Pine bark extract

Related Terms

4-Beta-D-glucoside, arbre d'or (French), bioflavonoid, borovice hvezdicovit? (Czech), caffeic acid, catechin, condensed tannins, epicatechin, ferulic acid, Flavangenol?, free glucose, French maritime pine bark extract, French Pinus maritime bark, gallic acid, L-(feruloyl)-beta-D-glucose, L-(p-coumaroyl)-beta-D-glucose, maritime pine tree bark, merim?nd (Estonian), oligomeric proanthocyanidin complexes, OPCs, PCOs, p-coumaric acid, phenolcarbonic acids, phenolic acids, phenolic fruit acid, p-hydroxybenzoic acid, pi mar?tim (Catalan), pi pinastre (Catalan), pin de Bordeaux (French), pin de Corte (French), pin des Landes (French), pin maritime (French), pin m?sog?en (French), Pinaceae (family), pinastro (Italian, Spanish), pinheiro-bravo (Portuguese), pino costiero (Italian), pino gallego (Spanish), pino mar?timo (Spanish), pino marittimo (Italian), pino resinero (Spanish), pino rodeno (Spanish), pino rubial (Spanish), Pinus pinaster, Pinus maritima, polyphenols, proanthocyanidins, procyanidins, procyanidolic oligomers, protocatechuic acid, PYC, pygenol, Pygenol?, strandfyr (Danish), Strandkiefer (German), taxifolin, terpentintall (Swedish), vanillic acid, vanillin.
Examples of combination products: Evelle? (vitamin C, vitamin E, carotenoids, selenium, zinc, amino acids, glycosaminoglycans, blueberry extract), GlucAffectT (Pycnogenol?, MadeglucylT, Silbinol?, Glucohelp, salacia, fish oil), Mirtogenol? (Mirtoselect? and Pycnogenol?), Prelox? (L-arginine aspartate and Pycnogenol?), PycnoQ10? (Pycnogenol? and coenzyme Q10), Zinopin? (Pycnogenol? and standardized ginger root extract).
Note: Pinus pinaster is sometimes confused with Pinus halepensis or Pinus brutia.

Background

French maritime pine bark extract grows in southwest France. It is a source of nutrients believed to contribute to its anti-inflammatory, antioxidant, immune-building, and heart health benefits.
Pycnogenol? is the registered trade name for a patented water extract of French maritime pine bark. The product contains antioxidants such as catechins, which are found in high concentrations in red wine, grapes, cocoa, cranberries, and apples. Consumption of these nutrients has been suggested as a reason for why the French have lower rates of heart disease and diabetes despite relatively high-fat diets.
There has been some confusion in the United States market regarding products containing Pycnogenol? or grape seed extract (GSE). This is because the generic term "pycnogenols," referring to a chemical found in the product, is the same as the patented trade name Pycnogenol?. In addition, some grape seed extract products have been incorrectly labeled and marketed in the United States as containing "pycnogenols." Although grape seed extracts and Pycnogenol? do contain similar chemical parts, the two products are distinct from one another.
Pycnogenol? has been studied for inflammation, skin problems (including rashes and chronic disorders), allergies, asthma, heart and circulation issues, high blood pressure, and blood vessel disease. When combined with a healthy diet and exercise, some sources claim that supplementing with Pycnogenol? may improve body mass index and heart health. Despite positive findings, further research is needed to determine the safety and effectiveness of French maritime pine bark extract.
In 2000, J&R Research (manufacturer of Pycnogenol?) settled a lawsuit with the U.S. Federal Trade Commission (FTC), agreeing to stop advertising Pycnogenol? as an ADHD treatment. Supplements that make health benefit claims are considered drugs under U.S. law and are strictly regulated. Although recent studies suggest that Pycnogenol? may help improve attention, the product lacks approval by the U.S. Food and Drug Administration (FDA) as a treatment for ADHD or any other condition.

Evidence Table

These uses have been tested in humans or animals. Safety and effectiveness have not always been proven. Some of these conditions are potentially serious, and should be evaluated by a qualified healthcare provider. GRADE *
These uses have been tested in humans or animals. Safety and effectiveness have not always been proven. Some of these conditions are potentially serious, and should be evaluated by a qualified healthcare provider. GRADE *


Pycnogenol? may benefit both children and adults with asthma. More study is needed before a strong conclusion can be made.

 B


Pycnogenol? may benefit both children and adults with asthma. More study is needed before a strong conclusion can be made.

