“I have been using this cream for a few years and it helped, a little”.
I am going to dive into creams for varicose veins and see if they work or not.
A common brand that keeps popping up is Carusos Varicose vein cream, but there are many in the market. I have no affiliation with them, but wanted to look at ingredients in many and whether they are effective.
The first thing I would say is there is a class of medications called vaso active drugs that have shown some evidence of improving blood flow and making the vessels smaller (Creating vasoconstriction).
If you look at the ingredients you will see a variety of them including horse shoe extract (Aescin), rutosides, diosmine, maritime pine bark extract and even flavonoids containing quercitin.
Most of them are plant based which is a good thing, but when taken orally can have lots of side effects in your tummy. More importantly they have to be prepared in an activated form orally if not they are pretty much useless. What I have found looking at the over-the-counter medications containing these ingredients is that they are not prepared in the activated form. Therefore, almost all of it would not be absorbed and will have no effect.
That leaves us with the topical preparations. Horseshoe extract is commonly found in some of them and there is evidence that shows it improves pain and swelling when taken orally in its activated form. When used topically, it does have the ability to cause some tightening of the vessels making them appear smaller, but when it is stopped the effects will not last.
From my experience with patients, it is a mixed bag. They find it helps with some pain, as a result of the vessels being constricted, but the visible look does not change much. The reduction in pain also does not last that long and when they stop it all comes back.
The reality is as varicose veins are part of a chronic spectrum, they worsen with time and become bigger due to the pressure within them. The creams provide little improvement for a short period, but have no lasting effect.
Oral medications have their place when prescribed by experienced doctors who can monitor your liver function as well, as all medications have their side effects as well.