Ruscus aculeatus (commonly known as butcher’s broom) has been traditionally used in Europe for circulatory disorders, particularly those involving venous insufficiency. In modern times, its root extract has been studied for potential benefits in treating chronic venous insufficiency (CVI), a condition closely related to varicose and spider veins. The active compounds, mainly ruscogenins, are believed to exert vasoconstrictive and anti-inflammatory effects on blood vessels, leading to improved venous tone and reduced capillary permeability.

Several clinical trials and meta-analyses have evaluated Ruscus extract, often in combination with hesperidin methyl chalcone and ascorbic acid, for CVI symptoms such as leg swelling, discomfort, and heaviness. These studies generally suggest modest benefits for CVI symptoms; however, evidence directly pertaining to the treatment or prevention of spider veins (telangiectasias) is limited. Most research focuses on larger, deeper veins rather than superficial spider veins.

Major reviews (e.g., the European Medicines Agency assessment and Cochrane reviews) recognize Ruscus as likely effective for symptomatic relief in CVI, but do not confirm its efficacy specifically for spider veins. In summary, while there is scientific support for Ruscus in improving venous insufficiency symptoms, direct high-quality evidence for spider veins is weak or lacking, justifying a moderate evidence rating.