 B


Chronic venous insufficiency (CVI) is a circulation disorder that causes symptoms such as leg swelling, varicose veins, pain, itching, skin changes, and skin ulcers. French maritime pine bark extract has been reported to reduce CVI symptoms such as swelling and pain. Further research is needed.

 B


Chronic venous insufficiency (CVI) is a circulation disorder that causes symptoms such as leg swelling, varicose veins, pain, itching, skin changes, and skin ulcers. French maritime pine bark extract has been reported to reduce CVI symptoms such as swelling and pain. Further research is needed.

 B


Early research suggests that French maritime pine bark extract may help decrease heart disease risk. However, a lack of effect on blood pressure, cholesterol, blood sugar, and inflammation has been reported, though positive effects have been found for other factors. More studies are needed in order to make firm conclusions.

 B


Early research suggests that French maritime pine bark extract may help decrease heart disease risk. However, a lack of effect on blood pressure, cholesterol, blood sugar, and inflammation has been reported, though positive effects have been found for other factors. More studies are needed in order to make firm conclusions.

 B


Pycnogenol? has been studied in both adults and children with ADHD. Although some positive effects have been found, results are conflicting. More research is needed in this area.

 C


Pycnogenol? has been studied in both adults and children with ADHD. Although some positive effects have been found, results are conflicting. More research is needed in this area.

 C


Early research suggests that French maritime pine bark extract during allergy season may decrease allergy symptoms and reduce the need for over-the-counter drugs. More research is needed to determine effects, timing, and dosages.

 C


Early research suggests that French maritime pine bark extract during allergy season may decrease allergy symptoms and reduce the need for over-the-counter drugs. More research is needed to determine effects, timing, and dosages.

 C


Early study suggests that French maritime pine bark extract may improve antioxidant status in children. However, some conflicting evidence exists in adults. Further research is needed before conclusions can be made.

 C


Early study suggests that French maritime pine bark extract may improve antioxidant status in children. However, some conflicting evidence exists in adults. Further research is needed before conclusions can be made.

 C


French maritime pine bark extract may reduce blood clots in smokers. However, available research has generally been of low quality. Further high-quality research is needed.

C


French maritime pine bark extract may reduce blood clots in smokers. However, available research has generally been of low quality. Further high-quality research is needed.

C


Pycnogenol? with or without compression stockings has been suggested for the prevention of deep vein thrombosis (blood clots in the veins) and for management of swelling. However, there is a lack of research in this area. Further study is needed to make firm conclusions.

 C


Pycnogenol? with or without compression stockings has been suggested for the prevention of deep vein thrombosis (blood clots in the veins) and for management of swelling. However, there is a lack of research in this area. Further study is needed to make firm conclusions.

 C


Early evidence suggests that Pycnogenol? may improve cognitive function in healthy, elderly people. More research is needed to confirm this effect.

 C


Early evidence suggests that Pycnogenol? may improve cognitive function in healthy, elderly people. More research is needed to confirm this effect.

 C


A combination of Pycnogenol? and coenzyme Q10 (PycnoQ10) has been studied in people with heart failure. Studies on French maritime pine bark extract alone are lacking. Future research is needed in this area.

 C


A combination of Pycnogenol? and coenzyme Q10 (PycnoQ10) has been studied in people with heart failure. Studies on French maritime pine bark extract alone are lacking. Future research is needed in this area.

 C


French maritime pine bark extract applied to the skin in combination with conventional diabetes treatment may lower blood sugar levels, manage symptoms such as ulcers, and improve blood vessel function in people with type 1 and type 2 diabetes. However, further research is needed.

 C


French maritime pine bark extract applied to the skin in combination with conventional diabetes treatment may lower blood sugar levels, manage symptoms such as ulcers, and improve blood vessel function in people with type 1 and type 2 diabetes. However, further research is needed.

 C


Early research suggests that French maritime pine bark extract may improve symptoms of diabetic blood vessel disease. Further study is needed before a firm conclusion can be made.

 C


Early research suggests that French maritime pine bark extract may improve symptoms of diabetic blood vessel disease. Further study is needed before a firm conclusion can be made.

 C


French maritime pine bark extract may treat, prevent, and slow the progression of retina damage in people with diabetes. Improved vision and reduced swelling have been reported. More evidence is needed to confirm these results.

