Horse chestnut, grape seed, Ginko biloba, coumarins and flavonoids. Even skin wraps for varicose veins. And there are a lot more! There seems to be any number of herbal and home remedies which are available for the treatment and removal of spider veins and varicose veins. Some of these products are cheap and others not so cheap but all seem to guarantee quick pain free removal of your veins with guaranteed results.
All these products are termed Veno-active drugs (VAD) or Phlebotonic drugs. They are mostly derived from plant extracts.
Such groups include:
· Benzopyrones (Coumarine, Flavonoids, Oxerutin, Rutin, Rutosides, Diosmine),
· Saponins (Horse chestnut and Butcher’s extract)
· Other plant extracts (Gingko Biloba, Maritime Pine extract, grape seed)
· Synthetic products or the Quinons ( naftazone and calcium dobesilate)
· Xanthine derivatives (Pentoxifylline )
There seem to be various modes of action depending on the individual drug. Beneficial effects include reduction in capillary leakage and anti-inflammatory effects by scavenging free radicals. Improvements in venous tone and on the lymphatic system have been proposed.
But what is the level of scientific evidence?
At a recent International Phlebology conference that I attended, Veno-Active Drugs (VAD) were one of the topics of discussion.
Pentoxifylline, Sulodoxine and micronized purified flavonoid fraction (Daflon®) have demonstrated some benefit to patients with Chronic Venous Disease in a few trials.
However “strong recommendations with Level 1 evidence” cannot be made about the use of any of the wide range of Veno-active drugs available in the treatment of Chronic Venous Disease at the moment.
Until more evidence is gathered sclerotherapy and Endothermal ablation remain the most successful and proven methods of removing varicose veins and spider veins.