Topically applied astringent herbs have been used traditionally as a treatment for hemorrhoids. A leading astringent herb for topical use is witch hazel,⁵ which is typically applied to hemorrhoids three or four times per day in an ointment base.

Comfrey has anti-inflammatory properties that may decrease bruising when the herb is applied topically.⁶ Comfrey is also widely used in traditional medicine as a topical application to help heal wounds.⁷Witch hazel can also be used topically to decrease inflammation and to stop bleeding.⁸ Native Americans used poultices of witch hazel leaves and bark to treat wounds, insect bites, and ulcers.⁹Horsetail can be used both internally and topically to decrease inflammation and promote wound healing.¹⁰

A cream prepared with witch hazel and phosphatidylcholine has been reported to be as effective as 1% hydrocortisone in the topical management of eczema, according to one double-blind trial.¹¹

Comfrey has anti-inflammatory properties that may decrease bruising when the herb is applied topically.¹² Comfrey is also widely used in traditional medicine as a topical application to help heal wounds.¹³Witch hazel can also be used topically to decrease inflammation and to stop bleeding.¹⁴ Native Americans used poultices of witch hazel leaves and bark to treat wounds, insect bites, and ulcers.¹⁵Horsetail can be used both internally and topically to decrease inflammation and promote wound healing.¹⁶

The proanthocyanidins in witch hazel have been shown to exert significant antiviral activity against herpes simplex 1 in the test tube.¹⁷ In a double-blind trial, people with acute cold sore outbreaks applied a topical cream containing 2% witch hazel bark extract or placebo six times a day for three to eight days.¹⁸ By the end of the eighth day, those using the witch-hazel cream had a pronounced and statistically significant reduction in the size and spread of the inflammation when compared to the placebo group.

Historically, herbs known as astringents have been used to soothe the pain of canker sores. These herbs usually contain tannins that can bind up fluids and possibly relieve inflammation. They are used as a mouth rinse and then are spit out. None of these herbs has been studied in modern times. Examples of astringent herbs include agrimony, cranesbill, tormentil, oak, periwinkle, and witch hazel. Witch hazel is approved by the German Commission E for local inflammations of the mouth, presumably a condition that includes canker sores.

The proanthocyanidins in witch hazel have been shown to exert significant antiviral activity against herpes simplex 1 in the test tube.¹⁹ In a double-blind trial, people with acute cold sore outbreaks applied a topical cream containing 2% witch hazel bark extract or placebo six times a day for three to eight days.²⁰ By the end of the eighth day, those using the witch-hazel cream had a pronounced and statistically significant reduction in the size and spread of the inflammation when compared to the placebo group.

Although witch hazel is known primarily for treating hemorrhoids, it may also be useful for varicose veins.²¹ Topical use of witch hazel to treat venous conditions is approved by the German Commission E, authorities on herbal medicine.²² Application of a witch hazel ointment three or more times per day for two or more weeks is necessary before results can be expected.

Cinnamon has been used historically for the treatment of various menstrual disorders, including heavy menstruation.²³ This is also the case with shepherd’s purse (Capsella bursa-pastoris).²⁴ Other herbs known as astringents (tannin-containing plants that tend to decrease discharges), such as cranesbill, periwinkle, witch hazel, and oak, were traditionally used for heavy menstruation. Human trials are lacking, so the usefulness of these herbs is unknown. Black horehound was sometimes used traditionally for heavy periods, though this approach has not been investigated by modern research.

Cinnamon has been used historically for the treatment of various menstrual disorders, including heavy menstruation.²⁵ This is also the case with shepherd’s purse (Capsella bursa-pastoris).²⁶ Other herbs known as astringents (tannin-containing plants that tend to decrease discharges), such as cranesbill, periwinkle, witch hazel, and oak, were traditionally used for heavy menstruation. Human trials are lacking, so the usefulness of these herbs is unknown. Black horehound was sometimes used traditionally for heavy periods, though this approach has not been investigated by modern research.

Tannin-containing herbs may be helpful to decrease diarrhea during acute flare-ups and have been used for this purpose in traditional medicine. A preliminary trial using isolated tannins in the course of usual drug therapy for Crohn’s disease found them to be more effective for reducing diarrhea than was no additional treatment.²⁷ Tannin-containing herbs of potential benefit include agrimony (Agrimonia spp.), green tea, oak, witch hazel, and cranesbill. Use of such herbs should be discontinued before the diarrhea is completely resolved; otherwise the disease may be aggravated.