Pycnogenol

    Researchedby:
    Katie Jantz

    Fact-checked

    by:

    Nick Milazzo
    Last Updated: March 13, 2024

    Pycnogenol is a standardized extract of bark from the French maritime pine Pinus pinaster that provides a concentrated source of polyphenols, predominantly procyanidins. Pycnogenol may reduce symptoms of chronic venous insufficiency and osteoarthritis thanks to its antioxidant, anti-inflammatory, and vasoactive properties; however, the evidence is relatively weak.

    examine-databaseExamine Database

    Pycnogenol is most often used for Cardiovascular Health. The Examine Database covers General Cardiovascular Health, Osteoarthritis, and 12 other conditions and goals.

    61 references on this page
    4,347 participants in 19 trials and 5 meta-analyses

    What is pycnogenol?

    Pycnogenol is a standardized pine bark extract derived specifically from French maritime pine trees (Pinus pinaster) found on the coast of France. It provides a concentrated source of flavonoids and phenolic acids, including procyanidin oligomers (65–75% by weight), catechin, epicatechin, taxifolin, caffeic acid, and ferulic acid. While other French maritime pine bark extracts exist (oligopin and flavangenol), their composition varies slightly due to different extraction techniques. Pycnogenol has been used in the vast majority of clinical trials to date, and will be the focus of this page unless otherwise mentioned.

    What are pycnogenol’s main benefits?

    Pycnogenol possesses anti-inflammatory, antioxidant, and vasoactive properties that may beneficially impact various health conditions. Despite some promising results, most health outcomes are supported by just a handful of small trials, and many of the existing trials have a high risk of bias.

    Pycnogenol may reduce the signs and symptoms of chronic venous insufficiency (e.g., leg pain, heaviness, and edema; venous ulcers; microangiopathy)[4][5][6][7] and reduce leg edema and blood clot risk during long-duration air travel (although the latter has only been observed in a single trial).[8][9]

    Short-term (≤3 months) trials have found that pycnogenol may reduce pain, improve physical functioning, and reduce the use of non-steroidal anti-inflammatory drugs (NSAIDs) in people with osteoarthritis.[10][11][12][13] Interestingly, research suggests that some compounds in pycnogenol can enter the synovial fluid in joints, where they may act locally to reduce inflammation and inhibit the breakdown of collagen.[14][15][16]

    Does pycnogenol affect cardiometabolic health?

    Does pycnogenol impact cognition or attention-deficit/hyperactivity disorder (ADHD)?

    Does pycnogenol affect skin health?

    Does pycnogenol affect erectile dysfunction?

    Does pycnogenol affect asthma or allergies?

    What are pycnogenol’s main drawbacks?

    Pycnogenol is generally considered safe and well tolerated. Side effects occur rarely and may include headache, dizziness, drowsiness, skin irritation, and gastrointestinal upset (e.g., nausea), the latter of which may improve if pycnogenol is taken with food.[1]

    Most of the research on pycnogenol has been at least partially funded by the manufacturer of pycnogenol. While this doesn’t invalidate the research, it does make it more prone to bias in favor of pycnogenol.

    How does pycnogenol work?

    The biological activity of pycnogenol is due to its diverse and rich content of polyphenols.[17] Following ingestion, some of these compounds are metabolized by bacteria in the colon into other bioactive compounds that can be absorbed. For example, bacteria can convert the procyanidins in pycnogenol into the compound M1 (δ-(3,4-dihydroxy-phenyl)-γ-valerolactone), which is thought to strongly contribute to its overall biological effects.[18][19]

    Pycnogenol seems to decrease pain and inflammation by reducing the activity of certain pathways in the body that lead to the production of pro-inflammatory compounds, including nuclear factor kappa B (NF-κB) and cyclooxygenase (COX)-1 and COX-2 enzymes.[15][20] As an antioxidant, in vitro and animal research suggests that pycnogenol may directly scavenge free radicals, regenerate other antioxidants in the body (e.g., vitamin C, vitamin E, and glutathione), and increase the activity of antioxidant enzymes.[21][22][23] The above effects, as well as pycnogenol's ability to enhance nitric oxide synthesis and increase capillary integrity, may contribute to reduced capillary permeability and increased blood flow.[24][7]

