With the arrival of the hot season, many varicose vein patients experience a return of swelling and tension in their legs. It is tempting to reach for vein creams and tablets instead of the unpopular compression stockings. But is this really sensible and healthy?
First, the good news:
Vein creams and tablets contain effective active ingredients!
When it comes to active ingredients, a distinction must be made between
- vasoconstrictive, i.e., constricting the veins and
- Ingredients that protect against edema, i.e., that counteract the escape of water into the tissue.
Both are very useful mechanisms of action in the treatment of varicose veins: the diseased vein is dilated and strengthening the muscles of the vein wall causes the vein to shrink again. On the other hand, in varicose veins, the increased pressure in the diseased vein causes water to leak through the vein wall into the surrounding tissue, leading to swelling in the ankle area. Protective active ingredients seal the cell walls of the vein wall, making it more difficult or even completely stopping this fluid leakage from the vein into the surrounding tissue.
What active ingredients are contained in vein creams and tablets?
In accordance with the two mechanisms mentioned above, a distinction is made between active ingredients with a vein-toning function—primarily horse chestnut, butcher's broom, and red vine leaves—and active ingredients with an anti-edematous effect. This group primarily includes diosmin, which is found in citrus fruits, but also the aforementioned ingredients from horse chestnut, butcher's broom, and red vine leaves. Most substances have a strengthening effect on the muscles of the vein wall as well as a cell-stabilizing effect, thus protecting against water leakage into the surrounding tissue. They are usually available only in pharmacies.
Has the effectiveness of vein creams and tablets been scientifically proven?
The effect of these vein medications on the symptoms of varicose veins has long been highly controversial among phlebologists. However, there are now several reputable, 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, these studies show a positive effect on the subjective feeling of heaviness and tension in the legs. However, there is much to suggest that taking a tablet is more effective than applying a cream. The use of a cream always carries the risk that the actual active ingredient will not penetrate the skin barrier properly and will not reach the intended site of action.
One thing should be made very clear here:
There is no cream or tablet that can treat varicose veins themselves!
All vein remedies—whether in cream or tablet form—are aimed exclusively at treating the symptoms of varicose veins, not the varicose veins themselves.
Do not use diuretics for long periods of time!
Sometimes, people affected by leg swelling also resort to taking diuretic medications. However, this is not recommended, as these medications have a strong effect on the kidneys and can disrupt the body's entire salt balance, which can be dangerous. Although they have a rapid and potent diuretic effect, this comes at the price of a number of possible complications and sometimes even a worsening of leg symptoms. Diuretics should only be taken for a maximum of one week for venous indications and should only be used for a short period of time in cases of very severe leg swelling. Please consult your doctor for more information. Apart from this, these medications are prescription only anyway.
What are the side effects of vein creams and tablets?
The package insert provides comprehensive information about the potential side effects of the respective active ingredient. Your pharmacist can also provide further assistance. Although these are naturally occurring active ingredients and the risk of serious complications is low, the potential side effects of using these vein medications should not be underestimated. The most significant concern is, of course, an allergic reaction to the active ingredient itself. However, listing all 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 part of the treatment for varicose veins. The basic treatment is still compression therapy with medical compression stockings of at least class I. If you have symptoms or to protect against venous thrombosis or consequential damage to the deep vein system, surgical intervention should also be considered, preferably with a minimally invasive endovenous procedure (laser, radiofrequency, foam sclerotherapy, or vein glue). The classic stripping procedure is of course 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 use these medications only for a short period of time, as varicose veins are a chronic and therefore lifelong condition and should be treated long-term when symptoms occur. In addition, it always takes a few days for the desired effect and relief of symptoms to set in. In this context, there is another important point to note:
The use of vein medication is only indicated for symptomatic varicose veins.
Venous creams and tablets should not be used for varicose veins without symptoms. Their purpose is to alleviate symptoms, not to treat the varicose veins themselves. Therefore, if there are no symptoms, there is no reason to use them.
Your phlebologist will be happy to advise you on the usefulness, advantages, and disadvantages of using vein creams and tablets in your individual case.
