A Brief Review on Herbs Used in the Treatment of Varicose Veins

Abstract

A weakening of the venous valves and walls is a common cause of varicose veins. Blood
might flow back and pool in veins due to damaged valves, causing them to enlarge.
Weakened vein walls are longer, broader, and less elastic than normal, causing valve flaps to
split, resulting in increased blood pooling and twisted veins. Primary varicose veins are
characterised by valvular incompetence and reflux, which have long been assumed to be the
cause. Recent research, on the other hand, reveals that valve dysfunction may be preceded
by alterations in the vein wall. This condition is referred to as "Siragranthi" in Ayurvedic
literature (ie.Varicose vein). As a result, the current review critically assesses the possible
utility of herbal medications in the treatment of varicose veins.
Keywords- Herbal Plants, Varicose veins, Types, Pathophysiology

Full text

Parihar et al Journal of Drug Delivery & Therapeutics. 2022; 12(1):158-162
ISSN: 2250-1177 [158] CODEN (USA): JDDTAO
Available online on 15.01.2022 at http://jddtonline.info
Journal of Drug Delivery and Therapeutics
Open Access to Pharmaceutical and Medical Research
Copyright © 2022 The Author(s): This is an open -access article distributed under the terms of the CC BY-NC 4.0
which permits unrestricted use, distribution, and reproduction in any medium for non-commercial use provided the
original author and source are credited
Open Access Full Text Article Review Article
A Brief Review on Herbs Used in the Treatment of Varicose Veins
Shweta Parihar1*, Sarswati2, Chattarpal3, Devender Sharma4,5
1 Research Scholar, Department of Pharmacognosy, Maharshi Dayanand University, Near Delhi Bypass, Rohtak, Haryana-124001, India
2 Assistant Professor, Department of Pharmacognosy, Rao Neki Ram Memorial College of Pharmacy,Turkapur, Pataudi, Gurugram, Harayana-
122503, sarswatiranga@gmail.com
3 Research Scholar, Department of Pharmacognosy, Maharshi Dayanand University, Near Delhi Bypass, Rohtak, Haryana-124001, India,
Chattarpalsfd@gmail.com
4 Research Scholar, Department of Pharmaceutics, Lovely Institute of Technology (Pharmacy), Lovely Professional University, Punjab-144411, India,
Sdevender350@gmail.com
5 Associate Professor, Department of Pharmaceutics, R. J. World College of Pharmacy Education and Technology, Jakhod, Surajgarh, Rajasthan -
333033, India
Article Info:
_________________________________________
Article History:
Received 10 November 2021
Reviewed 13 December 2021
Accepted 18 December 2021
Published 15 January 2022
_________________________________________
Cite this article as:
Parihar S, Sarsw ati, Chattarpal, Sharma D, A Brief
Review on Herbs Used in the Treatment of Varicose
Veins, Journal of Drug Delivery and Therapeutics.
2022; 12(1):158-162
DOI: http://dx.doi.org/10.22270/jddt.v12i1.5161
Abstract
______________________________________________________________________________________________________
A weakening of the venous valves and walls is a common cause of varicose veins. Blood
might flow back and pool in veins due to damaged valves, causing them to enlarge.
Weakened vein walls are longer, broader, and less elastic than normal, causing valve flaps to
split, resulting in increased blood pooling and twisted veins. Primary varicose veins are
characterised by valvular incompetence and reflux, which have long been assumed to be the
cause. Recent research, on the other hand, reveals that valve dysfunction may be preceded
by alterations in the vein wall. This condition is referred to as "Siragranthi" in Ayurvedic
literature (ie.Varicose vein). As a result, the current review critically assesses the possible
utility of herbal medications in the treatment of varicose veins.
Keywords- Herbal Plants, Varicose veins, Types, Pathophysiology
*Address for Correspondence:
Shweta Parihar, Research Scholar, Department of Pharmacognosy, Maharshi Dayanand University, Near Delhi Bypass, Rohtak, Haryana -124001, India Email ID:
Shwetaparihar2502@gmail.com
1. INTRODUCTION-
Varicose veins are veins that are tortuous, twisted, or
extended. Size alone does not suggest abnormalities unless
the growth is extreme, because size can change depending on
ambient temperature and, in women, hormonal factors.
