Pycnogenol (French maritime pine bark extract, Pinus pinaster)

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. AAD 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.

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. EAACI 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.

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.

Pycnogenol is sold for «cancer prevention» via antioxidant action. No evidence base for cancer incidence or mortality reduction in humans. USPSTF 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.

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 HbA1c 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. ADA 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.