 C


French maritime pine bark extract may treat, prevent, and slow the progression of retina damage in people with diabetes. Improved vision and reduced swelling have been reported. More evidence is needed to confirm these results.

 C


Pycnogenol?, in combination with L-arginine, may improve erectile dysfunction. Further research is needed.

C


Pycnogenol?, in combination with L-arginine, may improve erectile dysfunction. Further research is needed.

C


Evidence suggests that a combination treatment containing French maritime pine bark extract may reduce eye pressure, an important glaucoma risk factor. Evidence on the effect of French maritime pine bark extract alone is limited. Further research is needed.

 C


Evidence suggests that a combination treatment containing French maritime pine bark extract may reduce eye pressure, an important glaucoma risk factor. Evidence on the effect of French maritime pine bark extract alone is limited. Further research is needed.

 C


Chewing gum containing French maritime pine bark extract may reduce gum bleeding and plaque formation. However, evidence is limited. Further research is needed before a firm conclusion can be made.

 C


Chewing gum containing French maritime pine bark extract may reduce gum bleeding and plaque formation. However, evidence is limited. Further research is needed before a firm conclusion can be made.

 C


Early research suggests that French maritime pine bark extract may reduce symptoms of hemorrhoids when taken by mouth or applied to the skin. Further research is needed.

 C


Early research suggests that French maritime pine bark extract may reduce symptoms of hemorrhoids when taken by mouth or applied to the skin. Further research is needed.

 C


French maritime pine bark extract may reduce blood pressure and reduce the need for conventional medication in people with high blood pressure. However, results are conflicting. More study is needed before a conclusion can be made.

 C


French maritime pine bark extract may reduce blood pressure and reduce the need for conventional medication in people with high blood pressure. However, results are conflicting. More study is needed before a conclusion can be made.

 C


French maritime pine bark extract may lower levels of LDL or "bad" cholesterol, and increase levels of HDL or "good" cholesterol. However, there are mixed results. Further research is needed.

C


French maritime pine bark extract may lower levels of LDL or "bad" cholesterol, and increase levels of HDL or "good" cholesterol. However, there are mixed results. Further research is needed.

C


French maritime pine bark extract may have a protective effect on kidney function. More research is needed to confirm these findings.

 C


French maritime pine bark extract may have a protective effect on kidney function. More research is needed to confirm these findings.

 C


French maritime pine bark extract may improve sperm quality in men with fertility problems. Other research on Pycnogenol? in combination supplements showed similar results. However, more research is needed before a conclusion can be made.

 C


French maritime pine bark extract may improve sperm quality in men with fertility problems. Other research on Pycnogenol? in combination supplements showed similar results. However, more research is needed before a conclusion can be made.

 C


French maritime pine bark extract may improve menopause symptoms and cholesterol levels in menopausal women. However, results are conflicting. More research is needed.

 C


French maritime pine bark extract may improve menopause symptoms and cholesterol levels in menopausal women. However, results are conflicting. More research is needed.

 C


French maritime pine bark extract may relieve menstrual pain. However, further research is needed before any firm conclusions can be made.

 C


French maritime pine bark extract may relieve menstrual pain. However, further research is needed before any firm conclusions can be made.

 C


A combination product containing pine bark extract, vitamin C, and vitamin E may improve migraines. However, it is not possible to determine the effect of Pycnogenol? alone based on these results. More research is needed before conclusion can be made.

 C


A combination product containing pine bark extract, vitamin C, and vitamin E may improve migraines. However, it is not possible to determine the effect of Pycnogenol? alone based on these results. More research is needed before conclusion can be made.

 C


French maritime pine bark extract may improve muscle cramps in healthy people and in those with diabetic blood vessel disease. More research is needed in this area.

 C


French maritime pine bark extract may improve muscle cramps in healthy people and in those with diabetic blood vessel disease. More research is needed in this area.

 C


French maritime pine bark extract may reduce symptoms and inflammation in people with osteoarthritis. However, evidence is limited. More research is needed.

 C


French maritime pine bark extract may reduce symptoms and inflammation in people with osteoarthritis. However, evidence is limited. More research is needed.

 C


French maritime pine bark extract may reduce pain during the third trimester of pregnancy. Further study is needed.

 C


French maritime pine bark extract may reduce pain during the third trimester of pregnancy. Further study is needed.

 C


Early studies suggest that French maritime pine bark extract treatment may prevent blood clots in the veins during long flights. Swelling may also be reduced. Further research is needed to in this area.

