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Hamamelis virginiana (leaf, bark, twig)

Witch hazel

Witch hazel applied to the skin has a mild, short-lived anti-inflammatory effect in lab-style tests, but it is only weakly supported for real skin conditions and its haemorrhoid use rests on tradition and older, mostly combination-product studies. It is well tolerated on the skin, with allergic contact dermatitis the main risk.

Distilled witch hazel water contains almost no tannins, so it is a different product from bark or leaf extracts, and trial results for one do not carry over to the other.

Yellow witch hazel flowers on a bare branch
At a glance
Last reviewed 10 October 2026
Evidence
Limited
Best for
Minor skin inflammation
Typical form & use
Distillate cream/ointment, 5–30%
Onset
About a week
Safety
Rectal bleeding needs a doctor's check first. No interactions in our data.
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What it's used for

Evidence is rated per use. The same ingredient can be strong for one thing and traditional for another.

UseEvidenceWhat the research shows
Minor skin inflammation and irritationCompare remedies for skin →Limited

In volunteers with UV-induced redness, a lotion with 10% hamamelis distillate reduced erythema by about 20–27% over 48 hours, more than the base lotion (30 people). A second 40-person test found only one of three distillate lotions clearly beat its vehicle, and hydrocortisone worked better than all of them.

The EU regulator recognises distillate and bark preparations for minor skin inflammation and dryness on the basis of long-standing use, and says the effect seen is largely attributable to the vehicle.5,6,3,2,1

Itching and burning from haemorrhoidsTraditional

The EU regulator lists bark preparations (ointment, suppository, decoction dressings) for itching and burning associated with haemorrhoids, based on long-standing use alone.

The trials it summarises are small, mostly 1980s–90s German studies of combination ointments or unblinded comparisons, and one 90-person study found hamamelis ointment no different from active comparators, with no placebo arm. We found no systematic review or modern placebo-controlled trial.1,3

Nappy rash and minor skin injuries (ointment)Limited

A study of 309 children aged 27 days to 11 years found hamamelis ointment and dexpanthenol ointment both cut symptom scores significantly, with similar results and 12 of 309 children reporting any adverse event across both arms. There was no placebo group and children were not randomised equally, so it cannot show the ointment beats its base.7,3

Atopic eczemaTraditional

In a 72-patient double-blind trial over 14 days, distillate cream reduced itch, redness and scaling but did no better than the drug-free base, while 0.5% hydrocortisone cream was clearly superior. Other small older studies, mostly of leaf extracts, reported improvement but lacked placebo controls in the summaries we read. We do not rate it higher than traditional use.4,3

How much

Ranges below are what studies used and what supplements commonly contain. They are not a recommendation for you. Start at the low end.

Distillate (skin)
5–30% in a semi-solid product2
The EU monograph dose for distillate from fresh leaf and bark or dried twigs, applied several times a day. Witch hazel water sold as a liquid is not specified in that monograph.
Bark extract (skin, haemorrhoids)
Tincture 5–10% or dry extract 1.3% in ointment1
EU monograph doses for bark, applied several times daily. For haemorrhoids it also lists a decoction of 5–10 g bark per 250 ml as dressings up to three times a day, or a 66 mg dry-extract suppository two or three times a day.
Duration
1–2 weeks before seeking advice1,2
The EU monographs advise seeing a doctor or qualified practitioner if skin symptoms last more than 1 week (bark) or 2 weeks (distillate), or haemorrhoid symptoms more than 2 weeks.
Timing · The EU monographs say several times daily; no single schedule is specified. For haemorrhoid dressings, the bark monograph allows up to three applications a day.With food? · Not relevant to topical use. The EU regulator does not recommend oral use, and notes tannins can irritate the stomach and, rarely, be linked to liver damage.How long to trial · Judge it over one to two weeks. The EU monographs advise seeing a doctor if skin symptoms persist beyond 1 to 2 weeks or haemorrhoid symptoms beyond 2 weeks, and any rectal bleeding should be checked.