Furthermore, in a thin individual, typical superficial veins
may appear enormous, but varicose veins in an obese person
may be inconspicuous 5,7.
2. TYPES OF VARICOSE VEINS-
Trunk varicose veins, reticular varicose veins, and
telangiectasia varicose veins are the three types of varicose
veins. Spider veins, star bursts, thread veins, and matted
veins are all terms used to describe telangiectasia. Only a
small percentage of varicose veins are caused by secondary
disorders including deep vein thrombosis and occlusion,
pelvic tumours, or arteriovenous fistulae2.
3. ANATOMY-
A network of superficial veins connects to the deep veins via
small perforator veins to provide venous drainage to the
lower limbs. Varicose veins can be caused by disease in any
of these venous systems, but the number of systems affected
increases the severity of the symptoms. The vein wall
weakens due to a variety of pathophysiological causes,
resulting in varicosity over time. Varicosities are most
commonly found in the larger and smaller saphenous veins,
but they can also appear in branch channels. Varicose veins
can be caused by obstruction of the iliac veins or inferior
vena cava4,8.
4. PATHOPHYSIOLOGY-
The belief that varicose veins are caused by valve failure in
the superficial veins, resulting in venous reflux and vein
dilatation, has been replaced by the theory that valve
incompetence occurs after a change in the vein wall, rather
than before it. As a result, the vein wall in varicose veins is
naturally weak, causing dilation and separation of valve

Parihar et al Journal of Drug Delivery & Therapeutics. 2022; 12(1):158-162
ISSN: 2250-1177 [159] CODEN (USA): JDDTAO
cusps, rendering them ineffective. Varicose veins are caused
by advancing age and parity, as well as vocations that entail a
lot of standing. There is no indication that the prevalence of
varicose veins is influenced by social class, smoking, or
genetic makeup. In women, obesity is linked to the
development of varicose veins, but not in men2.
5. PRINCIPAL THAT CAUSE VARICOSE VEINS
ARE-
1. The principal pathophysiological mechanisms that cause
varicose veins are venous hypertension, venous valvular
incompetence, structural changes in the vein wall,
inflammation, and changes in shear stress.
2. Reflux due to venous valve incompetence, venous
outflow blockage, or calf-muscle pump failure causes
venous hypertension. Venous reflux can affect either the
superficial or deep venous systems, causing venous
hypertension below the venous valvular incompetence
area.
3. High pressures generated in the deep veins during calf
muscle contraction may be immediately conveyed to the
superficial system in patients with perforator vein
incompetence.
4. Valvular incompetence can be caused by valve leaflet
deformation, ripping, thinning, and adhesion.
Pathological weakening and dilatation are caused by
structural changes in the vein wall.
5. In histological examinations of varicose venous
segments, overproduction of collagen type I, decreased
synthesis of collagen type III, and disturbance of the
organisation of smooth muscle cells and elastin fibres
were found. Increased tissue inhibitors of matrix
metalloproteinases found in varicose vein specimens
may enhance extracellular matrix material deposition in
the vein wall.
6. In the walls of varicose veins, higher amounts of
transforming growth factor 1 and fibroblast growth
factor have been found, which may contribute to
structural degeneration.
7. The number of neutrophils, monocytes, macrophages,
and lymphocytes, as well as the levels of matrix
metalloproteinases, rose in venous valves exposed to
high pressures for extended periods of time in animal
models.
8. The venous valves exposed to high pressures had
unfavourable remodelling over time, with reduced leaflet
length and thickness. Turbulent flow, flow reversal, and
reduced shear stress promote inflammatory and
prothrombotic alterations, which may lead to the loss of
structural and functional integrity of vein walls and valve
leaflets6,9,10.
