Topical agents are widely used in the treatment of chronic venous diseases (CVD) and acute thrombophlebitis. However, vari-ous physicians are skeptical about the effectiveness of such medication. They believe that the effects of topical agents are based on massage manipulation rather pharmacological activity per se. Massage effect together with skin cooling caused by volatile matter evaporation can only partially explain symptoms improvement induced by transdermal system application. Significance of these effects is confirmed by short-term reduction of some specific venous symptoms following placebo. Effectiveness of heparin and escin-based remedies is determined by specific pharmacological properties with anti-inflammatory and decongestant effects. This review is devoted to transdermal forms of heparin and escin in combination with essential phospholipids. The last ones form liposomes, promote penetration of heparin and escin into deeper skin layers and potentiate their activity. These remedies reduce severity of specific venous symptoms (heaviness in legs, fatigue, edema, pain, convulsions) in patients with chronic venous diseases and relieve acute inflammation in case of acute thrombophlebitis.