 C


Early studies suggest that French maritime pine bark extract treatment may prevent blood clots in the veins during long flights. Swelling may also be reduced. Further research is needed to in this area.

 C


Supplementing with French maritime pine bark extract may benefit people who have ringing in the ears. However, further study is needed in this field.

 C


Supplementing with French maritime pine bark extract may benefit people who have ringing in the ears. However, further study is needed in this field.

 C


Early research suggests that French maritime pine bark extract may improve skin hydration and elasticity. Higher-quality research is needed before conclusions can be made.

 C


Early research suggests that French maritime pine bark extract may improve skin hydration and elasticity. Higher-quality research is needed before conclusions can be made.

 C


French maritime pine bark extract may benefit people who have skin diseases, including pigmentation problems. Further research is needed before conclusions can be made.

 C


French maritime pine bark extract may benefit people who have skin diseases, including pigmentation problems. Further research is needed before conclusions can be made.

 C


Melasma is a disorder in which dark patches form on skin that is exposed to sunlight. French maritime pine bark extract may reduce skin darkening and improve the associated symptoms of fatigue, constipation, body pains, and anxiety. Further research is needed before a clear conclusion can be made.

 C


Melasma is a disorder in which dark patches form on skin that is exposed to sunlight. French maritime pine bark extract may reduce skin darkening and improve the associated symptoms of fatigue, constipation, body pains, and anxiety. Further research is needed before a clear conclusion can be made.

 C


French maritime pine bark extract, taken by mouth, may reduce skin redness caused by sunlight. More research is needed before a firm conclusion can be made.

 C


French maritime pine bark extract, taken by mouth, may reduce skin redness caused by sunlight. More research is needed before a firm conclusion can be made.

 C


There is some evidence of swelling improvement in people supplemented with French maritime pine bark extract. However, more research is needed before any conclusion can be made.

 C


There is some evidence of swelling improvement in people supplemented with French maritime pine bark extract. However, more research is needed before any conclusion can be made.

 C


French maritime bark extract may be useful as a second line therapy to reduce inflammation associated with SLE. More research is needed in this field.

 C


French maritime bark extract may be useful as a second line therapy to reduce inflammation associated with SLE. More research is needed in this field.

 C


A combination treatment containing French maritime pine bark extract may help reduce symptoms of lower urinary tract infection. More research is needed on the possible benefit of pine bark extract alone.

 C


A combination treatment containing French maritime pine bark extract may help reduce symptoms of lower urinary tract infection. More research is needed on the possible benefit of pine bark extract alone.

 C


French maritime pine bark extract may benefit people who have venous leg ulcers (a type of wound common in older people). Research to date, however, has been limited. Further research is needed before a firm conclusion can be made.

 C


French maritime pine bark extract may benefit people who have venous leg ulcers (a type of wound common in older people). Research to date, however, has been limited. Further research is needed before a firm conclusion can be made.

 C
* Key to grades

A: Strong scientific evidence for this use
B: Good scientific evidence for this use
C: Unclear scientific evidence for this use
D: Fair scientific evidence for this use (it may not work)
F: Strong scientific evidence against this use (it likley does not work)
* Key to grades

A: Strong scientific evidence for this use
B: Good scientific evidence for this use
C: Unclear scientific evidence for this use
D: Fair scientific evidence for this use (it may not work)
F: Strong scientific evidence against this use (it likley does not work)

Tradition / Theory

The below uses are based on tradition, scientific theories, or limited research. They often have not been thoroughly tested in humans, and safety and effectiveness have not always been proven. Some of these conditions are potentially serious, and should be evaluated by a qualified healthcare provider. There may be other proposed uses that are not listed below.

