Herbal Treatment for Varicose Veins

by Mindy Green

In the body, blood pumps from the heart via arteries and returns back to the heart through veins. Down
in the legs, venous blood must work against gravity; to prevent backflow, intermittent valves open for the
blood and close behind it. A vein becomes varicose when valves break down or weaken, thereby putting
more pressure on other valves. This can cause a cycle of damage that tends to increase with time.
When valves no longer prevent backflow of venous blood, the abnormal pressure inflames the veins,
blood pools, and veins become permanently dilated.

More than half the middle-age population in the United States has enlarged, twisted or bluish varicose
veins. For reasons not wholly known, the condition occurs about four times more frequently in women
than in men.1

The underlying causes of varicose veins are multifaceted and can include pregnancy and chronic
constipation, both of which can increase venous pressure in the legs and lead to varicose veins.
Overweight individuals who have less muscle and tissue tone are more likely to have weakened vein
walls. Other factors are a hereditary predisposition, a lack of exercise and age. All these can be
compounded by a lack of muscle tone and degenerative changes in supporting connective tissue.
People in service positions who must stand on their feet for hours are most affected because their work
conditions increase venous pressure.

Most varicosities are close to the skin's surface and, though they are not a severe threat to health, may
hint at chronic circulatory problems. If ignored, they can become painful. Spider-web veins are tiny,
dilated blood vessels just under the skin. They don't bulge like varicose veins and, though unsightly, are
harmless. Deeper varicose veins can lead to stroke, heart problems or thrombophlebitis, a vein
inflammation in conjunction with an obstructive blood clot formation.

Varicose veins are not confined to the legs. Hemorrhoids are varicose veins in the rectum and are much
more common, frequently affecting pregnant women because of the extra pressure and weight in the
perineal area.

If a customer is concerned about varicose veins, you can recommend a number of healing herbs. The
herbs can be even more effective when integrated with appropriate dietary and lifestyle changes. Some
examples include increasing dietary fiber intake to prevent constipation, raising the legs for 10-minute
intervals throughout the day to relieve pressure and pain on the varicosities, and raising the foot of the
bed one to three inches to relieve pressure at night.

Phytotherapy
Teas or tinctures can be taken internally three to four times a day to help heal varicose veins from the
inside. The actions of the medicinal plants listed here can increase vein elasticity, reduce blood-vessel
fragility, stimulate circulation and reduce water retention.

Horse chestnut (Aesculus hippocastanum) strengthens blood vessels and is an effective astringent that
tones and tightens tissues.2 The herb reduces capillary fragility and swelling by regulating capillary
permeability, and it helps strengthen and repair blood vessels that have lost their elasticity.3

The shiny brown fruits of this ornamental shade tree have a long history of treating varicose veins. As is
the case with many herbs, horse chestnut's historical uses are being affirmed by modern research, and
now some animal, clinical and in vitro studies give evidence of the herb's benefit.4

At least two classes of compounds in horse chestnut, aesculin and aescin, may affect circulation. Both
are coumarin glycosides; coumarins slow the onset of blood coagulation and are found in more than 150
species of medicinal plants.

Aesculin thins blood and improves blood viscosity, so is thought to be endowed with vascular-protective
properties.5
Aescin is a complex mixture of saponins, which are soaplike agents found in plants such as potatoes
and beans that foam when cooked. Saponin compounds reduce the surface tension of liquids, and
aescin itself increases the permeability of the inner vascular walls, making it easier for tissue fluids to
drain into capillaries. Aescin, present at up to 13 percent in horse chestnut, is reported to have anti-
inflammatory, anti-swelling and anti-exudative (oozing of fluids) properties.5 Rutin, the key flavonoid in
buckwheat, and other flavonoids have long been used to treat weak capillaries and veins—and aescin is
300 times more potent than rutin.6

Commercial extracts of aescin from horse chestnut seeds also have been shown to reduce excessive
clotting. Researchers at Bastyr University in Kenmore, Wash., conducted a double-blind, randomized,
single-dose trial on 71 healthy individuals to assess the effects of a topical 2 percent aescin gel on
experimentally induced bruises (broken blood vessels). The aescin gel reduced inflammation and
tenderness in all cases over the recorded 10-hour period.7

Horse chestnut is most often used as a tincture rather than a tea and can be applied externally. It is also
sold in a massage oil. The tincture and the massage oil can be combined with essential oils (see
sidebar).

