Witch hazel is a plant extract used on skin as an astringent — for bruises, insect bites, minor grazes, haemorrhoids, oily skin and after shaving. It tightens tissue and reduces minor bleeding and weeping. It is a traditional remedy sold as a cosmetic or complementary product rather than a registered medicine.
What is Witch Hazel?
No product called witch hazel appears on the South African Medicine Price Registry, which lists SAHPRA-registered medicines. Witch hazel is sold as a cosmetic or complementary product, which is why it is absent.
Witch hazel is an extract of Hamamelis virginiana, a North American shrub. It has been used in Western herbal medicine for well over a century and remains one of the more widely used plant preparations.
The active constituents are tannins — chiefly hamamelitannin and related compounds — along with gallic acid and flavonoids. Tannins are astringents: they bind and precipitate proteins on the surface of skin and mucous membranes, forming a thin protective layer that tightens tissue, reduces weeping and seepage, and constricts small blood vessels.
That single mechanism explains every genuine use. It reduces oozing from a graze, calms the swelling of a bite, tightens the skin, and eases the discomfort of inflamed haemorrhoids.
Two forms are sold, and they are not equivalent:
Distilled witch hazel water — the version in most pharmacy bottles. Distillation removes most of the tannins, and what remains is largely the alcohol used as a preservative, typically around 14 per cent. This means the common product is a weaker astringent than the plant itself, and much of its effect comes from the cooling alcohol.
Witch hazel extract or decoction — retains the tannins and is a genuinely stronger astringent. Found in some medicated pads, suppositories and creams.
The evidence is modest but not absent. Trials support witch hazel for haemorrhoid symptoms and for mild skin inflammation, where some studies found it comparable to low-strength hydrocortisone for irritated skin — a reasonable claim for a plant extract. For most other uses the evidence is traditional rather than trialled.
What is Witch Hazel commonly used for?
- Haemorrhoids — its best-supported use, on medicated pads or as a cream, easing itching, swelling and weeping.
- After childbirth, on perineal pads for soreness and swelling.
- Bruises and minor swelling.
- Insect bites and stings, to reduce itching and swelling.
- Minor cuts and grazes, to reduce oozing.
- Oily skin and enlarged pores, as a facial toner. Its commonest cosmetic use.
- Mild acne, where it reduces oiliness — though it does not treat the cause.
- After shaving, to calm razor burn and reduce minor bleeding.
- Sunburn and mild skin irritation.
- Puffy eyes, on a cool compress — kept away from the eye itself.
- Varicose vein discomfort, traditionally.
Where something else works better:
- Haemorrhoids that keep returning — witch hazel eases the flare, but treating the constipation is what prevents the next one. More fibre, more water, not straining, and not sitting on the toilet for long do more than any topical product.
- Acne — benzoyl peroxide, salicylic acid or a retinoid actually treat it.
- An infected wound — spreading redness, pus and heat need proper treatment.
- Dry or sensitive skin — the alcohol in distilled witch hazel is drying and can worsen irritation. This is the commonest reason a toner makes skin worse rather than better.
How Witch Hazel fits into this medicine category
| Type | Examples | Notes |
|---|---|---|
| Astringents | Witch hazel, aluminium acetate | Tighten tissue, reduce weeping |
| Haemorrhoid preparations | Anusol, Preparation H, Scheriproct | Registered; steroid and anaesthetic options |
| Antiseptics | Chlorhexidine, povidone-iodine | Reduce bacteria on a wound |
| Topical steroids | Clomaderm | Stronger anti-inflammatory |
| Antifungals | Canex V | Fungal skin infection |
| Barrier preparations | Petroleum jelly, zinc and castor oil | Protect and seal |
| Acne treatments | Benzoyl peroxide, salicylic acid | Actually treat acne |
See the skin and wound care medicines hub.
What to check before using Witch Hazel
- Check whether it contains alcohol. Most distilled witch hazel does, at around 14 per cent. Alcohol-free versions exist and are better for dry, sensitive or broken skin.
- Do not get it in the eyes. For puffy eyes, apply to closed lids on a cool pad, never into the eye.
- Do not swallow it. Witch hazel is for external use; taken by mouth the tannins cause nausea and, in quantity, can affect the liver.
- Do a patch test on a small area first if you have sensitive skin.
- Do not use it on deep, open or infected wounds.
- Take care in children, particularly with alcohol-containing preparations, and keep it out of reach.
- Ask before using it in pregnancy or breastfeeding, though topical use on intact skin is generally considered low risk and it is widely used on perineal pads after childbirth.
For haemorrhoids specifically, witch hazel pads are a reasonable first step, but see a doctor rather than self-treating indefinitely if there is bleeding, a lump that will not reduce, or symptoms lasting more than a week.
Possible cautions and when to ask a pharmacist or doctor
Witch hazel is well tolerated on intact skin. The commonest problems are dryness, stinging, redness or tightness — usually from the alcohol rather than the extract — and occasionally contact dermatitis, an itchy rash where applied.
Stop and seek advice for:
- A rash, itching, blistering or worsening redness where applied.
- Skin becoming increasingly dry, flaky or irritated with regular use as a toner.
Get emergency help for swelling of the face, lips or tongue with difficulty breathing, or a widespread blistering rash.
See a doctor rather than continuing to self-treat if:
- Rectal bleeding continues, is heavy, or is mixed into the stool rather than on the paper. Bleeding that is new or persistent, and any rectal bleeding over the age of 45, should be examined. Haemorrhoids are the usual cause — but bowel cancer presents the same way, and treating the symptom is how the diagnosis gets delayed.
- You have unexplained weight loss, a persistent change in bowel habit, or anaemia.
- A wound is spreading, painful, discharging pus, or you have a fever.
- A bite or sting causes spreading swelling, difficulty breathing, or a widespread rash.
- Acne is significant or scarring — effective treatments exist and scarring is permanent.
- A bruise appears without injury, or you bruise very easily.
- Skin irritation is not settling after stopping.
Related medicine guides
Frequently asked questions
What is witch hazel used for? As a skin astringent — for haemorrhoids, bruises, insect bites, minor grazes, oily skin, after shaving, and post-childbirth soreness. It tightens tissue and reduces weeping.
How does it work? Its tannins bind proteins on the skin surface, forming a thin protective layer that tightens tissue, reduces oozing and constricts small blood vessels.
Is the bottled version as strong as the plant? No. Distillation removes most of the tannins, so distilled witch hazel water is a weaker astringent — and much of its effect comes from the alcohol it is preserved in.
Does it work for haemorrhoids? This is its best-supported use. It eases itching, swelling and weeping — but treating constipation is what prevents the next flare.
Can I use it as a facial toner? Yes, and it is popular for oily skin. The alcohol is drying, so it can worsen dry or sensitive skin — choose an alcohol-free version if that applies.
Will it clear acne? It reduces oiliness but does not treat the cause. Benzoyl peroxide, salicylic acid or a retinoid do.
Can I use it near my eyes? On closed lids with a cool pad, yes. Never into the eye.
Can I drink it? No. It is for external use. Swallowed, the tannins cause nausea and in quantity can affect the liver.
Is it a registered medicine? No. It is sold as a cosmetic or complementary product, which is why it does not appear on the medicine price register.