A varicose vein near a person's knee.

6 Treatment Options for Varicose Veins

Varicose Vein Treatment Options

We’re all familiar with varicose veins — those colored, enlarged and bulging veins that appear on people’s legs. Are they a serious health risk? Can they be treated and what is varicose vein treatment?

Varicose veins are a common condition and usually start appearing after the age of 50. Varicose veins affect up to 35% of people in the U.S. For most, varicose veins are mild and do not pose as a health risk. However, symptoms may become uncomfortable enough to need medical attention.

This article explains what varicose veins are, as well as the available treatments, ranging from at-home management to different medical interventions. We also discuss when treatment for varicose veins might be considered, the main risk factors and steps you can take to prevent varicose veins or stop them from becoming worse.

What Are Varicose Veins?

Varicose veins are the blue or purple, swollen, sometimes bulging and twisted veins that occur mostly on the legs. They should not be confused with spider veins, which are areas of skin covered with tiny visible veins that look like cobwebs.

Veins carry blood back to the heart and have one-way valves to prevent blood from flowing back towards the lower part of the limb. So, varicose veins occur mostly in the legs because the blood has to travel a long distance and against gravity.

Varicose veins develop when the valves no longer work properly, causing the blood to pool and veins to permanently stretch. With age, our vessel walls tend to become less elastic, causing the flaps of the valves to no longer meet in the middle. A valve can also be damaged by an injury.

The symptoms of varicose veins are related to poor blood flow in the affected limb and can be mild to more severe. The most common symptoms are pain, heaviness and swelling in the affected limb, particularly after standing for a long time. There can also be skin changes like dryness, flaking, discoloration and delayed wound healing.

Varicose Vein Treatment

Most often varicose veins do not cause any symptoms, and mild symptoms can be managed at home because the condition does not pose a health risk. Medical treatment should be considered if symptoms start to cause more significant discomfort or if complications develop.

The following are the potential treatments, ranging from those you can undertake yourself at home, to various medical interventions.

1. Improve Blood Flow in Your Legs

The following suggestions will help to improve blood flow in your lower leg and relieve the symptoms of varicose veins:

  • Lie down with your legs raised on a pillow for periods of 15 minutes at a time during the day.
  • Sleep with your legs raised on a pillow.
  • Avoid sitting for lengthy periods, especially with your legs crossed. Raise your legs on a chair while sitting.
  • Avoid standing for long periods. If you have to stand, try and move around every 30 minutes.
  • Exercise regularly; during walking and other exercise, the muscles of the lower legs help to squeeze the blood in the direction of the heart.
  • Avoid clothes that are tight around the abdomen and groin.

2. Wear Compression Stockings

Knee-high compression stockings are tight around the ankles and become looser farther up the legs. You can buy them from pharmacies or online. A doctor can prescribe stockings with a stronger level of compression than those available over the counter.

These specialized stockings compress the veins, helping to prevent blood from pooling or flowing backwards. You shouldn’t use compression stockings without medical advice if your skin is already dry and flaky, as they further reduce blood supply to the skin.

Compression stockings are effective in reducing the pain and swelling caused by varicose veins but research is not clear on whether they actually prevent the condition from becoming worse.

3. Over-the-Counter Treatments

Various creams are available over the counter, which may relieve the pain and improve the appearance. You can ask your pharmacist about these treatments.

A few herbal remedies have also shown some benefit for varicose veins, but more research is needed. Those with some promising results include grape vine essential oil, lavender, yarrow and horse chestnut essential oil.

4. Endovenous Ablation

Due to recent technological advances, various types of endovenous ablation therapies have become popular for treating varicose veins. Endovenous means inside the vein, and the medical term ablation refers to the removal or destruction of body tissue.

Endovenous ablation is minimally invasive and usually done in under local anesthetic. The procedure involves threading a thin tube into the vein, which is then sealed off with a source of heat (usually radiofrequency or laser). The loss of the vein is not a problem, as it was not functioning properly to begin with.

