The hot season brings back swelling and a feeling of tightness in the legs for many varicose vein patients. It's easy to be tempted to reach for vein creams and vein tablets instead of the unloved compression stockings. But is this really sensible and healthy?
The good news first:
Vein creams and tablets certainly contain effective active ingredients!
A distinction must be made between the following active ingredients
- toning the blood vessels, i.e. constricting and
- oedema-protective ingredients, i.e. ingredients that counteract the escape of water into the tissue.
Both of these are a perfectly sensible mechanism of action in varicose vein disease: the diseased vein is dilated and the vein becomes smaller again by strengthening the muscles of the vein wall. Secondly, in varicose vein disease, the increased pressure in the diseased vein leads to water leaking through the vein wall into the surrounding tissue and thus to swelling in the ankle area. Protective active substances seal the cell walls of the vein wall so that this fluid leakage from the vein into the surrounding tissue is made more difficult or even stopped completely.
Which active ingredients are contained in vein creams and tablets?
According to the two mechanisms mentioned above, a distinction is made between active ingredients with a venous toning function - above all horse chestnut, butcher's broom and red vine leaves - and active ingredients with an anti-oedematous effect. This group primarily includes diosmin, which is found in citrus fruits, but also the aforementioned ingredients of horse chestnut, butcher's broom and red vine leaves. Most of the substances have a strengthening effect on the muscles of the vein wall as well as stabilising the cells and thus protecting against water leaking into the surrounding tissue. They are usually available from pharmacies.
Has the effect of vein creams and tablets been scientifically proven?
The effect of these vein remedies on the symptoms of varicose veins was very controversial in the phlebological community for a long time. However, there are now some serious and placebo-controlled studies in which the administration of some of the above-mentioned substances has led to a reduction in subjective venous symptoms in patients. First and foremost, a positive influence on the subjective feeling of heaviness and tension in the legs should be mentioned here. However, there is much to suggest that taking a tablet is more effective than applying a cream. The application of a cream always harbours the risk that the actual active ingredient does not penetrate the skin barrier properly and does not reach the intended site of action.
One thing should be made very clear here once again:
There is no cream or tablet against the varicose vein itself!
All vein remedies - whether in cream or tablet form - are aimed exclusively at influencing the accompanying symptoms of varicose vein disease - not the varicose vein itself.
No prolonged use of diuretic medication („diuretics“)!
Sometimes those affected by leg swelling also resort to taking diuretics to flush out fluid. However, this is not advisable as these drugs have a strong effect on the kidneys and can upset the body's entire salt balance, which can be dangerous. Although they have a quick and potent flushing out effect, this effect comes at the price of a number of complications and sometimes also a worsening of leg symptoms. Diuretics should only be taken for a maximum of one week if there is a venous indication and should only be used in the short term for very severe leg swelling. Please consult your doctor about this. Apart from that, these medications are only available on prescription anyway.
What are the side effects of vein creams and tablets?
The package leaflet will tell you everything you need to know about the possible side effects of each active ingredient. Your pharmacist will also be able to help you further. Although these are naturally occurring active ingredients and the risk of a serious complication is low, the risk of possible side effects when using these vein remedies should not be underestimated. First and foremost, of course, is an allergic reaction to the active ingredient itself. However, a list of the specific side effects would go beyond the scope of this article and can be found in the relevant section.
Do vein creams and tablets help in the long term?
Taking vein tablets or applying vein creams is only a small pillar of therapy for varicose vein disease. Compression therapy with a medical compression stocking of at least class I remains the basic therapy. If symptoms occur or to protect against venous thrombosis or secondary damage to the deep vein system, surgical intervention should also be considered, preferably using a minimally invasive endovenous procedure (laser, radiofrequency, foam sclerotherapy or vein glue). The classic stripping procedure is of course also still available.
If you decide to use a vein ointment or take vein tablets, this is always a long-term treatment. It makes no sense to only use these medications in the short term, as varicose vein disease is a chronic and therefore lifelong condition and should also be treated in the long term if symptoms occur. In addition, it always takes a few days for the desired effect and relief of symptoms to set in. Another important observation in this context:
The use of vein remedies is only indicated for symptomatic varicose veins
Vein creams and vein tablets should not be used for varicose veins without symptoms. Their purpose is to alleviate symptoms and not to treat the varicose vein itself. There is therefore no reason to use them in the absence of symptoms.
Your phlebologist will be happy to advise you on the usefulness, advantages and disadvantages of using vein creams and tablets in your individual case.