6. HERBAL PLANTS-
A wide variety of therapeutic plants can be found all over the
world. Many weeds in our environment are highly effective
medicinal plants that can help with a variety of significant
health issues 11,12,13. India has long been known as a great
store of natural remedies among ancient cultures 14,15,16.
TABLE- 1. List of herbal plants that are used in the treatment
of varicose veins1,3. TABLE-2. List of herbs used to support
liver and decrease blockage in the blood flow1,3. TABLE-3.
List of oils that are used in the treatment of varicose veins.
some ayurvedic marketed formulations of varicose veins are-
Sahacharadi Kashaya, Sahacharadi Thailam, Rasa Thailam,
Chamomile Ointment3,5.
Table 1: List of herbal plants that are used in the treatment of varicose veins1,3
S.N.
Plant Name
Plant Part
Used
Scientific Names And
Family
Mode Of Action
1
Butcher’s
broom
Root
Ruscus aculeatus
(Liliaceae)
Anti-inflammatory, vasoconstrictor, antihemorrhagic
2
Gotu kola
Whole plant
Centella asiatica
(Umbelliferae)
Anti-inflammatory, diurectic, laxative, antiseptic,
stimulant, heals wound and ulcers, improve memory,
sluggish digestion, leprosy, skin eruptions, varicose
veins, improve capillary permeability, ulcers, fever
3
Horse chestnut
Ripe chestnut
and bark
Asculus hippocastanum
(Hippocastanaceae)
Improve vascular resistance, reduced pathologically
induced capillary wall permeability, antringent
4
Stone roots
Roots
Collinsonia canadensis
(Lamiaceae)
Act as gastro-intenteritis with diarrhoea, hemorrhoids
and laryngeal inflammations, hemorroids,
vasoconstriture, stimulants, tones alimentary mucos
membranes, diurectics, astringent
5
Cayenne
Leaves and
fruits
Capsicum frutescent
(Solanaceae)
Fibrinolytic action which is helpful in varicose veins
treatment
6
Garlic
Flower bulb
Allium sativum
(Amaryllidaceae)
Treat rheumatism, arthritis, gout, fluid retention,
obesity, diuretic remedy, improve blood circulation,
reduces blood pressure, antibiotic
7
Ginger
rhizome
(underground
stem)
Zingiber officinale
(family Zingiberaceae)
relief from rheumatoid arthritis (RA), osteoarthritis,
menstrual pain, upper respiratory tract infections,
cough, respiratory problems, migraine headache,
bronchitis, and diabetes.
8
Agrimony
Aerial parts
Agrimonia spp.
(Rosaceae)
Diurectics, astringent, stimulating gastrointestinal
tonic, hepatic atony, enuresis
9
Bayberry
Bark
Myrica cerifera
(Myricaceae)
Astringent, styptic, tonifying the atonic tissues, used
in passive hemorrhages, ulcerations, venous atony,

Parihar et al Journal of Drug Delivery & Therapeutics. 2022; 12(1):158-162
ISSN: 2250-1177 [160] CODEN (USA): JDDTAO
congestion
10
Cinnamon
Inner bark
Lauraceae
Astringent, stimulant, carminatives, hemostatic,
flavoring, antibacterial, antifungal, gastrointestinal
tonic, warming herb, passive pulmonary, gastric,
intestinal, and renal bleeding, used in nausea and
vomiting
10
Geranium
Root
Geranium maculatum
(Geraniaceae)
Used as styptic, atonic tissues, passive hemorrhages,
ulcerations in mucous membranes, digestive tract,
venous atony, congestion
11
White oak
Bark
Quercus alba (Fagaceae)
Astringent, styptic, mucous membrane irritation,
passive hemorrhages, venous laxity, congestion,
bleeding hemorrhoids, varicosities
12
Witch Hazel
Bark
Hamamelis virginiana
(Hamamelidaceae)
Astringent, styptic, mucous membrane irritation,
passive hemorrhages, venous laxity, congestion,
