Horse chestnut cream is an herbal ointment made from horse chestnut extract. It is used to relieve pain and swelling in the leg muscles, joints and tendons. It is also considered useful in reducing the appearance of swollen leg veins, called varicose veins, and smaller bulges called spider veins. It is also used to treat painful leg muscle spasms or cramps.

The Latin name for horse chestnut is aesculus hippocastanum. The horse chestnut tree is native to the southeastern European region called the Balkans. The tree does not produce the chestnut commonly used for food. Its leaves, bark and flowers were traditionally used to make medicinal treatments. The leaves were made into a cough syrup, and the bark was used in a tea to reduce fever.

Most commercial horse chestnut preparations sold in the West now utilize only the seed. The main active ingredient in horse chestnut seed is its extract aescin, also spelled escin. Aescin is considered an anti-inflammatory and venotonic, which means a tonic for the veins. When taken internally in capsule form, the astringency of horse chestnut extract is supposed to tone and tighten lapsed veins. Applied externally as horse chestnut cream, it may increase blood circulation to reduce swelling.

The standard application dosage for horse chestnut cream is three to four times a day on the affected area. Once signs of improvement begin, the applications may be less frequent. Many physicians and pharmacists believe aspirin and horse chestnut cream should not be used together because both are blood thinners. Overuse of blood thinners or anticoagulants may cause bruising or excessive bleeding.

Many Western practitioners of herbal medicine feel the most effective course of action to treat swollen veins does not involve relying solely on horse chestnut cream. There are several traditional remedies thought to work well. Compression garments, ice packs and leg elevation may all be useful and safe remedies to provide additional relief. Leg massage and exercise are thought beneficial to vein health, too.

Unprocessed horse chestnut seeds are toxic. The benefits of horse chestnut cream have not been evaluated by the American Food and Drug Administration (FDA). A rare reported side effect of using horse chestnut cream is a severe skin allergic reaction. People who are pregnant or undergoing treatment for kidney or liver disease should not use horse chestnut cream. A physician should always be consulted before taking any herbal supplement.