Witch hazel is a herbal plant-derived medicine available as oil, cream, water, and ointment. It is used to treat the following conditions:

• Skin irritations
• Anal and vulval pruritis
• Hemorrhoids
• Diarrhea
• anorectal surgical wounds
• episiotomies
• acne
• scars

Witch hazel rose water toner:

• It is used as antiseptic, for dry skin, skin irritation, and for skin brightening.
• It is also used in perfumes.
• The famous formulation available as over the counter solution is the "Dickinson's witch hazel with rose water", "Dickinson's deep cleansing astringent"

Witch hazel for acne:

• Witch hazel has anti-inflammatory and astringent properties. It also balances fluid and oil in the skin.
• Thus, it results in skin toning, tightening, and drying.
• It is used for acne in teens (with or without vitamin A derivatives like adapalene) and puffy eyes in the elderly as a foaming face wash.
• It is also used for acne scars and post-inflammatory hyperpigmentation.
• The famous formulation available in the markets and on Amazon is "Dickinson face toner", "Dickinson face wipes", and "Dickinson face wash"
• Other formulations available for acne are "Witch hazel pore strips"

Witch hazel on blisters and bug bites:

Because of its inflammatory and antiseptic properties, it is used to relieve irritation, itching, swelling, and pain when applied over blisters and bug bites.

Witch hazel on eczema and psoriasis:

Eczema and psoriasis are manifested by dry, scaly, hyperkeratotic, and itchy lesions. It has been used for centuries on irritating skin lesions. It is currently used to treat individuals with eczema, oozing skin lesions, itchy, and inflamed skin lesions.

Witch hazel for dark marks:

Because of its inflammatory properties and skin toning properties, it is used in combination with salicylic acid and vitamin C (or lemon extract) for post-inflammatory hyperpigmentation and dark marks. It is also used in females after childbirth for the relief of stretch marks.

Hemorrhoids witch hazel extract:

It is used to treat itching, skin excoriation, inflammation, and antiseptic for hemorrhoids. The extract is poured over a cloth or cotton and applied four to six times a day or post-defecation in patients with hemorrhoids.

Miscellaneous uses:

It is also used for ingrown hair, sensitive skin as a body wash, and in shaving gels for skin soothing and as antiseptic solution. Witch hazel eyewash and eye gel are used in patients with frequent styes and dandruff of the eyelashes and eyebrows. It may be used as an oral solution for oral rinses in patients with sore throat. 2 - 4 teaspoons orally is considered safe.

Witch hazel Dose in Adults

Witch hazel Dose in the treatment of Hemorrhoids:

• To treat hemorrhoids with witch hazel, you can apply it to the area around your bottom whenever you need it, up to six times a day, or after you go to the bathroom.

For skin conditions like eczema, psoriasis, and vaginal soreness, it may be applied four times a day four days a week.

Witch hazel Dose in Children

Avoid using in infants. Children 12 years of age or more should fo

Use in Pregnancy  and lactation:

Data is limited regarding its use in pregnancy. However, most experts recommend avoiding its use in pregnancy.

Use during breastfeeding:

Topical application, other than application over or around the nipple should be avoided.

Witch hazel Dose in Renal Disease:

Not studied. Topical application is safe in renal disease.

Witch hazel Dose in Liver Disease:

Not studied. Topical application may be used safely.

Witch hazel side effects:

• When ingested it may cause mild gastrointestinal upset manifested as bloating, heartburn, and abdominal pain.
• Ingesting large amounts of witch hazel may result in serious liver injury.
• Topical applications may result in minor skin irritation. 

Contraindications and warnings:

• It contains high amonuts of tannins that may result in toxicity.
• It may cause minor skin irritations, however, when ingested, it may cause liver injury.
• It also contains safrole that is thought to be carcinogenic when ingested.
• In rats and mice, it has been studied and found to be a weak carcinogen resulting in liver cancers.

Monitoring Parameters: 

• Monitor for hypersensitivity reactions and improvement in the underlying condition.
• Patients with a high-grade hemorrohoids and those who bleed should consult a healthcare provider. 

How to apply Witch hazel?

• It is applied over the skin, vagina, and external hemorrhoids every four to six hourly.
• The paste, liquid, solution, or water is added to cotton or a clean cloth and applied topically.
• Experts recommend using it intermittently to give the skin a break. Long term continuous use is not recommended. Apply it four times a week.

Mechanism of action?

• The mechanism of action of witch hazel is not clear.
• The mechanism of action may in part be due to the presence of gallotanins, safrole, calcium oxalate, carvacrol, and eugenol. It is used to treat the following conditions:
• Psoriasis
• Eczema
• SKin irritation and soreness
• Insect bites
• Poison ivy
• for the relief of soreness after childbirth
• Hemorrhoids
• Vaginal soreness and inflammation
• Diaper rash

Witch hazel International Brands:

• E.R. Traveler
• E.R. Witch Hazel
• CVS Hygienic Cleansing
• Hemorrhoidal Hygiene
• Medi Pads
• Medi-Pads
• Pre-Moistened Witch Hazel
• Preparation H for Women
• Preparation H Totables Wipes
• Preparation H
• Sooze Pads
• Preparation H Cleansing Pads

Witch hazel Brands in Pakistan:

It is not available in Pakistan.