bleeding hemorrhoids, varicosities, heal wounds and
local inflammatons
13
Yarrow
Flowers and
leaves
Achillea millefolium
(Asteraceae)
Bitter tonic, antiseptic, styptic, stimulating
diaphoretic, anti-inflammatory, anodyne, atonic,
relaxed tissues where thre is free discharge bleeding
of bright red blood, diarrhea, hemorrhoids, excessive
menstural flow, vaginitis, Hemostatic
14
Slippery elm
Inner bark
Ulmus spp. (rubra, fulva)
Demulcent, diuretic, anti-inflammatory, soothing
mucos membrane irritation in GIT, respiratory tract,
and urinary tract. Used internally in inflammations of
mouths, throat, stomach, intestines, bladder, urethra,
used externally in burns, ulcers, skin disorders,
wounds, respiratory tract disorders
15
Psyllium
Seed
Plantago ovata
(Plantaginaceae)
Soothe GIT mucosa, demulcent, bulking agents, helps
in constipation, diarrhea
16
Flax seeds
Seed
Linum usitatissimum
(Linaceae)
Mucilaginous, bulking, lubricating agents, chronic
constipations, arthritis, psoriasis, anthrosclerosis
17
Calendula
Flowers prior
to fully
opening
Calendula officinalis
(Asteraceae)
Antiseptic, anti-inflammatory, choleretic, demulcent,
vulnerary, immune stimulant, antiviral, support
creation of normal connective tissues structures,
wound healing, burns, boils, rashes, formulations of
granulations tissues
18
Comfrey
Root and main
rib
Symphytum officinalis
(Boraginaceae)
Heal inflammation of thrombophlebitis and phlebitis,
skin wounds, irritations, sprains, contusions, burns,
ulcer, skin disorders
19
Plantain
Leaf
Plantago spp.
(Plantaginaceae)
Antiseptic, astringent, anti-inflammatory, cooling
agent for use with haemorrhoid, vulnerary
20
Saint john’s
wort
Flowering tops
Hypericum perforatum
(Guttiferae)
Antiviral, Antiseptic, astringent, anti-inflammatory,
antibacterial, nervine, sedative, trophorestorative,
lymphagogues, haemorrhoid, vulnerary
21
Cleavers
Fresh
succulent
aerial parts in
flowering/see
d forming
stage
Gallium aparine
(Rubiaceae)
Diuretic, nutritive, vulnerary, hypotensive,
lymphagogues, bladder and kidney problems,
prostatic hypertrophy, reduce stones
22
Red root
Root
Ceanothus americanus
(Rhamnaceae)
Expectorant, astringent, lymphatic, splenic, liver
congestion, enlarged lymph nodes, sinustitis,
tonsillitis, laryngitis, pharyngitis, chronic post-nasal
drip, mononucleosis, increase platelates counts,
reduce cysts, subacute and chronic conditions,
lymphagogues
23
Bhrami
Whole plant
Centella
Asiatic (Apiaceae)
Alzheimer's disease, improving memory, anxiety,
attention deficit-hyperactivity disorder (ADHD),
allergic conditions, irritable bowel syndrome, and as a
general tonic to fight stress

Parihar et al Journal of Drug Delivery & Therapeutics. 2022; 12(1):158-162
ISSN: 2250-1177 [161] CODEN (USA): JDDTAO
24
Guduci
Stem, leaf
Tinospora cordifolia
Willd (Menispermaceae)
Curing liver diseases, blood purification capabilities
help in fighting bacteria, antipyretic properties, treat
fevers like dengue, malaria, and swine flu.
25
Onion
Bulb
Allium cepa
treating digestion problems including loss of appetite,
upset stomach, and gallbladder disorders; for treating
heart and blood vessel problems including chest pain
(angina) and high blood pressure; and for preventing
“hardening of the arteries” (atherosclerosis).
26
Manjistha
Rubia
cordifolia (Rubiaceae)
treat uric acid and arthritis, urinary infections,
diarrhea, dysentery, and chronic fevers.