Dosing

Adults (18 years and older)
Note: Due to occasional minor stomach discomfort and bad taste, it is often recommended that Pycnogenol? be taken with or after food.
For allergy, 50 milligrams of Pycnogenol? have been taken by mouth twice daily for up to eight weeks before allergy season.
For antioxidant effects, 1 milligram per kilogram or 150-360 milligrams of Pycnogenol? has been taken by mouth daily for up to three months.
For asthma, 1 milligram per pound of Pycnogenol? (maximum of 200 milligrams daily) has been taken by mouth as a single dose or twice daily for four weeks to three months.
For ADHD, 1 milligram per pound of Pycnogenol? has been taken by mouth daily for three weeks.
For heart disease prevention, 150-200 milligrams of Pycnogenol? have been taken by mouth in single or three divided doses for 4-8 weeks.
For cognitive function, 150 milligrams of Pycnogenol? have been taken by mouth daily for three months.
For circulation problems (chronic venous insufficiency), 50-360 milligrams of Pycnogenol? have been taken by mouth daily in divided doses for 1-2 months.
For diabetes, 100-150 milligrams of Pycnogenol? have been taken by mouth daily for 6-12 weeks. A dose of 100 milligrams of Pycnogenol? has been applied to the skin with or without 150 milligrams of Pycnogenol? taken by mouth daily for six weeks.
For diabetic blood vessel disease, 50 milligrams of Pycnogenol? has been taken by mouth three times daily for four weeks. A dose of 150 milligrams of Pycnogenol? has been taken by mouth daily with or without applying 100 milligrams to the skin daily.
For menstrual pain, 30 milligrams of Pycnogenol? in 1-2 capsules has been taken by mouth twice daily, beginning on the eighth day of the first or second menstrual cycle and continued until the seventh day of the third or fourth menstrual cycle.
For swelling, 360 milligrams of Pycnogenol? have been taken by mouth for six days.
For erectile dysfunction, 120 milligrams of Pycnogenol? have been taken by mouth daily for three months.
For gum bleeding and plaque, 5 milligrams of Pycnogenol? (in the form of six pieces of chewing gum) have been taken by mouth daily for 14 days.
For hemorrhoids, six tablets of 50 milligrams of Pycnogenol? have been taken by mouth daily for four days, followed by three 50 milligram tablets for three days. A 0.5 percent Pycnogenol? cream has been applied in combination with Pycnogenol? taken by mouth.
For high cholesterol, 360 milligrams of Pycnogenol? have been taken by mouth daily for four weeks.
For high blood pressure, 100-200 milligrams of Pycnogenol? have been taken by mouth daily in single or up to four divided doses for 8-12 weeks, with or without nifedipine.
For male infertility, 200 milligrams of Pycnogenol? have been taken by mouth daily for 90 days.
For skin pigmentation disorders (melasma), a 25 milligram tablet of Pycnogenol? has been taken with meals three times daily for 30 days.
For menopause, 30-200 milligrams of Pycnogenol? have been taken by mouth in single or divided doses daily for up to six months.
For muscle cramps, 50 milligrams of Pycnogenol? have been taken by mouth four times daily for four weeks.
For osteoarthritis, 100-150 milligrams of Pycnogenol? have been taken by mouth daily for three months.
For blood clotting disorders, 200 milligrams of Pycnogenol? have been taken by mouth daily for 4-8 weeks.
For pelvic pain in pregnancy, 30 milligrams of Pycnogenol? have been taken by mouth daily during the third trimester.
For the prevention of blood clots during long airplane flights, two 100 milligram Pycnogenol? capsules have been taken 2-3 hours before flying with 250 milliliters of water, followed by two 100 milligram Pycnogenol? capsules taken six hours later with 250 milliliters of water, and one 100 milligram Pycnogenol? capsule taken the next day.
For retina damage, 50 milligrams of Pycnogenol? have been taken by mouth three times daily for two months.
For skin diseases, 25 milligrams of Pycnogenol? have been taken by mouth three times daily for one month.
For sunburn, 1.1 milligrams of Pycnogenol? per kilogram of body weight have been taken by mouth daily for the first four weeks, followed by 1.66 milligrams per kilogram daily for the next four weeks.
For chronic inflammation (systemic lupus erythematosus), 120 milligrams of Pycnogenol? have been taken by mouth daily for 30 days, followed by 60 milligrams daily for 30 days.
For venous leg ulcers, 50 milligrams of Pycnogenol? have been taken by mouth three times daily along with Pycnogenol? powder applied to the skin for six weeks.

Safety

The U.S. Food and Drug Administration does not strictly regulate herbs and supplements. There is no guarantee of strength, purity or safety of products, and effects may vary. You should always read product labels. If you have a medical condition, or are taking other drugs, herbs, or supplements, you should speak with a qualified healthcare provider before starting a new therapy. Consult a healthcare provider immediately if you experience side effects.

