This herb is approved by German Commission E for CVI, lupus and ulcer therapy. In homeopathy horse chestnut treats hemorrhoids. The mechanisms of action include inhibition of elastase and hyaluronase primarily by aesin, a triterpene saponin which has anti-exudative effects by decreasing capillary permeability, inhibits leukocyte activation, and induces vasoncontriction. The active compounds in seeds of this herb contain 50% polysaccharides and oligosaccharides, other triterpene saponins, fatty oils, sterols and flavonoids including quercetin and OPCs (3,22).
Leg circumference, heaviness, and pain were statistically significantly reduced in multiple CVI trials with oral therapy. Topically applied horse chestnut reduced the symptoms of CVI in one trial and hemorrhoids in another (42). Photoaging clinical studies are lacking.
The health risks of horse chestnut include hepatotoxicity, renal toxicity, urticaria, anaphylaxis, and mucocutaneous irritant and allergic dermatitis. It may also interact with salicylates and warfarin. This herb is administered as tea, tincture for infusion, gel, or ointments (3,22).