This treatment has been found to be beneficial, with faster recovery and fewer complications than some of the older treatment methods. However, it is only suitable for varicose veins that are relatively straight.

5. Sclerotherapy

Sclerotherapy can be used for small-to-medium-sized varicose veins that are very twisted and not suitable for ablation therapy.

This treatment also involves inserting a tube into the vein through a small tube. A chemical in then injected into the vein, which scars the tissue, causing it to shut down. This procedure may have to be repeated more than once to close the vein completely.

6. Phlebectomy

The standard treatment for varicose veins in the past was the surgical removal of the varicose vein under general anesthetic. This procedure is still used for large veins.

A phlebectomy involves removing the whole vein through ligation and stripping. This means making a small cut in the groin and lower down, then pulling out the whole vein with a wire. This is a minor surgical procedure and does not usually require an overnight stay, although movement is usually limited for a few weeks.

An updated procedure, transilluminated powered phlebecomy, uses a special light under the skin to target specific veins and remove them piece by piece with suction through small incisions.

When Should Varicose Veins Be Treated?

Most people do not experience any symptoms from varicose veins. Some might experience mild aching, heaviness and swelling in the lower legs, especially after standing for a long time.

With mild symptoms, where there is no particular health risk, the condition does not need a medical diagnosis or treatment. Some people might decide on treatment for cosmetic reasons.

Treatment can be considered if the above symptoms cause increasing discomfort or further symptoms, like leg cramps, bleeding and slow healing of small wounds and skin changes, like dryness, flaking, discoloration and eczema.

In rare cases, complications might require medical intervention. Poor blood supply can lead to varicose ulcers, which take long to heal, and very seldom a vein can burst, causing extensive bleeding.

Occasionally, a blood clots can develop in a varicose vein, causing pain, redness and hard swelling. This condition is called phlebitis and normally resolves within a few months after treatment. Because varicose veins are surface veins, they do not carry the same risk as deep vein thrombosis: clots traveling to the heart or lung.

Specialized Vein Treatment Centers

Increasingly, treatment for varicose veins is provided by vascular surgeons, many of whom work at special vascular clinics. These clinics can be found across the country, and you can search the internet for the one closest to you.

Vascular surgeons are experts in treating conditions related to blood vessels, so they stay up to date with the new treatments that are emerging all the time.

Surgery might not be the best option for you. After a complete physical examination, and possibly a scan to investigate the structure of the veins, the vascular surgeon will be able to determine the best treatment for you.

Risk Factors and Prevention of Varicose Veins

The risk factors for developing varicose veins all have an effect on blood circulation in the legs and include aging, family history, standing or sitting for long periods, injury to the veins, pregnancy, obesity and type 2 diabetes.

These risk factors make it clear that, as with most chronic conditions, a healthy lifestyle will help to prevent varicose veins or stop them from progressing.

  • Follow a healthy diet with the necessary nutrients to help slow the aging process and prevent obesity and diabetes.
  • Drink enough fluids, as dehydration also affects circulation.
  • Get enough sleep to allow the body to recover.
  • Exercise to keep every part of your body functioning properly and stimulate blood circulation.
  • Avoid long periods of standing and sitting – try to move around for a few minutes every hour.

Managing Varicose Veins

Varicose veins are a common condition and seldom pose as a serious health risk. Most often they do not require treatment and there are various options to manage mild symptoms yourself. You can also take steps to prevent varicose veins from getting worse.

However, if varicose veins are causing you serious discomfort or you are unhappy about how they are affecting your appearance, there are various medical treatment options available. With modern technology, the treatments are becoming increasingly less invasive, with a good outlook for recovery and minimal risks.

If you are considering treatment, the recommended course of action is to consult a vascular surgeon who will be able to make a detailed diagnosis and determine the best course of action for you.