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Escin is the name of a product containing horse chestnut (Aesculus hippocastanum) used to treat spider veins and varicose veins. An inherited weakness in the structure of veins, much more common in women than in men, predisposes a person to varicosities when veins are subjected to increased pressure over time. The best preventive measures are avoidance of prolonged standing, frequent elevation of legs when seated, and conscientious use of elastic support stockings if standing is necessary. Conventional medical and surgical treatments are very invasive and often not successful. Horse chestnut is a promising alternative, primary used as a topical application. It is sometimes sold under the name escin. This herbal remedy is much better known in Europe than in America, but creams containing it are becoming available here. (European doctors also prescribe escin internally, but because of potential toxicity only topical use is recommended.)