The horse chestnut has been used as a traditional remedy for arthritis, rheumatism and the management of varicose and hemorrhoids. The seeds are toxic, and many methods have been used to rid them of toxicity. The herb is more popularly used in Europe.

The useful constituents of horse chestnut are derived from the seeds and bark of the Aesculus tree. Aescin seems to provide some weak diuretic activity and may decrease the permeability of venous capillaries. It also has a tonic effect on the veins and prevents collagen breakdown by inhibiting glycosaminoglycan hydrolases. Sterol content may have some anti-inflammatory activity. The toxic glycoside, aesculin, is a hydroxycoumarin with potential antithrombotic activity; however, the toxin is removed during preparation. Horse chestnut is available as capsules and as creams made from an aescin/cholesterol complex, in products such as Arthro-Therapy, Cell-U-Var Cream, Varicare, Varicosin, Venocare Ultrajoint Response, and Venastat.