Compression stockings versus polyphenols for cellulite and water retention

TL;DR: For the more severe cases of water retention, compression garments (stockings, socks, tights etc) make sense but for any other cases polyphenol-rich supplements offer blood vessel support from within.

For cellulite compression garments conceal cellulite immediately but they are detrimental in the long run.

Polyphenols vs compression stockings for cellulite: what is best?

Does compression help with cellulite and water retention?

Graduated compression stockings can offer some relief from water retention, however they are quite uncomfortable, especially in the summer, when they are most needed.

For cellulite, things are even more complicated, as compression leggings help in some ways and are detrimental in some others.

Clearly there must be a better way and for water retention this is no other than the combination of healthy eating, exercise and - as we will see below - supplementation with key polyphenols.

For cellulite we can add high-power, deep tissue radiofrequency/ultrasound, which also offer fast results - always in combination with diet, exercise, polyphenols.

Compression socks for water retention? Cellulite stockings? No thanks, polyphenols are much better.

For water retention prevention, as well as for reduction, certain natural herbal extracts (such as gotu kola, horse chestnut, pine bark and ruscus aculeatus, among others) and citrus flavonoids (such as hesperidin, rutin, quercetin and diosmin among others) have been proven to be as good or better than compression garments in the long run (four such research papers are listed at the end of this article).

This is because these plant chemicals help actual blood and lymphatic vessels to function, rather than providing an external help with compression.

For example, the combination of diosmin with hesperidin has been used in continental Europe for decades as a prescription medication endorsed by national health services for the effective treatment of water retention.

(In the UK, our NHS is, of course, asleep on the wheel… The same applies to probiotics, which have been prescribed in continental Europe for decades for the treatment of diarrhoea and other gastrointestinal complaints.)

All the herbal extracts mentioned above are also beneficial for cellulite in ways other than water retention. For example, gotu kola also helps with fibrosis, fat accumulation, glycation and skin firming.

Plus the polyphenols contained in the above herbal extracts are also beneficial for whole body health, which compression garments cannot provide.

So in addition to a healthy lifestyle (healthy eating, exercise etc) it makes sense to add those to your regime, rather than wearing compression stockings, leggings and tights all the time, especially in the summer.

For more severe water retention cases, polyphenol supplementation and compression garments can always be combined, anyway.

(This does not apply to severe cellulite, though, which compression stockings/leggings will make worse.)

Note: Before taking any supplements or stopping the use of medical devices, such as compression garments, always consult with your healthcare practitioner first.

Polyphenols in cellulite creams

Highly concentrated, pure polyphenol molecules specific to cellulite, can also be found in a very small number of cellulite creams, for topical help with cellulite, where it is needed.

Two caveats here:

  • Choose a cream with HIGH concentrations of actives, in PURE molecule form. Unfortunately, most products are too diluted and contain crude extracts, as opposed to purified molecules.

  • Use the cream for 6-12 weeks for some good results, not the usual 1-2 weeks

Topical products can offer valuable relief for water retention on the skin (part of the cellulite appearance) but they would not help with deeper / more clinical water retention.

For a deeper effect oral supplementation is better, as mentioned above.

However, you can always combine topical and oral supplementation, for maximum results.

Horse chestnut seed extract for chronic venous insufficiency

  • Research paper link: https://pubmed.ncbi.nlm.nih.gov/23152216

  • Abstract: Background: Conservative therapy of chronic venous insufficiency (CVI) consists largely of compression treatment. However, this often causes discomfort and has been associated with poor compliance. Therefore, oral drug treatment is an attractive option. This is an update of a Cochrane review first published in 2002 and updated in 2004, 2006, 2008 and 2010. Objectives: To review the efficacy and safety of oral horse chestnut seed extract (HCSE) versus placebo, or reference therapy, for the treatment of CVI. Search methods: For this update the Cochrane Peripheral Vascular Diseases Review Group searched their Specialised Register (last searched June 2012) and CENTRAL (Issue 5, 2012). For the previous versions of the review the authors searched AMED (inception to July 2005) and Phytobase (inception to January 2001) for randomised controlled trials (RCTs) of HCSE for CVI. Manufacturers of HCSE preparations and experts on the subject were contacted for published and unpublished material. There were no restrictions on language. Selection criteria: RCTs comparing oral HCSE mono-preparations with placebo, or reference therapy, in people with CVI. Trials assessing HCSE as one of several active components in a combination preparation, or as a part of a combination treatment, were excluded. Data collection and analysis: Both authors independently selected the studies and, using a standard scoring system, assessed methodological quality and extracted data. Disagreements concerning evaluation of individual trials were resolved through discussion. Main results: Overall, there appeared to be an improvement in CVI related signs and symptoms with HCSE compared with placebo. Leg pain was assessed in seven placebo-controlled trials. Six reported a significant reduction of leg pain in the HCSE groups compared with the placebo groups, while another reported a statistically significant improvement compared with baseline. One trial suggested a weighted mean difference (WMD) of 42.4 mm (95% confidence interval (CI) 34.9 to 49.9) measured on a 100 mm visual analogue scale. Leg volume was assessed in seven placebo-controlled trials. Six trials (n = 502) suggested a WMD of 32.1ml (95% CI 13.49 to 50.72) in favour of HCSE compared with placebo. One trial indicated that HCSE may be as effective as treatment with compression stockings. Adverse events were usually mild and infrequent.