    What are other names for Pycnogenol

    Note that Pycnogenol is also known as:
    • Pine Bark Extract
    • French maritime pine bark extract
    • Pinus pinaster bark extract
    • Oligopin (a different standardized extract)
    • Flavangenol (a different standardized extract)
    Pycnogenol should not be confused with:
    • Enzogenol (standardized extract of Pinus radiata)
    • Pinus massoniana bark extract

    Dosage information

    Most research on French maritime pine extract has used pycnogenol, as opposed to the other standardized extracts, oligopin and flavangenol. These extracts have slightly different chemical compositions, due to different extraction techniques, and there currently isn’t enough evidence to know whether oligopin and flavangenol work the same as pycnogenol.

    Pycnogenol is available as capsules or loose powder and is usually given at a dosage of 100 to 200 mg daily, split into two or three doses (e.g., 100 mg twice daily, 50 mg three times daily). Taking pycnogenol with food may reduce gastrointestinal side effects.[1]

    Pycnogenol is also available in topical formulations. For healing ulcers associated with chronic vascular insufficiency or diabetes, combining oral and topical pycnogenol appears to be more effective than oral pycnogenol alone.[2][3]

    Examine Database: Pycnogenol

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    Frequently asked questions

    What is pycnogenol?

    Pycnogenol is a standardized pine bark extract derived specifically from French maritime pine trees (Pinus pinaster) found on the coast of France. It provides a concentrated source of flavonoids and phenolic acids, including procyanidin oligomers (65–75% by weight), catechin, epicatechin, taxifolin, caffeic acid, and ferulic acid. While other French maritime pine bark extracts exist (oligopin and flavangenol), their composition varies slightly due to different extraction techniques. Pycnogenol has been used in the vast majority of clinical trials to date, and will be the focus of this page unless otherwise mentioned.

    What are pycnogenol’s main benefits?

    Pycnogenol possesses anti-inflammatory, antioxidant, and vasoactive properties that may beneficially impact various health conditions. Despite some promising results, most health outcomes are supported by just a handful of small trials, and many of the existing trials have a high risk of bias.

    Pycnogenol may reduce the signs and symptoms of chronic venous insufficiency (e.g., leg pain, heaviness, and edema; venous ulcers; microangiopathy)[4][5][6][7] and reduce leg edema and blood clot risk during long-duration air travel (although the latter has only been observed in a single trial).[8][9]

    Short-term (≤3 months) trials have found that pycnogenol may reduce pain, improve physical functioning, and reduce the use of non-steroidal anti-inflammatory drugs (NSAIDs) in people with osteoarthritis.[10][11][12][13] Interestingly, research suggests that some compounds in pycnogenol can enter the synovial fluid in joints, where they may act locally to reduce inflammation and inhibit the breakdown of collagen.[14][15][16]

    Does pycnogenol affect cardiometabolic health?

    Pycnogenol might improve some aspects of cardiometabolic health, but research has generally been mixed.

    Pycnogenol may increase glycemic control by reducing fasting blood glucose and hemoglobin A1c (HbA1c).[25] This is thought to occur primarily in the intestines by reducing the digestion and absorption of carbohydrates.[26] Interestingly, pycnogenol may also improve the healing of diabetic ulcers.[3]

    Some research suggests that pycnogenol has a blood pressure lowering effect;[27] however, when trials with a high risk of bias are excluded, this effect is generally lost.[28][29] Interestingly, two trials observed that taking pycnogenol along with other blood pressure-lowering medications (ramipril or nifedipine) allowed for lower overall doses of the antihypertensive medications after 12 weeks.[30][31]

    The effects of pycnogenol on lipid parameters are similarly mixed. Some research suggests that pycnogenol may increase high-density lipoprotein (HDL) cholesterol but likely does not affect other lipid parameters (e.g., low-density lipoprotein (LDL) cholesterol, total cholesterol, or triglycerides.)[17]

    Does pycnogenol impact cognition or attention-deficit/hyperactivity disorder (ADHD)?

    While pycnogenol might impact cognition or ADHD, the existing evidence is not sufficient to draw any meaningful conclusions.