27
Raw potatoes
grated
Fruit
Solanum
tuberosum (Solanaceae),
Paste is use on varicose veins legs
28
Raw grated
apples
Fruit
Malus pumila
(Rosaceae)
Apple cider vinegar is used in treatment of varicose
veins
29
Red rose petals
Leaves, flower
Rosaceae
Use to wash varicose veins legs with warm water
7. LIVER HERBS
Supporting the liver decreases blockage in the flow of blood from the rectal veins to the portal vein and therefore decreases
venous distention and hemorrhoids due to liver disfunction.
Table 2: List of herbs used to support liver and decrease blockage in the blood flow1,3
S.N.
Plant Name
Scientific Name
And Family
Plant Part
Used
Pharmacological Activity
1
Burdock
Atrium lappa
(Asteraceae)
Root
Diuretic, stimulant, blood and lymp cleanser, liver tonic,
choleretic, mild laxative, stimulates natural flow of lymphatic
fluid thereby supporting excreation of toxic products of cells,
helps in removing accumulated toxic byproducts of skin, kidney,
liver, gallbladder, mucous, serous membrane through catabolism
2
Dandelion
Taraxacum
officinalis
(Asteraceae)
Whole plant,
leaves,
flower, roots
Diuretic, stomachic, mild laxative, cholagogue, choleretic, lower
blood pressure, cholesterol, decrease edema, normalize sugar
level, arthritis, gout, skin diseases
3
Licorice
Glycyrrhiza
glabra
(Fabaceae)
Root
Demulcent, adaptogen, adrenal-modulator, antibacterial,
antiviral, expectorant with secretolytic ans secretomotor activity,
nutritive, spasmolytic, antioxidant, anti-inflammatory,
estrogenic, immune stimulant, liver tonic, protectant,
Glycyrrhizinic acid and aglycone Glycyrrhizinic acid decrease
inflammation by increasing the movement of leucocytes towards
inflamed area, Glycyrrhizin inhibits the activity of phospholipase
A and formation of prostaglandin E2 in activated peritoneal
macrophages
3
Milk thistle
Silybum
marianum
(Asteraceae)
Seed
Hepatoprotective, antioxidant, it stimulate RNA polymerase A
which enhances ribosome proteins synthesis and activates the
regenerative capacity of liver cells
4
Turmeric
Curcuma longa
(Zingiberaceae)
Rhizome
Antiarthritic, antibacterial, antifungal, hypotensive, anti-
atherosclerotic, cholagogue, choleretic, emmenagogue, anti-
inflammatory, lower cholesterol, stimulates digestive enzymes,
carminative, hepatoprotective, vulnerary, anticoagulant,
flatulence, jaundice, menstrual difficulties, gallstones,
haemorrhages, toothache, bruises, colic, arthritis, sprains,
wounds, anticancer
5
Corylus
avellana
Corylus avellana
(Betulaceae)
Fruit
Venotonic action, protective effect against hypertension, chronic
heart diseases
6
Vaccinium
myrtillos
Vaccinium
myrtillos
(Ericaceae)
Fruit wild
blueberries
Use in venous insufficiency by varicose veins and hemorrhoids,
vascular disorders

Parihar et al Journal of Drug Delivery & Therapeutics. 2022; 12(1):158-162
ISSN: 2250-1177 [162] CODEN (USA): JDDTAO
Table 3: List of oils that are used in the treatment of varicose veins
S.N.
Oil Name
Plants Name And Family
References
1
Pumpkin
Cucurbita (Cucurbitaceae)
5
2
Sunflower
Helianthus annuus
(Asteraceae)
5
3
Grapes seed oil
Vitis vinifera
(Vitaceae)
5
4
Rice bran oil
Oryza sativa L (Poaceae)
5
8. CONCLUSIONS
All of the medications covered in this study play a significant
function in the treatment of varicose veins. In contrast, the
mode of action of bioactive phyto-molecules found in plants
is less well understood, but there is no doubt about the
importance of plants in the treatment of varicose veins. In
the treatment of varicose veins and ulcers, Ayurveda can
offer a glimpse of hope. Traditional drug formulations, on
the other hand, must be investigated and re-standardized
using new methodologies and approaches for controlling
varicosis.
