The science behind spider vein creams

Whether you choose to call them spider veins or thread veins, their appearance is unwanted. They are generally small red or blue capillaries under the skin: most often occurring on the legs and in some cases the neck and the face.

They’re a common enough occurrence, but knowing this isn’t comforting if spider veins are affecting your body confidence. If you have spider veins it’s natural to want to look for treatments, but it can be difficult to decide what is the best option. Creams and laser surgery are options, but how do you know what’s best for you?

If you have spider veins on your body, a natural first resort is a pharmacy, but with a dizzying array of creams on offer, how do you choose? To help you decide which, if any, might be best for you – it’s time to take the science behind these creams back to basics.

Tackling the technical

Each cream has an active ingredient: the component of the cream that manufacturers claim will make a difference to your spider veins. Many companies will use science as a screen, using complex terms and making bold claims to win your loyalty to their brand. Often they do this without explaining exactly what their cream is made from, which can leave many of us feeling confused or apprehensive when tasked with choosing a product.

Understanding some of the active ingredients in your cream will help you make a more informed choice about the products on the market. Here, we take a look at some of the active ingredients available in the most popular creams on the market, describe what exactly they are and how they might work to reduce your spider veins.

Horse Chestnut extract

Horse chestnut seeds aren’t just the preserve of classic playground games. The seeds can be processed, with the active chemicals concentrated to form a potent extract. This extract is often used in spider vein creams as there is some research to suggest that it could have benefits for treating a related condition called Chronic Venous Insufficiency (CVI)1. CVI is a condition which is characterised by symptoms related to poor circulation.

Researchers have claimed that horse chestnut extract can have a significant positive effect for those suffering with CVI to reduce leg pain and swelling of the vein: indicators of improved circulation1. However, this has only been concluded in relation to oral consumption of the extract, and is still yet to be shown as beneficial specifically for spider veins or other circulatory conditions.

Vitamin K

Vitamin K is one of the body’s most essential vitamins, playing a key role in the blood clotting process and in the health of our veins too2. While there are no studies to confirm it, some cream manufacturers claim that Vitamin K applied directly to spider veins, works its way through the skin into the capillaries where it can clot the pooled blood. The tissue can then reabsorb the pooled blood, and repair itself effectively.

Of course you can obtain Vitamin K from your diet, including food particularly rich in the vitamin such as: kale, broccoli, cabbage and spring onions. However, additional sources can be helpful in the form of a good quality supplement to take alongside a balanced diet.

Grape seed extract

There is some evidence to suggest that spider veins are caused by a process called oxidative stress.3 This is a process called oxidation whereby free radicals (unstable chemicals) are produced which can damage the cells within our bodies.

Grape seeds are rich in a powerful antioxidant called ‘ proanthocyanidins’. Some cream manufacturers claim this antioxidant can help to reduce the appearance of spider veins by making the blood vessels more elastic, allowing the collected blood to dissipate and so reduce this oxidative stress.

The creams containing grape seed extract have become popular in recent years and although they are prescribed in France for certain vein issues, there is little scientific evidence to suggest topical application is of any benefit.


The relationship between collagen levels, vein health, and the thinning of the skin is arguably the strongest when it comes to choosing a spider vein product (whether that be a cream or supplement).

Our capillaries are largely comprised of collagen, an essential protein which is an integral part of the capillary wall. As collagen levels decline, (due to age or lack of nutrients), so the capillaries become weakened. As a result there is a risk that spider veins will appear5.
‘Collagen infused’ creams profess to work by adding more collagen directly to the area of the body where spider veins have appeared. The problem is, if applied directly to the skin, there is no evidence to show that the collagen within the cream will permeate through and have an effect on your spider veins. The reason is that the skin itself is an effective barrier – even to seemingly beneficial substances such as collagen creams. A number of creams claim that they have developed unique mechanisms to overcome this, but there’s little direct evidence to support the fact that they actually work.

The body’s barrier

So, do creams work in treating spider veins? It’s time to get back to basics for the answer. Think about it, if you pour alcohol onto your skin you do not absorb or become affected by that alcohol. Some active ingredients may make their way into the body and can have a positive effect, such as moisturisers which work to hydrate the skin. However, the majority of substances simply sit on the surface of the skin, and do not work to permeate deep into the skin where problems, such as spider veins, might occur.

The good news is that the majority of spider vein creams on the market won’t have a harmful effect on the body. It’s also important to recognise that research into the area is limited. The lack of research doesn’t necessarily mean these creams do not work, just that their impact hasn’t been measured and recorded systematically.

If you are considering using a cream to improve the appearance of your spider veins, it’s also important to be more self-aware of the consequences of your everyday choices. Smoking, obesity, sun damage, and even drinking alcohol are all more significant factors in the development of spider veins, so it might be worth reconsidering some aspects of your lifestyle before resorting to a spider vein cream.

For more friendly advice have a look around our website or to one of our Nutrition Advisors.

1. Pittler MH, Ernst E (2012) Horse chestnut seed extract for long-term or chronic venous insufficiency. Cochrane.
2. Cario-Toumaniantz C et a. (2007) Identification of Differentially Expressed Genes in Human Varicose Veins: Involvement of Matrix Gla Protein in Extracellular Matrix Remodeling. Journal of vascular research. DOI:10.1159/00010618.
3. Bagchi D1, Sen CK, Bagchi M, Atalay M. (2004) Anti-angiogenic, antioxidant, and anti-carcinogenic properties of a novel anthocyanin-rich berry extract formula. Biochemistry (Mosc). 2004 Jan;69(1):75-80, 1 p preceding 75.
4. Ozguner, F. Koyu, A. Cesur, G. (2005) Active smoking causes stress and decreases blood melatonin levels. Toxicology and Industrial Health. DOI: 10.1191/0748233705th211oa
5. Ghaderian, S. and Khodaii, Z. (2012) Tissue remodeling investigation in varicose veins. International Journal of Molecular and Cellular Medicine. PMCID: PMC3920493. (

Lawrie Jones

Lawrie Jones

Lawrie is an experienced medical content specialist and strategist, having worked for NHS Bristol and a number of medical-based charities.