Horse chestnut

Authors: Prof. Dr. med. Peter Altmeyer, Prof. Dr. med. Martina Bacharach-Buhles

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Last updated on: 07.05.2024

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Aesculus hippocastanum; Chestnut; Gout tree; Horse and sow chestnut

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Horse chestnut is a deciduous tree up to 35 m high, with a dense arched crown and strong trunk, which can live up to 200 years. Originally native to the mountains of Eastern Europe, Asia Minor, from the Balkans to the Himalayas, spread throughout Europe from the 16th century. Thick, cone-shaped, sticky buds form in spring. The large leaves are 5- to 7-fingered and sit on long stalks. The fruits ripen in September/October.

Stem plant of the officinal preparations of:

Horse chestnut seeds in the form of standardized dry extracts as rational phytotherapy (well established use) for the treatment of chronic venous insufficiency (CVI) with its typical symptoms (swollen legs, varicose veins, heavy and tired legs, pain, itching, muscle tension and calf cramps).

ESCOP: In chronic venous insufficiency and varicose veinsCommission
E: In chronic venous insufficiency (pain and heaviness in the legs, cramps in the calves, itching, leg swelling).

According to the HMPC, horse chestnut bark is traditionally used for CVI and hemorrhoids.

General information
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Only horse chestnut seeds in the form of finished medicinal products standardized to triterpene saponins(aescin) with the appropriate dosage orally for chronic (long-term) venous insufficiency, swollen legs, varicose veins, heaviness in the legs, pain, tiredness, itching, tension and cramps in the calves count as rational phytotherapy (HMPC).

Traditionally used orally or locally for discomfort and heaviness in the legs associated with minor circulatory problems in the veins, to relieve bruising, local swelling and hematomas.

A paste made from the seeds is said to help with gout and rheumatic complaints (gout tree).

Extracts from the seeds are also used in medicine today. They contain a mixture of plant-based active ingredients, with aescin, a complex of biologically active triterpene saponins, being the best-known main active ingredient. Aescin is said to have vascular-sealing, venotonic and anti-oedematous effects. Aesculin, a glycosidic coumarin derivative, is also said to have a vein-toning effect. Preparations made from horse chestnut extract are prescribed for cardiac and venous oedema as well as for pain and heaviness in the lower extremities. Their effectiveness has been proven in various studies.

The fluorescence of aesculin was reported as early as the 19th century. In 1929, the German chemist Paul Krais observed that textiles (wool and flax fibers) appeared optically brighter after treatment with aesculin. 4-methylumbelliferone, the first industrially produced optical brightener, was derived from aesculin.

Glacier ointments against sunburn can contain extracts from their buds.

"Chestnut Bud" is the name given to the essence from horse chestnut buds in Bach flower therapy.

The bark used to be used to treat fevers. The flowers and leaves are used externally in various preparations for painful injuries/sprains, bruising, oedema, varicose veins, pain in the spine, circulatory problems, palpitations and runny nose.

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oral administration: headache, stomach discomfort, nausea and itching.

with local application: possibly itching

General therapy
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For horse chestnut seeds(Hippocastani semen) the quality is defined in the European Pharmacopoeia (Ph. Eur.), for horse chestnut bark(Cortex Hippocastani) no pharmacopoeia quality description is available.

Preparations: e.g. Antistax®, Venoplant retard®.

Aescorin® N Ointment, Anisan® Hemorrhoidal Ointment S, Arthrodynat® Ointment, Eye Drops Stulln® mono, Intradermi® Fluid N, Trauma-cyl Ointment, Varicylum® S Ointment, Venen-Fluid, Venostasin® N Ointment, Venotrulan® Ointment

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Leaves, recipes for chestnut leaf, blossom and bark teas, chestnut blossom essence (as bath additives), chestnut spirit, chestnut extract, tincture and mash are available in health food shops and pharmacies.

Allergologically, the pollen of the chestnuts does not play a significant role.

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  1. Suter A et al. (2006) Treatment of patients with venous insufficiency with fresh plant horse chestnut seed extract: a review of 5 clinical studies. Adv Ther 23: 170-190
  4. Wenigmann M. (2017) Phytotherapy medicinal drugs, phytopharmaceuticals, application. Urban & Fischer, pp. 184-185