    Both pycnogenol and oligopin (a different standardized extract of French maritime pine bark) have demonstrated mixed and unconvincing results when used in ADHD. Some research has reported reductions in the symptoms of ADHD (e.g., inattentiveness, hyperactivity) in children, but the effects tend to vary based on who is assessing the symptoms and what measurement tool is used.[32][33][34] Pycnogenol does seem to improve antioxidant status in children with ADHD, but whether this is clinically meaningful still needs to be determined.[35][36]

    Several trials have assessed the effects of pycnogenol on cognition in a variety of populations, including university students,[37] people with mild cognitive impairment,[38] professionals without apparent health conditions,[39] people with elevated levels of oxidative stress,[40] and elderly individuals.[41] All studies reported improvements in some aspect of cognition (e.g., alertness, memory, attention), but only one study was placebo-controlled, which undermines the validity of these results.

    Does pycnogenol affect skin health?

    Some preliminary research suggests that pycnogenol, taken orally, might beneficially impact several aspects of skin health; however, most of these trials have been uncontrolled, which reduces our confidence in these findings.

    When used alone or in addition to standard treatment, pycnogenol may reduce the appearance of facial melasma — a type of hyperpigmentation that can appear as brown spots on sun-exposed areas of skin. [42][43][44] This is further supported by in vitro research showing that pycnogenol may inhibit the synthesis of melanin, the major pigment in skin.[45] A single uncontrolled trial using flavangenol (a different standardized extract of French maritime pine bark) also reported beneficial effects on skin pigmentation.[46]

    Further, there is some limited research to suggest that pycnogenol may reduce skin redness following ultraviolet (UV) radiation exposure in fair-skinned individuals[47] and increase skin hydration and elasticity, which might correspond with increases in the synthesis of collagen and hyaluronic acid.[48][49]

    Does pycnogenol affect erectile dysfunction?

    Preliminary research suggests that pycnogenol may reduce erectile dysfunction, particularly when combined with L-arginine.

    In people with mild to moderate erectile dysfunction, the combination of pycnogenol and L-arginine may improve several aspects of erectile dysfunction, including the ability to achieve and maintain an erection, intercourse satisfaction, and the ability to reach orgasm.[50] While it’s less clear if pycnogenol is effective on its own, preliminary research suggests it may be.[51]

    The combination of pycnogenol and L-arginine is unique in that L-arginine is used as a building block for the synthesis of nitric oxide, and pycnogenol is thought to enhance the activity of nitric oxide synthase, the enzyme responsible for producing nitric oxide.[50]

    Does pycnogenol affect asthma or allergies?

    Preliminary research suggests that pycnogenol may have a beneficial role in allergy prevention and asthma control, but more research is needed.

    Pycnogenol may have a beneficial effect on mild to moderate asthma, with research suggesting that supplementation may improve lung function in both children and adults.[52][53][54] In adults with allergic asthma, those who were supplemented with pycnogenol were more likely to reduce their required dose of inhaled corticosteroids.[54] In childhood asthma, supplementation led to a reduced need for rescue inhalers compared to placebo.[52]

    In terms of allergies, one study found that pycnogenol reduced symptoms of allergic rhinitis and the use of allergy medications (antihistamines) compared to placebo when started at least 5 weeks before allergy season. This effect could be due to pycnogenol reducing the release of histamine from mast cells, which has been observed in in vitro and animal studies.[55][26]

    What are pycnogenol’s main drawbacks?

    Pycnogenol is generally considered safe and well tolerated. Side effects occur rarely and may include headache, dizziness, drowsiness, skin irritation, and gastrointestinal upset (e.g., nausea), the latter of which may improve if pycnogenol is taken with food.[1]

    Most of the research on pycnogenol has been at least partially funded by the manufacturer of pycnogenol. While this doesn’t invalidate the research, it does make it more prone to bias in favor of pycnogenol.

    How does pycnogenol work?

