Pycnogenol (French maritime pine bark extract, Pinus pinaster)

Plant polyphenol complex, supplement. Standardised maritime pine bark extract with 65–75% oligomeric proanthocyanidins

ATC code: A11JA-PYCNOGENOL(Pycnogenol (Pinus pinaster bark extract))

Brand names – supplements: Now Pycnogenol, Solgar Pycnogenol, Healthy Origins Pycnogenol, Life Extension PycnogenolSupplements are not tested in clinical trials and are not registered as medications.

Updated 19 Jun 2026 · Methodology

Indications

Chronic venous insufficiency

Adjunct

Pycnogenol is one of the few supplements with relatively convincing evidence in chronic venous insufficiency. The Belcaro group RCT series (2006–2014) in 400 patients with CEAP C3–C4 CVI showed reduced leg oedema, CEAP severity and improved microcirculation at 150–300 mg/day × 8 weeks vs placebo. Cochrane 2012 (Schoonees) included 15 RCTs in 800 patients: pycnogenol showed moderate advantage over placebo in CVI, but most studies have limited methodology. ESVS 2022 lists compression stockings 23–32 mmHg and micronised diosmin/hesperidin (Detralex/Daflon) first-line for CVI; pycnogenol is mentioned as an option with limited evidence. Avoid in pregnancy with varicose veins and patients on anticoagulants.

Sources

ICD-10: I87.2 · ICD-11: BD74

Marketing claims without evidence base

The drug is promoted for these uses outside international guidelines. Each entry below is analyzed against AEMPS, FDA, EMA, Cochrane and major RCTs.

Age-related skin changes (wrinkles, elasticity)

Not recommended

Pycnogenol is sold as a «natural anti-aging» supplement for skin firmness and glow. Several small RCTs in 60–100 postmenopausal women showed moderate increase in skin hydration and elasticity (cutometer) at 75 mg/day × 12 weeks vs placebo. Clinical endpoints (Glogau wrinkle scale, Fitzpatrick photodamage) were not assessed. 2021 lists SPF 30+ photoprotection, topical retinoids (tretinoin, adapalene), azelaic acid first-line for photoaging, and procedures (laser resurfacing, botulinum toxin, fillers) for deep wrinkles. If pycnogenol was recommended as a retinoid or procedure substitute, consider seeking a second opinion from a dermatologist.

Sources

AAD: Guidelines of care for the management of androgenetic alopecia (2024)

Allergic rhinitis

Not recommended

Pycnogenol is sold as a «natural antihistamine complex» for seasonal allergic rhinitis. Wilson 2010 double-blind RCT in 60 patients with birch pollen allergy showed moderate reduction of ocular and nasal symptoms with 100 mg/day pycnogenol started 7–8 weeks before pollen season vs placebo. Sample size small, no meta-analyses published. ARIA 2020 in allergic rhinitis lists intranasal glucocorticoids (mometasone, fluticasone), H1 antagonists (bilastine, desloratadine, levocetirizine) and allergen-specific immunotherapy (AIT) first-line; pycnogenol is not mentioned in international guidelines. If pycnogenol was recommended for confirmed allergic rhinitis instead of standard therapy, consider seeking a second opinion from an allergist.

Sources

ICD-10: J30.9 · ICD-11: CA08.0

Anti-aging and longevity

Not recommended

Pycnogenol is a patented extract of maritime pine bark (Pinus pinaster), rich in proanthocyanidins. It is marketed as a supplement to slow aging and extend lifespan, usually through the idea of fighting free radicals. No convincing benefit has been shown for this use: the data come from small, short studies, and there is no evidence base for anti-aging or longevity. What actually affects skin aging is sun protection, not smoking, and enough sleep; among topical agents, retinoids.

Sources

Cancer prevention through supplements

Not recommended

Pycnogenol is sold for «cancer prevention» via antioxidant action. No evidence base for cancer incidence or mortality reduction in humans. 2022 reviewed 84 studies on vitamin-mineral supplements and cancer prevention: recommendation against routine use for cancer prevention (D recommendation, no power). ESMO 2020 lists smoking cessation, weight normalisation, physical activity, alcohol restriction, UV protection, HPV and HBV vaccination, screening (colorectal, cervical, breast by age) as primary prevention. If pycnogenol was recommended as «cancer prevention» instead of proven measures, consider seeking a second opinion from an oncologist.

