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Varicose Veins


Standing up or sitting down for long spells can cause the veins in your legs to bulge and become more visible. According to research or other evidence, the following self-care steps may help you care for your vital vessels:

What you need to know

  • Try a beneficial flavonoid
  • Take 1,000 mg a day of hydroxyethylrutoside to reduce the size of varicose veins associated with pregnancy
  • Compress and elevate
  • Relieve the symptoms of varicose veins by wearing compression stockings and elevating your legs frequently
  • Get a checkup
  • Visit your healthcare provider to find out if your varicose veins may be the result of a more serious venous condition

These recommendations are not comprehensive and are not intended to replace the advice of your doctor or pharmacist. Continue reading the full varicose veins article for more in-depth, fully-referenced information on medicines, vitamins, herbs, and dietary and lifestyle changes that may be helpful.

About varicose veins

Varicose veins are twisted, enlarged veins close to the surface. They can occur almost anywhere but most commonly occur in the esophagus and the legs.

Veins, which return blood to the heart, contain valves that keep blood from flowing backward as a result of gravity. When these valves become weak, blood pools in the veins of the legs and causes them to bulge. These enlarged vessels are called varicose veins. Standing and sitting for long periods of time, lack of exercise, obesity, and pregnancy all tend to promote the formation of varicose veins. Sometimes varicose veins are painful, but elevating the affected leg usually brings significant relief.

Product ratings for varicose veins

Science Ratings Nutritional Supplements Herbs

Flavonoids (hydroxyethylrutosides)


Butcher’s broom

Gotu kola

Horse chestnut

Witch hazel

See also:  Homeopathic Remedies for Varicose Veins
3Stars Reliable and relatively consistent scientific data showing a substantial health benefit.
2Stars Contradictory, insufficient, or preliminary studies suggesting a health benefit or minimal health benefit.
1Star For an herb, supported by traditional use but minimal or no scientific evidence. For a supplement, little scientific support and/or minimal health benefit.

What are the symptoms?

Symptoms of varicose veins may include a dull pain, itch, or heavy sensation in the legs. The sensation is worse after prolonged standing and better when the legs are elevated. Varicose veins typically appear on the legs as dilated, tortuous veins close to the surface of the skin, and may look blue. Advanced varicose veins may cause ankle and leg swelling or skin ulcers.

Medical options

Other treatment is to elevate the legs frequently, avoid prolonged standing or sitting, and wear compression stockings with supportive shoes. Other treatments include surgery to remove the vein, laser therapy, and sclerotherapy, which involves the injection of a chemical solution into the vein to cause it to close. Any skin ulcers that develop are treated with compressive bandages that contain antibiotic solutions.

Lifestyle changes that may be helpful

Keeping the legs elevated relieves pain. People with varicose veins should avoid sitting or standing for prolonged periods of time and should walk regularly.

Vitamins that may be helpful

A controlled clinical trial found that oral supplementation with hydroxyethylrutosides (HR), a type of flavonoid that is derived from rutin, improved varicose veins in a group of pregnant women.1 Further research is needed to confirm the benefits observed in this preliminary trial. A typical amount of HR is 1000 mg per day.

A small, preliminary trial found that supplementation with 150 mg of proanthocyanidins per day improved the function of leg veins after a single application in people with widespread varicose veins.2 Double-blind trials are needed to determine whether extended use of proanthocyanidins can substantially improve this condition.

Are there any side effects or interactions?
Refer to the individual supplement for information about any side effects or interactions.

Herbs that may be helpful

Although witch hazel is known primarily for treating hemorrhoids, it may also be useful for varicose veins.3 Topical use of witch hazel to treat venous conditions is approved by the German Commission E, authorities on herbal medicine.4 Application of a witch hazel ointment three or more times per day for two or more weeks is necessary before results can be expected.

Horse chestnut seed extract can be taken orally or used as an external application for disorders of venous circulation, including varicose veins.5 Preliminary studies in humans have shown that 300 mg three times per day of a standardized extract of horse chestnut seed reduced the formation of enzymes thought to cause varicose veins.6 Topical gel or creams containing 2% aescin can be applied topically three or four time per day to the affected limb(s).

Oral supplementation with butcher’s broom7 or gotu kola8 may also be helpful for varicose veins.

Are there any side effects or interactions?
Refer to the individual herb for information about any side effects or interactions.


1. Sohn C, Jahnichen C, Bastert G. [Effectiveness of beta-hydroxyethylrutoside in patients with varicose veins in pregnancy]. Zentralbl Gynakol 1995;117:190–7 [in German].

2. Royer RJ, Schmidt CL. [Evaluation of venotropic drugs by venous gas plethysmography. A study of procyanidolic oligomers]. Sem Hop 1981;57:2009–13 [in French].

3. European Scientific Cooperative on Phytotherapy. Hamamelidis folium (Hamamelis leaf). ESCOP Monographs on the Medicinal Uses of Plant Drugs. Exeter, UK: ESCOP, 1997.

4. Blumenthal M, Busse WR, Goldberg A, et al. (eds). The Complete German Commission E Monographs: Therapeutic Guide to Herbal Medicines. Austin, TX: American Botanical Council and Boston: Integrative Medicine Communications, 1998, 231.

5. Blumenthal M, Busse WR, Goldberg A, et al. (eds). The Complete German Commission E Monographs: Therapeutic Guide to Herbal Medicines. Austin, TX: American Botanical Council and Boston: Integrative Medicine Communications, 1998, 149.

6. Kreysel HW, Nissen HP, Enghofer E. A possible role of lysosomal enzymes in the pathogenesis of varicosis and the reduction in their serum activity by Venostasin. Vasa 1983;12:377–82.

7. Capelli R, Nicora M, Di Perri T. Use of extract of Ruscus aculeatus in venous disease in the lower limbs. Drugs Exp Clin Res 1988;14:277–83.

8. Brinkhaus B, Linder M, Schuppan D, Hahn EG. Chemical, pharmacological and clinical profile of the East Asian medical plant Centella asiatica. Phytomed 2000;7:427–48.

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