Traditional Indications

Horse chestnut is an alterative, anaelgesic, anti-inflammatory, astringent, diuretic, expectorant, febrifuge, haemostatic, narcotic, tonic, vasoconstrictor and vulnerary. Horse chestnut is an astringent, anti-inflammatory herb that helps to tone the vein walls which, when slack or distended, may become varicose, haemorrhoidal or otherwise problematic. The plant also reduces fluid retention by increasing the permeability of the capillaries and allowing the re-absorption of excess fluid back into the circulatory system. The plant is taken in small doses internally for the treatment of a wide range of venous diseases, including hardening of the arteries, varicose veins, phlebitis, leg ulcers, haemorrhoids and frostbite. It is also made into a lotion or gel for external application. The pericarp is peripherally vasoconstrictive. The seeds are decongestant, expectorant and tonic. They have been used in the treatment of rheumatism, neuralgia and haemorrhoids. They are said to be narcotic and that 10 grains of the nut are equal to 3 grains of opium. (1)

Pharmacognosy

Multiple Cochrane database system reviews have concluded the evidence presented suggests that horse chestnut extract is an efficacious and safe short-term treatment for chronic venous insufficiency (CVI) and that it is as effective as compression treatment however compliance is greater. (2, 3)

1. PFAF. Horse Chestnut 2019.
2. Pittler MH, Ernst E. Horse chestnut seed extract for chronic venous insufficiency. Cochrane Database Syst Rev. 2012;11:Cd003230.
3. Pittler MH, Ernst E. Horse chestnut seed extract for chronic venous insufficiency. Cochrane Database Syst Rev. 2004(2):Cd003230.