Given the right combination of factors, even the most health-conscious person can get varicose veins. The condition may occur in almost any part of the body, but it’s most common in the lower extremities. It can be caused by anything that restricts circulation: pregnancy, obesity, and smoking, as well as sitting, standing, or crossing the legs at the knees for prolonged periods. Other contributing factors include genetics, a low-fiber diet, and a breakdown of capillary structure. Symptoms range from pain in the feet and ankles to swelling, skin ulcerations, and severe bleeding if the vein is injured.
Treatment focuses on increasing circulation and strengthening connective tissue. Wearing elastic stockings and elevating the legs above the level of the head often relieve the congested feeling of varicose veins, though only temporarily. But a program of exercise, proper diet, and herbs can make a big difference in long-term health. Exercise, in particular, increases circulation and strengthens the action of the venous valves. It helps improve muscle function around the vein, which in turn helps tighten and support the blood vessels.
Prior to any self-treatment, consult your doctor to rule out hidden conditions such as deep blood clots.
Flavonoids: Circulation enhancers
Most herbal treaments for varicose veins include flavonoids, compounds that aid the circulatory system and strengthen capillaries. Flavonoids are pigments found in herbs and plants; they’re responsible for the intense colors you see in autumn leaves, brightly colored flowers, and dark colored fruits. Including more of them in your diet will help. Follow label instructions for herbal products or use a tablespoon or so of the bulk herb to make a tea.
Flavonoid-rich foods: cherries, rose hips, blackberries, apricots, buckwheat, bell peppers, onions, asparagus, brussels sprouts, apples, pears, and the thin inner layer of citrus rinds.
Flavonoid-rich herbs: hawthorn (Crataegus spp.), ginkgo (Ginkgo biloba), German chamomile (Matricaria recutita), calendula (Calendula officinalis), and bilberry (Vaccinium myrtillus).
Horse chestnut: Vein strengthener
Horse chestnut (Aesculus hippocastanum) products (including both oral and topical dosage forms) are the single most widely prescribed remedy in Germany for edema with chronic venous insufficiency (CVI)—a condition sometimes associated with varicose veins. At least thirteen placebo-controlled, double-blind studies published between 1973 and 1996 show that oral standardized horse chestnut relieves CVI.
Horse chestnut extracts help veins withstand damage, reduce capillary-wall permeability, and prevent absorption of damaging UV radiation. A compound in the extracts called aescin (or escin) helps seal tiny openings in capillary walls, reducing the outflow of fluid into surrounding tissue.
Studies show the extracts reduced leg edema, improved vascular tone, and lessened subjective symptoms such as a feeling of heaviness in the legs, nighttime calf muscle spasms, itching, and swelling. Most trials used an oral dose of 600 mg of an extract a day, containing 100 mg a day of aescin. Topical products are not absorbed systemically; they do, however, absorb into the tissues on which they’re directly applied. Follow label instructions for topical products.
Standardized horse chestnut oral and topical products (capsules or tablets) are available in the United States.
Caution: Use only standardized, manufactured products; the crude herb may be toxic.
In rare instances, internal use may cause stomach upset, nausea, and itching. Controlled-release dosage forms reduce the chance of stomach upset. It may also make aspirin and other blood thinners more potent, so avoid mixing with those medications. No other contraindications or interaction with other drugs are known.
Other Herbal Treatments
If you have ever steeped tea too long or tasted a particularly dry wine, you know the tight, puckering feeling of tannins in your mouth. Tannins tighten and constrict tissues, which is useful for treating varicose veins. Astringent herbs such as witch hazel (Hamamelis virginiana) are high in tannins. They constrict blood vessels and can reduce inflammation and swelling. Tinctures of witch hazel contain tannins specific to an external application on varicose veins and can be used in poultice or lotion form.
Butcher’s broom (Ruscus aculeatus) has been used for varicose veins because it reduces inflammation and constricts dilated blood vessels. Don’t use this herb if you have high blood pressure. A standard daily dose is 300 mg of a dried extract, containing 7 to 11 mg of total ruscogenin.
Terri Merriken is the executive director of the National College of Phytotherapy and director of the New Mexico Herb Center in Albuquerque. Herbs for Health lead editorial adviser Steven Foster contributed research to this article.