Horse chestnut is a fairly toxic herb that can cause vomiting and sometimes paralysis. However,
cautionary notes on the internal use of this herb are conflicting. Although horse chestnut is often
included in References on poisonous plants, it has high therapeutic value with low acute and chronic
toxicities noted, except in children, who don't normally have varicose veins anyway. Nevertheless, this
tincture should be used carefully when taken internally because the potency of commercial preparations
varies widely. Some German pharmaceutical companies offer compounds specifically for internal use,
often in combination with supportive herbs or nutritional substances including vitamins B and C. Since
strengths and formulations vary, it is best to follow the recommended dosage on the label. Pregnant
women should consult their health care practitioners before taking horse chestnut products, though the
external use of gels, ointments, teas or tinctures poses no harm. Customers already using prescription
anticoagulant medications should consult their health care practitioners because horse chestnut is also
a weak blood thinner.

Butcher's broom (Ruscus aculeatus) has been used historically to treat varicose veins because it is
believed to improve vein tone and encourage blood flow. Research shows that both internal and topical
applications may improve symptoms of poor circulation such as blood pooling in the legs, swelling and
constricted blood vessels. The pharmacological activity is attributed to steroidal saponins, mainly the
sugar-derivative glycosides called ruscogenin and neoruscogenin, which have vasoconstricting and anti-
inflammatory effects.

In a double-blind clinical trial of 20 healthy people, a combination of ruscus extract and the flavonoid
hesperidine improved the tone of varicose vein walls; the herb also reduced foot swelling.8

A double-blind, placebo-controlled, crossover study was conducted on 30 females and 10 males

between the ages of 28 and 74. The trial involved two treatment periods of two months, with a 15-day
washout period. Participants took two capsules three times a day. Each capsule contained either
placebo or 16.5 mg Ruscus aculeatus extract, 75 mg hesperidine and 50 mg vitamin C—a daily total of
99 mg ruscus, 450 mg hesperidine and 300 mg vitamin C. Researchers noted a significant decrease in
swelling in the supplement group.9

A tea or tincture of butcher's broom can be taken internally up to three times a day, or applied directly.
Internal use should be avoided by pregnant women.

Other astringent herbs include white oak (Quercus alba) bark and witch hazel (Hamamelis virginiana).
The healing and anti-inflammatory actions of calendula (Calendula officinalis) are also well suited for
treating varicose veins. These herbs can be taken as teas and used in sitz baths or used as compresses
with a few drops of the essential oils added for their synergistic effects. A salve can be made of any of
these herbs for treating hemorrhoids.

Other herbs stimulate peripheral circulation, thereby aiding blood flow in the legs. These include ginkgo
(Ginkgo biloba), ginger (Zingiber officinalis), cayenne (Capsicum frutescens), and prickly ash
(Zanthoxylum americanum). Garlic (Allium sativum), either fresh cloves or odorless standardized
capsules, and bromelain from pineapple both contain enzymes that improve circulation by dissolving
blood vessel fibrin that forms lumpy deposits around the veins.10-11 If water retention causes ankle or leg
swelling, a diuretic such as dandelion (Taraxacum officinale) or yarrow (Achillea millefolium) is also
helpful. Hawthorn (Crataegus spp.) is said to improve circulation by safely toning the heart muscle.
Hawthorn also contains proanthocyanidins and anthocyanidins, which increase capillary strength and
tone veins.12-14

Liver tonic and cleansing herbs such as Oregon grape (Berberis aquifolium), milk thistle (Silybum
marianum), dandelion and burdock (Arctium lappa) are important for varicose vein treatment. A popular
remedy is yellow dock (Rumex crispus); though not for varicose veins specifically, it is a helpful liver
tonic and cleanser, and is a safe, mild laxative.

Finally, nonherbal methods can also ease the discomfort of varicose veins. Sitz baths (for
hemorrhoids) or hot and cold compresses (for varicose veins in the legs) often provide the greatest
immediate pain relief. Hot and cold water added to a bath in one- to three-minute intervals improves
circulation and helps decongest the veins. Compression stockings also relieve the pain of varicose
veins, but the stockings themselves can be a nuisance. Also, using a slantboard to raise the legs above
the level of the head for 10-minute intervals several times a day can bring relief.

Even though chronic venous insufficiency is one of the more common health conditions of the adult
population, it's nice to know nature offers effective remedies for its treatment.

Sidebars:
Essential Oils Soothe Varicosities

Mindy Green has 26 years of herbal experience and is director of educational services at the
Herb Research Foundation and a faculty member at the Rocky Mountain Center for Botanical
Studies, both in Boulder, Colo. She is author of Calendula (Keats, 1998).