointment containing 25% witch hazel extract, but two of these patients were
sensitive to wool fat in the ointment base.(G50)
CONTRA-INDICATIONS, WARNINGS
None documented for witch hazel. In view of the tannin constituents,
excessive ingestion of witch hazel is not recommended. Pregnancy and lactation In
view of the lack of information on the safety of witch hazel preparations
administered orally, their use during pregnancy and lactation should be
avoided. There are no known problems associated with topical use of witch hazel
during pregnancy and lactation.
INTERACTIONS
Drug
Iron salts: Witch hazel leaf, bark tea may decrease the absorption
of iron salts; separate by 2 hours.
CLIENT CONSIDERATIONS
ASSESS
·
Assess for hypersensitivity
reactions, including contact dermatitis. If present, discontinue the use of
witch hazel and administer an antihistamine or other appropriate therapy.
·
Assess for right upper-quadrant
pain. Assess hepatic function tests (AST, ALT, bilirubin). If results are
elevated, discontinue the use of witch hazel.
ADMINISTER
·
Advise the client to use witch
hazel topically or as gargle only; it should not be taken internally.
·
Instruct the client to store
witch hazel products in a sealed container away from heat and moisture.
TEACH CLIENT/FAMILY
·
Caution the client not to use
witch hazel during pregnancy and breastfeeding until more research is
available.
PREPARATIONS
PROPRIETARY SINGLE-INGREDIENT
PREPARATIONS
Australia:
Optrex Original; Witch Doctor. Austria: Hametum. Canada: Optrex. Chile: Sperti
Preparacion H Clear Gel. France: Optrex. Germany: Hamasana; Hametum; Posterine;
Venoplant top. Italy: Acqua Virginiana; Derminiol; Optrex. Malaysia: Optrex. Mexico:
Tia Puppy. New Zealand: Optrex. Singapore: Optrex. Spain: Derminiol; Hametol;
Hemo Derminiol; Optrex. Switzerland: Mavena Anal-Gen; Optrex. Thai- Figure 3 Witch
hazel – dried drug substance (bark). 602 Witch Hazelland: Optrex. UK: Optrex;
Preparation H Clear Gel; Witch Doctor; Witch Sunsore. USA: A-E-R; Neutrogena
Drying.
PROPRIETARY MULTI-INGREDIENT
PREPARATIONS
Argentina:
Domuderm; Ecnagel; Esculeol P; Lavandula Oligoplex; Manzan; Venoful; VNS 45. Australia:
Anusol; Bioglan Cirflo; Gentlees; Hemocane; Optrex; Proflo. Austria: Arnicet; Inotyol;
Inotyol; Mirfulan; Sulgan 99; Sulgan 99; Tampositorien mit Belladonna. Belgium:
Rectovasol. Brazil: Bromidrastina; Hemodotti; Hemorroidex; Malvatricin Natural
Organic; Manolio; Mirorroidin; Proctosan; Supositorio Hamamelis Composto;
Varizol; Varizol; Visionom. Canada: Onrectal; Penaten; Preparation H Cooling
Gel; Tucks. Chile: Proctoplex. Czech Republic: Aviril H. France: Aphloine P;
Climaxol; Ekseme; Evarose; Fluon; HEC; Histo-Fluine P; Jouvence de l'Abbe
Soury; Jouvence de l'Abbe Soury; Jouvence de l'Abbe Soury; Keracnyl eau
nettoyante; Mediflor Tisane Circulation du Sang No 12; Ophtalmine; Pastilles
Monleon; Phlebosedol; Phytomelis; Veinostase. Germany: Aescusan; Chlorophyllin Salbe
"Schuh"; Eulatin NN; Leukona-Wundsalbe; Mirfulan; Sagittaproct;
Sanaderm; Trauma-cyl; Varicylum-S; Weleda Hamorrhoidalzapfchen. Israel: Aforinol;
Derma Care; Inotyol. Italy: Centella Complex; Centella Complex; Centeril H; Centeril
H; Decon Ovuli; Dermilia Flebozin; Dermitina; Dermoprolyn; Eulux; Ginoxil Ecoschiuma;
Intim; Iridil; Lycia Luminique; Nevril; Proctopure; Sacnel; Salviette H; Steril
Zeta; Varicogel; Venactive; Venoplus. Mexico: Almodin; Prespir; Supranettes
Naturalag. New Zealand: Lacto Calamine; Optrex Red-Eye Relief. Portugal: Hemofissural.
South Africa: Lotio Pruni Comp cum Cupro; Stibium Comp. Singapore: Stop-Itch Plus.
Spain: Banoftal; Ojosbel; Roidhemo; Ruscimel; Solucion Schoum; Venofit. Switzerland:
Collypan; Euproctol N; Haemocortin; Haemolan; HEC; Mavena Proctal-Gen;
Oculosan; Optrex compresses; Tendro. Thailand: Opplin. UK: Adiantine; Eye Dew;
Heemex; Lacto Calamine; Lacto Calamine; Modern Herbals Pile; Optrex Red Eyes;
Swarm; Tea Tree & Witch Hazel Cream; Varicose Ointment; Vital Eyes. USA: Clearasil
Double Clear; Preparation H Cooling Gel; Succus Cineraria Maritima; Tucks. Venezuela:
Biomicovo; Camolyn; Supranettes.
REFERENCE
Barnes, J., Anderson, L. A., and
Phillipson, J. D. 2007. Herbal Medicines Third Edition. Pharmaceutical
Press. Auckland and London.
Duke, J. A. with Mary Jo
Bogenschutz-Godwin, Judi duCellier, Peggy-Ann K. Duke. 2002. Handbook
of Medicinal Herbs 2nd Ed. CRC Press LLC. USA.
Gruenwald, J., Brendler, T., Jaenicke,
Ch. 2000. PDR for Herbal Medicines. Medical
Economics Company, Inc. at Montvale, NJ 07645-1742. USA
Kraft, K and Hobbs, C. 2004 . Pocket
Guide to Herbal Medicine. Thieme.
Stuttgart New York.
Linda S-Roth. 2010. Mosby’s
Handbook Of Herbs & Natural Supplements, Fourth Edition. Mosby
Elsevier. USA
WITCH
HAZEL
(wich
hayz’uhl)
Hamamelis
virginiana
SUMMARY AND PHARMACEUTICAL COMMENT
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