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© Steven Foster
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Botanical name: Aesculus hippocastanum
Parts of Horse Chestnut used and where is Horse Chestnut grown
The horse chestnut tree is native to Asia and northern Greece, but it is now cultivated in
many areas of Europe and North America. The tree produces fruits that are made up of a spiny
capsule containing one to three large seeds, known as horse chestnuts. Traditionally, many of
the aerial parts of the horse chestnut tree, including the seeds, leaves, and bark, were used
in medicinal preparations. Modern extracts of horse chestnut are usually made from the seeds,
which are high in the active constituent aescin (also known as escin).
Historical or traditional use of Horse Chestnut (may
or may not be supported by scientific studies)
Horse chestnut leaves have been used by herbalists as a cough remedy and to reduce fevers.1 The
leaves were also believed to reduce pain and inflammation of arthritis and rheumatism. In
traditional herbal medicine, poultices of the seeds have been used topically to treat skin
ulcers and skin cancer. Other uses include the
internal and external application for problems of venous circulation, including varicose veins and hemorrhoids.
Active constituents of Horse Chestnut
The seeds are the source of a saponin known as aescin, which has been shown to promote
circulation through the veins.2 Aescin fosters normal tone in the walls of the
veins, thereby promoting return of blood to the heart. This has made both topical and internal
horse chestnut extracts popular in Europe for the treatment of chronic venous insufficiency and, to a lesser extent,
varicose veins. Aescin also possesses
anti-inflammatory properties and has been shown to reduce edema (swelling with fluid) following trauma,
particularly following sports injury, surgery, and head injury.3 4 A
topical aescin preparation is very popular in Europe for the treatment of acute sprains during
sporting events. Horse chestnuts also contain
flavonoids, sterols, and tannins.
Double-blind and preliminary clinical trials have shown that oral horse chestnut extracts
reduce the symptoms of chronic venous
insufficiency, including swelling and pain.5 6 Those suffering edema
after surgery have also found relief from topical application of horse chestnut extracts,
according to preliminary studies.7
How much Horse Chestnut is usually taken?
For treatment of chronic venous
insufficiency horse chestnut seed extracts standardized for aescin content (16–20%),
300 mg two to three times per day, are recommended.8 9 Tincture,
1–4 ml taken three times per day, can be used though it is questionable whether a
significant amount of aescin can be absorbed this way.10 Gels or creams containing
2% aescin can be applied topically three or four times per day for hemorrhoids, skin ulcers, varicose veins, sports injuries, and trauma of other
kinds.
Are there any side effects or interactions with Horse Chestnut?
Internal use of horse chestnut seed extracts standardized for aescin at recommended amounts
is generally safe. However, in rare cases oral intake of horse chestnut may cause itching,
nausea, and upset stomach.11 Based on reports of worsening kidney function in
people with kidney disease who received intravenous aescin, horse chestnut should be avoided
by anyone with kidney disease.12 13 People with liver disease should
also avoid the use of horse chestnut. There are no known reasons to avoid horse chestnut
during pregnancy.14 Topically,
horse chestnut has been associated with rare cases of allergic skin reactions. Circulation
disorders and trauma associated with swelling may be the sign of a serious condition.
Therefore, a healthcare professional should be consulted before self-treating with horse
chestnut.
Are there any drug
interactions?
Certain medicines may interact with horse chestnut. Refer to drug interactions for a list of those medicines.
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purposes only. It is based on scientific studies (human, animal, or in
vitro), clinical experience, or traditional usage as cited in each article.
The results reported may not necessarily occur in all individuals. For many of
the conditions discussed, treatment with prescription or over the counter
medication is also available. Consult your doctor, practitioner, and/or
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making any changes in prescribed medications.
References:
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