Horse chestnut seed extract - an effective therapy principle in general practice. Drug therapy of chronic venous insufficiency.

  • Research paper link: https://pubmed.ncbi.nlm.nih.gov/8767939/

  • Abstract: Within the framework of a case observation study involving more than 800 general practitioners, more than 5,000 patients with chronic venous insufficiency (CVI) were treated with standardised horse chestnut extract and followed up at regular intervals. The evolution of the symptoms, tolerability and adverse drug reactions were recorded. All of the symptoms investigated-pain, tiredness, tension and swelling in the leg, as well as itching and the tendency towards edema-all improved markedly or disappeared completely. The results of this study show that rational treatment with horse chestnut extract represents an economical, practice-relevant therapeutic "pillar", which in comparison with compression has the additional advantage of better compliance.

Management of Varicose Veins and Chronic Venous Insufficiency in a Comparative Registry with Nine Venoactive Products in Comparison with Stockings

  • Research paper link: https://pubmed.ncbi.nlm.nih.gov/28804235/

  • Abstract: The aim of this registry study was to compare products used to control symptoms of CVI. Endpoints of the study were microcirculation, effects on volume changes, and symptoms (analogue scale). Pycnogenol, venoruton, troxerutin, the complex diosmin-hesperidin, Antistax, Mirtoselect (bilberry), escin, and the combination Venoruton-Pycnogenol (VE-PY) were compared with compressions. No safety or tolerability problems were observed. At inclusion, measurements in the groups were comparable: 1,051 patients completed the registry. Best performers : Venoruton, Pycnogenol, and the combination VE-PY produced the best effects on skin flux. These products and the combination VE-PY better improved PO 2 and PCO 2 . The edema score was decreased more effectively with the combination and with Pycnogenol. Venoruton; Antistax also had good results. Considering volumetry, the best performers were the combination PY-VE and the two single products Venoruton and Pycnogenol. Antistax results for edema were also good. The best improvement in symptoms score were obtained with Pycnogenol and compression. A larger decrease in oxidative stress was observed with Pycnogenol, Venoruton, and with the VE-PY combination. Good effects of Antistax were also observed. Parestesias were lower with Pycnogenol and with Antistax. Considering the need for interventions, the best performers were Pycnogenol, VE-PY, and compression. The efficacy of Pycnogenol and the combination are competitive with stockings that do not have the same tolerability in warmer climates. A larger and more prolonged evaluation is suggested to evaluate cost-efficacy (and non-interference with drugs) of these products in the management of CVI. The registry is in progress; other products are in evaluation.

Effectiveness of the combination of alpha tocopherol, rutin, melilotus, and centella asiatica in the treatment of patients with chronic venous insufficiency

  • Research paper link: https://pubmed.ncbi.nlm.nih.gov/11292962/

  • Abstract: Background: The aim of this comparative clinical study was to evaluate the efficacy of the association of alphatocopherol, rutin, melilotus officinalis, and centella asiatica with oral administration in patients with chronic venous insufficiency. Methods: Thirty patients with chronic venous insufficiency have been randomized in two groups of fifteen subjects (control and treatment group). During the period of treatment the patients didn't wear elastocompressive stockings. The therapeutic efficacy and the clinical tolerability of this association have been valued with clinical-instrumental evaluations and by a control after 15 and 30 days. Functional bothers, cramps and the edema have been valued in function presence and of their gravity with a clinical-score between 0 and 4. Results: At the end of the observation period, a significant improvement of the clinical simptomatology was obtained, characterised by a diminution of the suprafascial edema. Conclusions: The present study confirms previous clinical experiences regarding the described treatment and suggests its application in chronic venous insufficiency.

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