Interactions

Interactions with Drugs
French maritime pine bark extract may increase the risk of bleeding when taken with drugs that increase the risk of bleeding. Some examples include aspirin, anticoagulants ("blood thinners") such as warfarin (Coumadin?) or heparin, anti-platelet drugs such as clopidogrel (Plavix?), and non-steroidal anti-inflammatory drugs such as ibuprofen (Motrin?, Advil?) or naproxen (Naprosyn?, Aleve?).
French maritime pine bark extract may lower blood sugar levels. Caution is advised when using medications that may also lower blood sugar. People taking drugs for diabetes by mouth or insulin should be monitored closely by a qualified healthcare professional, including a pharmacist. Medication adjustments may be necessary.
French maritime pine bark extract may cause low blood pressure. Caution is advised in people taking drugs that lower blood pressure.
French maritime pine bark extract may also interact with agents that affect the immune system, agents that improve breathing, alcohol, anti-androgens, antibiotics, anticancer agents, antifungals, antihistamines, anti-inflammatory agents, aspirin, calcium channel blockers, central nervous system (CNS) stimulants, cholesterol-lowering agents, fertility agents, fluoride, inotropes, radioactive agents, pain relievers, and phosphodiesterase inhibitors.

Attribution

This information is based on a systematic review of scientific literature edited and peer-reviewed by contributors to the Natural Standard Research Collaboration (www.naturalstandard.com).

Bibliography

Aoki H, Nagao J, Ueda T, et al. Clinical assessment of a supplement of Pycnogenol(R) and L-arginine in Japanese patients with mild to moderate erectile dysfunction. Phytother.Res. 2012;26(2):204-207.
Belcaro G, Luzzi R, Cesinaro Di Rocco P, et al. Pycnogenol(R) improvements in asthma management. Panminerva Med. 2011;53(3 Suppl 1):57-64.
Clark CE, Arnold E, Lasserson TJ, et al. Herbal interventions for chronic asthma in adults and children: a systematic review and meta-analysis. Prim.Care Respir.J. 2010;19(4):307-314.
D'Andrea G. Pycnogenol: a blend of procyanidins with multifaceted therapeutic applications? Fitoterapia 2010;81(7):724-736.
Dvorakova M, Paduchova Z, Muchova J, et al. How does pycnogenol(R) influence oxidative damage to DNA and its repair ability in elderly people? Prague.Med.Rep. 2010;111(4):263-271.
Errichi BM, Belcaro G, Hosoi M, et al. Prevention of post thrombotic syndrome with Pycnogenol(R) in a twelve month study. Panminerva Med. 2011;53(3 Suppl 1):21-27.
Errichi S, Bottari A, Belcaro G, et al. Supplementation with Pycnogenol(R) improves signs and symptoms of menopausal transition. Panminerva Med. 2011;53(3 Suppl 1):65-70.
Furumura M, Sato N, Kusaba N, et al. Oral administration of French maritime pine bark extract (Flavangenol((R))) improves clinical symptoms in photoaged facial skin. Clin.Interv.Aging 2012;7:275-286.
Henrotin Y, Lambert C, Couchourel D, et al. Nutraceuticals: do they represent a new era in the management of osteoarthritis? - a narrative review from the lessons taken with five products. Osteoarthritis.Cartilage. 2011;19(1):1-21.
Kohama T, Negami M. Effect of Low-dose French Maritime Pine Bark Extract on Climacteric Syndrome in 170 Perimenopausal Women: A Randomized, Double-blind, Placebo-controlled Trial. J Reproductive Med 2013;58(1):39-47.
Luzzi R, Belcaro G, Zulli C, et al. Pycnogenol(R) supplementation improves cognitive function, attention and mental performance in students. Panminerva Med. 2011;53(3 Suppl 1):75-82.
Maimoona A, Naeem I, Saddiqe Z, et al. A review on biological, nutraceutical and clinical aspects of French maritime pine bark extract. J.Ethnopharmacol. 1-27-2011;133(2):261-277.
Marini A, Grether-Beck S, Jaenicke T, et al. Pycnogenol(R) effects on skin elasticity and hydration coincide with increased gene expressions of collagen type I and hyaluronic acid synthase in women. Skin Pharmacol.Physiol 2012;25(2):86-92.
Ohkita M, Kiso Y, and Matsumura Y. Pharmacology in health foods: improvement of vascular endothelial function by French maritime pine bark extract (Flavangenol). J.Pharmacol.Sci. 2011;115(4):461-465.
Schoonees A, Visser J, Musekiwa A, et al. Pycnogenol((R)) for the treatment of chronic disorders. Cochrane.Database.Syst.Rev. 2012;2:CD008294.