Certain compounds have shown some benefit. They include the saponins (horse chestnut seed extract) and flavonoids (such as hesperidin, diosmin, micronized purified flavonoid fraction and rutosides).
Horse chestnut seed extract (aescin) can reduce swelling, discomfort and itching. Typical dosages are 50mg of the active compound aescin, twice daily. Formulations sold are often 250mg horse chestnut (20% being aescin), twice daily.
The flavonoids appear to have anti-inflammatory effects and may reduce swelling. Flavonoids can be found in grape seed, blueberry, cranberry, hawthorn and pine bark.
The drug pentoxifylline appears to help with venous ulcer healing, particularly at the higher dose of 800mg three times a day (but has a high rate of gastric upset).