    The biological activity of pycnogenol is due to its diverse and rich content of polyphenols.[17] Following ingestion, some of these compounds are metabolized by bacteria in the colon into other bioactive compounds that can be absorbed. For example, bacteria can convert the procyanidins in pycnogenol into the compound M1 (δ-(3,4-dihydroxy-phenyl)-γ-valerolactone), which is thought to strongly contribute to its overall biological effects.[18][19]

    Pycnogenol seems to decrease pain and inflammation by reducing the activity of certain pathways in the body that lead to the production of pro-inflammatory compounds, including nuclear factor kappa B (NF-κB) and cyclooxygenase (COX)-1 and COX-2 enzymes.[15][20] As an antioxidant, in vitro and animal research suggests that pycnogenol may directly scavenge free radicals, regenerate other antioxidants in the body (e.g., vitamin C, vitamin E, and glutathione), and increase the activity of antioxidant enzymes.[21][22][23] The above effects, as well as pycnogenol's ability to enhance nitric oxide synthesis and increase capillary integrity, may contribute to reduced capillary permeability and increased blood flow.[24][7]

    Update History

    References

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    Examine Database References

    1. Skin Quality - Marini A, Grether-Beck S, Jaenicke T, Weber M, Burki C, Formann P, Brenden H, Schönlau F, Krutmann JPycnogenol® effects on skin elasticity and hydration coincide with increased gene expressions of collagen type I and hyaluronic acid synthase in womenSkin Pharmacol Physiol.(2012)
    2. Low-density lipoprotein (LDL) - Zibadi S, Rohdewald PJ, Park D, Watson RRReduction of cardiovascular risk factors in subjects with type 2 diabetes by Pycnogenol supplementationNutr Res.(2008 May)
    3. Endothelin-1 - Ximing Liu, Ha-Jun Zhou, Peter RohdewaldFrench maritime pine bark extract Pycnogenol dose-dependently lowers glucose in type 2 diabetic patientsDiabetes Care.(2004 Mar)
    4. Asthma Symptoms - Hosseini S, Pishnamazi S, Sadrzadeh SM, Farid F, Farid R, Watson RRPycnogenol((R)) in the Management of AsthmaJ Med Food.(2001 Winter)
    5. Asthma Symptoms - G Belcaro, R Luzzi, P Cesinaro Di Rocco, M R Cesarone, M Dugall, B Feragalli, B M Errichi, E Ippolito, M G Grossi, M Hosoi, S Errichi, U Cornelli, A Ledda, G GizziPycnogenol® improvements in asthma managementPanminerva Med.(2011 Sep)
    6. Blood Flow - Nishioka K, Hidaka T, Nakamura S, Umemura T, Jitsuiki D, Soga J, Goto C, Chayama K, Yoshizumi M, Higashi YPycnogenol, French maritime pine bark extract, augments endothelium-dependent vasodilation in humansHypertens Res.(2007 Sep)
    7. High-density lipoprotein (HDL) - Devaraj S, Vega-López S, Kaul N, Schönlau F, Rohdewald P, Jialal ISupplementation with a pine bark extract rich in polyphenols increases plasma antioxidant capacity and alters the plasma lipoprotein profileLipids.(2002 Oct)
    8. High-density lipoprotein (HDL) - Hadi A, Pourmasoumi M, Mohammadi H, Javaheri A, Rouhani MHThe impact of pycnogenol supplementation on plasma lipids in humans: A systematic review and meta-analysis of clinical trials.Phytother Res.(2019-Feb)
    9. Blood glucose - Malekahmadi M, Moradi Moghaddam O, Firouzi S, Daryabeygi-Khotbehsara R, Shariful Islam SM, Norouzy A, Soltani SEffects of pycnogenol on cardiometabolic health: A systematic review and meta-analysis of randomized controlled trials.Pharmacol Res.(2019-Dec)
    10. C-Reactive Protein (CRP) - Omid Nikpayam, Mohammad Hossein Rouhani, Makan Pourmasoumi, Neda Roshanravan, Ehsan Ghaedi, Hamed MohammadiThe Effect of Pycnogenol Supplementation on Plasma C-Reactive Protein Concentration: a Systematic Review and Meta-AnalysisClin Nutr Res.(2018 Apr)
