Pycnogenol (Pine Bark)

Pinus pinaster · Pine bark extract · French maritime pine · Maritime pine bark

Snapshot

Indications	Contraindications
Chronic venous insufficiency¹ Cardiometabolic risk factors² Gingival inflammation^3–6 Restless legs syndrome⁷	Pregnancy or nursing⁸ Autoimmune disease⁸ Surgery within two weeks⁸

Pycnogenol is a standardized extract of French maritime pine (Pinus pinaster) bark that is rich in procyanidins⁹. It acts through antioxidant, anti-inflammatory, and endothelial nitric oxide pathways³. Supplementation is used for vascular and microcirculatory support, including chronic venous insufficiency and cardiometabolic risk factors.³ It is also used for gingival inflammation, melasma, cognition, and attention deficit hyperactivity disorder (ADHD)³.

Cochrane reviews of pine bark extract found too few small trials for definitive conclusions on efficacy or safety^{10, 11}. A 2025 meta-analysis of pine bark extract trials reported lower blood pressure, fasting glucose, and low-density lipoprotein cholesterol². A Cochrane review of phlebotonics, including two pine bark trials, found a slight reduction in leg oedema across the class¹. Products listing pine bark number several thousand, mostly capsules, with standardized pycnogenol distinguished from generic pine bark; see Form comparison.

Per United States (US) product labels, a minority warn against use in pregnancy and nursing⁸ and ask for discontinuation before surgery⁸. One label directs people taking blood pressure medication or blood thinners to a healthcare practitioner first⁸.

Last updated October 15, 2026. Read how we make monographs.

In the full monograph

64 sources, 50 studies

When to useThe situations practitioners use it for, each with the reason and the study behind it.
SafetyWho should avoid it, who needs extra care, and the side effects reported in studies.
InteractionsThe medicines and supplements it interacts with, the effect of each, and what labeling says to watch.
Protocol notesThe doses used in studies, how and when they were taken, and how the forms on the market compare.
How it worksWhat it is and how it works in the body, in plain terms.
Published studiesThe studies behind each use, popular claims checked against them, and trials still under way.
Word of mouthWhat patients and practitioners report online, kept separate from the clinical evidence.
Clinical perspectiveA closing read of where the evidence is solid, where it is thin, and what has not been studied.

Snapshot

In the full monograph

Sources