REFERENCES
1. Palanisamy JK, Ponnu S, Mani S, Balakrishnan S. A critical review
on traditional herbal drugs: an emerging alternative drug for
varicose veins. World Journal of Pharmaceutical Research. 2018
Jan 8; 7(5):316-38.
2. Nick J M London, Roddy Nash, ABC of arterial and venous disease
Varicose veins BMJ 20 MAY 2000; VOLUME 320
https://doi.org/10.1136/bmj.320.7246.1391
3. Garg N, Jain A. Ayurvedic perspective of varicose veins. World J
Pharm Res. 2017; 6(3).
4. Lim CS, Davies AH. Pathogenesis of primary varicose veins.
Journal of British Surgery. 2009 Nov; 96(11):1231-42.
https://doi.org/10.1002/bjs.6798
5. Ionescu N, Neagu AM, Popescu M. Preparation and
Characterization of Vegetable Oils And Plant Extracts with Effect
in the Treatment of Varicose Veins. U.P.B. Sci. Bull., Series B,
2021; 83(3):185-192
6. Piazza G. Varicose veins. Circulation. 2014 Aug 12; 130(7):582-7.
https://doi.org/10.1161/CIRCULATIONAHA.113.008331
7. Gawas M, Bains A, Janghu S, Kamat P, Chawla P. A Comprehensive
Review on Varicose Veins: Preventive Measures and Different
Treatments. Journal of the American College of Nutrition. 2021
Jun 16:1-2. https://doi.org/10.1080/07315724.2021.1909510
8. Raffetto JD, Khalil RA. Mechanisms of varicose vein formation:
valve dysfunction and wall dilation. Phlebology. 2008 Apr;
23(2):85-98. https://doi.org/10.1258/phleb.2007.007027
9. Tunalier Z, Koşar M, Küpeli E, Çaliş İ, Başer KH. Antioxidant, anti-
inflammatory, anti-nociceptive activities and composition of
Lythrum salicaria L. extracts. Journal of Ethnopharmacology.
2007 Apr 4; 110(3):539-47.
https://doi.org/10.1016/j.jep.2006.10.024
10. Hamidpour R, Rashan L. A Unique Natural Remedy that
Alleviates Varicose Vein. Transl Biomed. 2017; 8(3):127.
https://doi.org/10.21767/2172-0479.100127
11. Chaudhary, K, Parihar, S, Sharma, D. A Critical Review on
Nanoscience Advancement: In Treatment of Viral Infection.
Journal of Drug Delivery and Therapeutics 2021 Nov;
11(6):225-237. https://doi.org/10.22270/jddt.v11i6.5030
12. Parihar S, Sharma, D. Cynodondactylon: A Review of
Pharmacological Activities. Sch Acad J Pharm Nov 2021; 11:183-
189.
13. Parihar S, Sharma, D. Navagraha (nine planets) plants: the
traditional uses and the therapeutic potential of nine sacred
plants of india that symbolises nine planets. IJRAR 2021;
8(4):96-108.
14. Parihar S, Sharma, D. A brief overview on Asparagus racemous.
IJRAR Dec 2021; 8(4):96-108.
15. Telrandhe UB, Lokhande RR, Lodhe VN, Kosalge SB, Parihar S,
Sharma D. Review on Herbal Drugs used in Dental Care
Management. Asian Journal of Pharmaceutical Research and
Development. 2021; 9(6):71-9.
16. Parihar S, Sharma D, A Brief Overview on Crinum Latifolium.
International Journal of Science and Research (IJSR) 2021; 10
(12):725-728.
17. Parihar S, Chattarpal, Sharma D. Literature review on the list of
plants used in the treatment of lung cancer. World journal of
pharmacy and pharmaceutical sciences. 2022; 11(1). DOI:
https://doi.org/10.20959/wjpps20221-21068.