Grape seed extract (Vitis vinifera, oligomeric proanthocyanidins)

Grape seed extract is sold as a «natural collagen protector» for skin firmness. No RCTs with clinical wrinkle assessment endpoints (Glogau, Fitzpatrick) or skin histology. AAD 2021 lists SPF 30+ photoprotection, topical retinoids (tretinoin, adapalene), azelaic acid first-line for photoaging, and procedures (laser resurfacing, botulinum toxin, fillers) for deep wrinkles. If grape seed extract was recommended as a retinoid or procedure substitute, consider seeking a second opinion from a dermatologist.

Grape seed extract contains oligomeric proanthocyanidins, plant antioxidants marketed to slow aging and extend lifespan. Studies have not shown convincing benefit for this use: there is no solid evidence that the supplement actually affects aging or how long people live. What does help these outcomes is the ordinary stuff – sleep, diet, physical activity and sun protection for the skin.

Grape seed extract is sold as «natural help for veins and vessels». Several small RCTs in 50–150 patients with CEAP C2–C3 CVI showed moderate reduction of leg heaviness and calf circumference at 150–300 mg/day × 4–8 weeks vs placebo. No Cochrane-level systematic reviews. ESVS 2022 lists compression stockings 23–32 mmHg and micronised diosmin/hesperidin (Detralex/Daflon, Venoruton, rutosides) first-line for CVI; grape seed extract is not mentioned in international guidelines. If grape seed extract was recommended as a compression or venotonic substitute, consider seeking a second opinion from a phlebologist.

Grape seed extract is sold as a «natural cardioprotector» and cholesterol-lowering supplement. Feringa 2011 meta-analysis of 9 RCTs in 390 patients showed modest systolic BP reduction (−1.5 mmHg) without significant effect on total cholesterol, LDL or HDL. ESC dyslipidaemia 2024 at LDL >1.8–3.0 mmol/L (depending on CV risk) lists statins (atorvastatin, rosuvastatin) first-line; if not at goal – ezetimibe, PCSK9 inhibitors (alirocumab, evolocumab) or bempedoic acid; grape seed extract is not in guidelines. If grape seed extract was recommended as a statin substitute in primary or familial hypercholesterolaemia, consider seeking a second opinion from a cardiologist.