How people take it

Distilled witch hazel waterDistillate 5–30% in semi-solid products (EU)Steam distillate of twigs, leaves or bark; the US pharmacopoeia version contains 14–15% ethanol and only a trace of tannins. Most of the controlled trials used distillate in creams or lotions.
Cream or ointment (distillate or extract)Distillate 5–30%, bark extract 1.3%The form used in the skin and nappy-rash studies. Results in one trial were largely explained by the base, so the vehicle matters.
Suppository or bark decoction dressing66 mg dry extract; decoction 5–10 g bark per 250 mlThe forms named in the EU bark monograph for haemorrhoids. Bark and leaf extracts contain tannins, unlike distillate.

Safety

Who should avoid
  • Known allergy to witch hazel — allergic contact dermatitis is reported
  • Rectal bleeding — see a doctor before self-treating haemorrhoids
  • Pregnancy and breastfeeding — safety not established, EU advises against
  • Children: under 12 (bark, skin), under 18 (haemorrhoids), under 6 (distillate)
  • Swallowing it — oral use not recommended; tannins can irritate the stomach
  • Eyes — only use products licensed as eye drops; conjunctivitis has been reported
Known interactions
No interactions in our data. Absence of a flag is not clearance.

Questions people ask

Does witch hazel work for haemorrhoids?

The EU regulator recognises bark preparations for itching and burning from haemorrhoids on the basis of traditional use only. The supporting trials are small, old and mostly of combination ointments, so we cannot say how much it adds beyond the base or simple cooling. Rectal bleeding should be checked by a doctor, not treated at home.

Is witch hazel water the same as witch hazel extract?

No. Distilled witch hazel water contains very little tannin, whereas bark and leaf extracts are tannin-rich (roughly 8–12% in bark and 3–10% in leaf). Most of the placebo-controlled skin trials tested distillate, so their results do not tell us how a tannin-rich extract performs, and the reverse is also true.

Can witch hazel treat eczema or acne?

For atopic eczema, the one placebo-controlled trial we found showed distillate cream did no better than its base, and hydrocortisone was clearly better. We found no clinical trial of witch hazel for acne, so we make no claim for it.

Is witch hazel safe on skin and for babies?

On intact skin it is well tolerated, and the main risk is allergic contact dermatitis. The EU monograph does not recommend distillate under 6 or bark products for the skin under 12 because of limited data, although a study of 309 children up to 11 reported few side effects.

Sources (8)

  1. Regulator monograph European Medicines Agency HMPC. Community herbal monograph on Hamamelis virginiana L., cortex (EMA/HMPC/114583/2008 Corr. 1). 2009, corrected 2019.
  2. Regulator monograph European Medicines Agency HMPC. Community herbal monograph on Hamamelis virginiana L., folium et cortex aut ramunculus destillatum. 2009.
  3. Regulator assessment report European Medicines Agency HMPC. Assessment report on Hamamelis virginiana L., cortex; folium; folium et cortex aut ramunculus destillatum (EMA/HMPC/114585/2008). 2009.
  4. Randomised controlled trial Korting HC, Schäfer-Korting M, Klövekorn W, Klövekorn G, Martin C, Laux P. Comparative efficacy of hamamelis distillate and hydrocortisone cream in atopic eczema. Eur J Clin Pharmacol. 1995.
  5. Randomised controlled trial Hughes-Formella BJ, Bohnsack K, Rippke F, et al. Anti-inflammatory effect of hamamelis lotion in a UVB erythema test. Dermatology. 1998.
  6. Randomised controlled trial Hughes-Formella BJ, Filbry A, Gassmueller J, Rippke F. Anti-inflammatory efficacy of topical preparations with 10% hamamelis distillate in a UV erythema test. Skin Pharmacol Appl Skin Physiol. 2002.
  7. Observational study Wolff HH, Kieser M. Hamamelis in children with skin disorders and skin injuries: results of an observational study. Eur J Pediatr. 2007.
  8. Narrative review Wójciak M, Pacuła W, Sowa I, Feldo M, Graczyk F, Załuski D. Hamamelis virginiana L. in Skin Care: A Review of Its Pharmacological Properties and Cosmetological Applications. Molecules. 2025.

Reader notes

Experiences and questions from readers, read by an editor before they appear. They are personal accounts, not evidence, and are not medical advice.

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Last reviewed 10 October 2026 · Next review April 2027 · How we rate evidence