    11. Blood Pressure - Federica Fogacci, Giuliano Tocci, Amirhossein Sahebkar, Vivianne Presta, Maciej Banach, Arrigo Francesco Giuseppe CiceroEffect of Pycnogenol on Blood Pressure: Findings From a PRISMA Compliant Systematic Review and Meta-Analysis of Randomized, Double-Blind, Placebo-Controlled, Clinical StudiesAngiology.(2020 Mar)
    12. Heart Rate - Enseleit F, Sudano I, Périat D, Winnik S, Wolfrum M, Flammer AJ, Fröhlich GM, Kaiser P, Hirt A, Haile SR, Krasniqi N, Matter CM, Uhlenhut K, Högger P, Neidhart M, Lüscher TF, Ruschitzka F, Noll GEffects of Pycnogenol on endothelial function in patients with stable coronary artery disease: a double-blind, randomized, placebo-controlled, cross-over studyEur Heart J.(2012 Jul)
    13. Pain - Reza Farid, Zahra Mirfeizi, Mahyar Mirheidari, Zahra Rezaieyazdi, Hassan Mansouri, Habib Esmaelli, Sherma Zibadi, Peter Rohdewald, Ronald Ross WatsonPycnogenol supplementation reduces pain and stiffness and improves physical function in adults with knee osteoarthritisNutrition Research.()
    14. Osteoarthritis Symptoms - Belcaro G, Cesarone MR, Errichi S, Zulli C, Errichi BM, Vinciguerra G, Ledda A, Di Renzo A, Stuard S, Dugall M, Pellegrini L, Errichi S, Gizzi G, Ippolito E, Ricci A, Cacchio M, Cipollone G, Ruffini I, Fano F, Hosoi M, Rohdewald PTreatment of osteoarthritis with Pycnogenol. The SVOS (San Valentino Osteo-arthrosis Study). Evaluation of signs, symptoms, physical performance and vascular aspectsPhytother Res.(2008 Apr)
    15. Chronic Venous Insufficiency Signs - Cesarone MR, Belcaro G, Rohdewald P, Pellegrini L, Ledda A, Vinciguerra G, Ricci A, Gizzi G, Ippolito E, Fano F, Dugall M, Acerbi G, Cacchio M, Di Renzo A, Hosoi M, Stuard S, Corsi MComparison of Pycnogenol and Daflon in treating chronic venous insufficiency: a prospective, controlled studyClin Appl Thromb Hemost.(2006 Apr)
    16. Chronic Venous Insufficiency Signs - Rainer KochComparative study of Venostasin and Pycnogenol in chronic venous insufficiencyPhytother Res.(2002 Mar)
    17. Leg Edema - Chan V, Wang L, Allman-Farinelli MEfficacy of Functional Foods, Beverages, and Supplements Claiming to Alleviate Air Travel Symptoms: Systematic Review and Meta-Analysis.Nutrients.(2021-Mar-16)
    18. Cognition - Luzzi R, Belcaro G, Zulli C, Cesarone MR, Cornelli U, Dugall M, Hosoi M, Feragalli BPycnogenol® supplementation improves cognitive function, attention and mental performance in studentsPanminerva Med.(2011 Sep)
    19. Erections - R Stanislavov, V NikolovaTreatment of erectile dysfunction with pycnogenol and L-arginineJ Sex Marital Ther.(May-Jun 2003)
    20. Blood Pressure - Liu X, Wei J, Tan F, Zhou S, Würthwein G, Rohdewald PPycnogenol, French maritime pine bark extract, improves endothelial function of hypertensive patientsLife Sci.(2004 Jan 2)
    21. Blood Pressure - Saeed Hosseini, Jeongmin Lee, Ramon T. Sepulveda, Peter Rohdewald, Ronald R. WatsonA randomized, double-blind, placebo-controlled, prospective, 16 week crossover study to determine the role of Pycnogenol in modifying blood pressure in mildly hypertensive patientsNutrition Research.()
    22. Menopausal Symptoms - Errichi S, Bottari A, Belcaro G, Cesarone MR, Hosoi M, Cornelli U, Dugall M, Ledda A, Feragalli BSupplementation with Pycnogenol® improves signs and symptoms of menopausal transitionPanminerva Med.(2011 Sep)
    23. NF-kB Activity - Tanja Grimm, Zuzana Chovanová, Jana Muchová, Katarína Sumegová, Anna Liptáková, Zdeňka Ďuračková and Petra HöggerInhibition of NF-κB activation and MMP-9 secretion by plasma of human volunteers after ingestion of maritime pine bark extract (Pycnogenol)Journal of Inflammation.()
    24. Irritable Bowel Syndrome Symptoms - Belcaro G, Gizzi G, Pellegrini L, Feragalli B, Cotellese R, Cacchio M, Corsi MPycnogenol® supplementation improves the control of irritable bowel syndrome symptomsPanminerva Med.(2018 Jun)