Many cosmetic companies have woken up to the big demand for topical treatments and have used natural active ingredients at high levels in creams to provide alternatives to clinical treatments for spider veins.

If you're worried about how well spider vein creams work ? there are many clinical studies with results that should put your mind at rest. Scientists first became interested in many of these natural ingredients because of anecdotal evidence but there's more to it than "old wives" tales. Many first rate clinical studies have now been carried out which validate many of the claims made by the makers of spider vein creams.

So what are the main tried and tested ingredients in spider vein creams and how do they work? The top five most effective ingredients currently used in spider vein creams are:

1. Vitamin K - proven to repair veins and capillaries, and used extensively by doctors to reduce the appearance of bruises and spider veins.

2. Japanese Pagoda Tree - used widely in Europe since the mid-1960s for treatment of various vein conditions including spider veins and has been shown to enhance vein stability, improve circulation and reduce inflammation.

3. Horse chestnut extract - as an extract has been used for many decades as a herbal preparation for spider and varicose veins. It has been shown to reduce inflammation and improve vein wall tone, mend tiny leaks in veins and capillaries and strengthen and improve the elasticity of vein walls.

4. Butcher's Broom ? has been shown to strengthen and tone veins, as well as lessen swelling and inflammation and relieve numbness, cramping, and the "heavy" sensation in the leg.

5. Grape Seed Extract - well known for its antioxidant properties, also shown to improve circulation, strengthen connective tissues, and reduce the effects of aging on skin.

There are an increasing number of studies that demonstrate the effectiveness of these natural ingredients - applied topically - in improving overall vein health and diminishing the appearance of spider veins.

The most often studied spider vein cream ingredient is horse chestnut. Horse chestnut contains blood thinning chemicals which are believed to reduce the pressure put on the veins wall and the vein valve.

Butcher's broom was the basis of a study done in the 1980's which demonstrated that Butcher's Broom was effective in treating spider veins. The majority of the twenty patients tested reported lessened swelling and improved vein tone. This seems to be due to the steroid-like compounds in the plant, which reduce pressure on the veins.

Many of the creams available will contain one or more of these ingredients. The trick is to go for a reputable manufacturer and the highest concentration of active ingredients you can find.