A lot of patients are apprehensive about surgery for varicose veins, even with the recent advances in surgical techniques, and would prefer to treat their veins with medications, preferably ‘natural’ methods rather than by prescription drugs.
There are several different medications that can be used to treat the symptoms that varicose veins cause – some of these compounds have actually been studied and there is some scientific evidence to suggest that some of them do have a beneficial effect on the vein circulation.
Although no drugs or herbal remedies can naturally repair the failed valves in the vein system, the use of some compounds may help with the aching, swelling and discomfort seen in vein trouble. Such drugs are referred to as ‘veno active’ compounds – in other words drugs that have an effect on the veins.
The effects of venoactive drugs are thought to fall into a number of different categories or mechanisms of action – effects on the swelling and inflammation caused by high vein pressure, improvements in the vein ‘tone’ or integrity of the vein wall and changes in the ‘stickiness’ of the blood to make it flow through the veins more easily.
Horse chestnut extract is a commonly used natural treatment for varicose veins and chronic venous insufficiency, a related condition.
Horse chestnut is thought to contain an active compound called Aescin, which appears to block the release of enzymes that damage vein walls.
In 2006, the Cochrane Collaboration (an international medical experts review body) reviewed studies comparing the use of oral horse chestnut extract or placebo for patients with chronic venous insufficiency.
Horse chestnut extract was reported as showing a significant reduction in leg pain and swelling compared with a placebo in patients with venous insufficiency.
Another set of compounds derived from plant extracts are the flavinoids. These chemicals are found in a variety of plants such as St Johns Wort and witch hazel. It is thought that flavinoids have an effect on the vein wall to increase the tone within the vessel as well as anti-inflammatory effects on the tissue around the veins. Flavanoid extract has been concentrated into a drug called Daflon 500, which is quite often used, in other European countries to treat the effects of chronic varicose veins. Several studies have reported a beneficial effect on leg swelling and inflammation using Daflon vs. Placebo and, venous ulcers treated with compression may heal up faster if Daflon is used as an additional treatment. Another drug, which demonstrated similar effects in speeding up the healing of venous ulcers, is calcium dobesilate.
Several other plants contain anti-inflammatory compounds that have pain relieving effects such as aspirin, which is derived from the willow bark plant salix (aspirins medical name is salicylic acid) – extracts of willow bark have been used to treat vein symptoms for many years – either as pills or as creams to rub on topically.
It should be remembered that many plants contain compounds such as flavinoids or Aescin in varying quantities, so several herbal remedies may be expected to show some effect on the symptoms of varicose veins – a lot of ‘modern’ drugs are derived from plant extracts, where the active ingredient of the plant has been identified, purified and concentrated for use as a drug – a herbal remedy is not necessarily ‘better’ than the concentrated equivalent – they may very well be the same thing but wrapped up in different packaging!
In the final analysis however, despite some evidence of benefit for drugs of this nature, most vein specialist agree that the best and most definitive treatment for varicose veins is a surgical approach by minimally invasive means. Drugs and herbal type remedies may be of benefit as an adjunct to surgery but are unlikely to replace it in the longer term.
Eddie Chaloner, a consultant vascular surgeon from Radiance Health in London, wrote this post. Eddie treats over 600 people a year using the latest minimally invasive techniques for the treatment of varicose veins, thread veins, spider veins, and deep vein thrombosis.