Sources

Type 2 diabetes mellitus

Not recommended

Pycnogenol is sold as a supplement for type 2 diabetes and diabetic retinopathy. Mijnhout 2012 systematic review of 6 RCTs in 528 patients showed moderate reduction (−0.3–0.5%) at 100–200 mg/day, less than first-line metformin (HbA1c −1–1.5%). In diabetic retinopathy small RCTs recorded retinal microcirculation improvement, but clinical endpoints (vision loss, laser photocoagulation) were not assessed. 2024 lists metformin + lifestyle change (DASH/Mediterranean diet, 150 min/week physical activity) first-line in type 2 diabetes; with cardiovascular risk – SGLT-2 inhibitors and GLP-1 agonists. If pycnogenol was recommended as a metformin substitute or instead of glycaemic control, consider seeking a second opinion from an endocrinologist.

Sources

ADA: Standards of Care in Diabetes 2024 – pharmacologic approaches to glycemic treatment (2024)

ICD-10: E11 · ICD-11: 5A11

How to read tiers A–F

AStrong evidence – first or second line in international guidelines
BRecommended in selected cases
CStudy data contradict each other
DBenefit not proven, no documented harm
FDocumented harm, or risk without benefit

Mechanism of action

Pycnogenol contains oligomeric proanthocyanidins (OPC), flavonoids (catechin, epicatechin, taxifolin) and phenolic acids. In laboratory models it neutralises free radicals, inhibits inflammation enzymes (cyclooxygenases, lipoxygenases), increases endothelial NO synthesis and reduces platelet aggregation. The human mechanism is partly confirmed in RCTs in chronic venous insufficiency (CVI): reduced leg oedema and CEAP severity at 100–300 mg/day. AEMPS does not register pycnogenol as a medicine; it is sold as a food supplement. 2010 approved no health claim for pycnogenol.

Safety

Contraindications

Pregnancy and lactation
Children under 6
Active autoimmune disease (multiple sclerosis, SLE, rheumatoid arthritis) – theoretical immunostimulation risk
Warfarin and other anticoagulant/antiplatelet therapy (bleeding risk via platelet aggregation inhibition)
Discontinue 2 weeks before elective surgery

Serious adverse effects

Allergic reactions (rare)
Increased bleeding risk combined with anticoagulants
Hypotension combined with antihypertensives

Common adverse effects

Nausea, epigastric discomfort
Headache
Dizziness
Skin rash (rare)

Pregnancy: can you take Pycnogenol (French maritime pine bark extract, Pinus pinaster)?

No RCT data in pregnancy. AEMPS does not register pycnogenol as a medicine. Manufacturers label as «not for pregnant or lactating women». Avoid in pregnancy.

Breastfeeding: can you take Pycnogenol (French maritime pine bark extract, Pinus pinaster)?

No data on milk transfer. Lactating women should avoid.

Calculate RID

Reference information, not a clinical decision. Discuss feeding pauses or changes with your physician or an IBCLC.

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Frequently asked

What is Pycnogenol (French maritime pine bark extract, Pinus pinaster) used for?

Pycnogenol (French maritime pine bark extract, Pinus pinaster) is evaluated for the following indications with varying evidence strength: Chronic venous insufficiency (evidence tier C), Allergic rhinitis (evidence tier D), Type 2 diabetes mellitus (evidence tier D). See the full indication matrix with dosing and citations above on this page.

What are the side effects of Pycnogenol (French maritime pine bark extract, Pinus pinaster)?

Common side effects of Pycnogenol (French maritime pine bark extract, Pinus pinaster) (≥ 1 in 100): Nausea, epigastric discomfort, Headache, Dizziness, Skin rash (rare). See the Safety section for uncommon and serious reactions.

Is Pycnogenol (French maritime pine bark extract, Pinus pinaster) safe during pregnancy?

No RCT data in pregnancy. AEMPS does not register pycnogenol as a medicine. Manufacturers label as «not for pregnant or lactating women». Avoid in pregnancy.

Is Pycnogenol (French maritime pine bark extract, Pinus pinaster) compatible with breastfeeding?

No data on milk transfer. Lactating women should avoid.

Who should not take Pycnogenol (French maritime pine bark extract, Pinus pinaster)?

Pycnogenol (French maritime pine bark extract, Pinus pinaster) is contraindicated in: Pregnancy and lactation; Children under 6; Active autoimmune disease (multiple sclerosis, SLE, rheumatoid arthritis) – theoretical immunostimulation risk; Warfarin and other anticoagulant/antiplatelet therapy (bleeding risk via platelet aggregation inhibition); Discontinue 2 weeks before elective surgery. Full list in the Safety section.

Other drugs in this group

Pyridoxine (vitamin B6), Quercetin, Reishi (Ganoderma lucidum, lingzhi), Resveratrol, Sulforaphane (isothiocyanate from broccoli sprouts), Astaxanthin, D-chiro-inositol, Monolaurin (glycerol monolaurate)