What are the uses of Aesculus hippocastanum (Horse Chestnut)?

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Last updated: February 11, 2025View editorial policy

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From the Guidelines

Aesculus hippocastanum, commonly known as Horse Chestnut, is primarily used for its antiplatelet and antithrombin effects, and is often held 2 weeks before surgery due to these properties.

Uses and Considerations

  • The seed extract of Horse Chestnut may have antiplatelet effects 1, which can increase the risk of bleeding during surgery.
  • The bark of Horse Chestnut contains a compound called esculin, which has a direct antithrombin effect, but this compound should not be present in the seed extract 1.
  • Horse Chestnut is often recommended to be held 2 weeks before surgery due to its potential to affect bleeding risk 1.

Perioperative Management

  • The Society for Perioperative Assessment and Quality Improvement (SPAQI) recommends holding Horse Chestnut for 2 weeks before surgery due to its potential to increase bleeding risk 1.
  • This recommendation is based on the varying metabolism and uncertainty about drug clearance of Horse Chestnut, as well as its potential to interact with other medications 1.

From the Research

Uses of Aesculus hippocastanum (Horse Chestnut)

The uses of Aesculus hippocastanum, also known as Horse Chestnut, are varied and have been studied in several clinical trials. Some of the key uses include:

  • Management of chronic venous insufficiency (CVI) 2, 3, 4, 5
  • Treatment of haemorrhoids 3
  • Reduction of post-operative oedema 3
  • Cosmetic skin-care products due to its anti-inflammatory and anti-oxidant properties 6
  • Treatment of varicose veins 5

Key Benefits

The key benefits of using Aesculus hippocastanum include:

  • Reduction of lower leg swelling and edema 2, 5
  • Alleviation of leg pain, heaviness, and itching 5
  • Improvement of venous tone and reduction of capillary fragility 6, 3
  • Anti-inflammatory and anti-oxidant effects 6

Precautions and Interactions

It is essential to note that:

  • Horse chestnut seed extract may interact with anticoagulants and antidiabetics, and caution is advised in patients taking these drugs 4
  • The most common side effects are gastrointestinal disturbances, dizziness, and calf-muscle spasms 4
  • Raw seed, branch bark, or leaf of the horse chestnut tree are known to be toxic when ingested and should not be used 2

References

Guideline

Guideline Directed Topic Overview

Dr.Oracle Medical Advisory Board & Editors, 2025

Research

Horse chestnut:a multidisciplinary clinical review.

Journal of herbal pharmacotherapy, 2002

Research

[Horse chestnut--remedy for chronic venous insufficiency].

Tidsskrift for den Norske laegeforening : tidsskrift for praktisk medicin, ny raekke, 2009

Professional Medical Disclaimer

This information is intended for healthcare professionals. Any medical decision-making should rely on clinical judgment and independently verified information. The content provided herein does not replace professional discretion and should be considered supplementary to established clinical guidelines. Healthcare providers should verify all information against primary literature and current practice standards before application in patient care. Dr.Oracle assumes no liability for clinical decisions based on this content.

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