How are varicose veins treated?

Medically reviewed by Danielle McNeil, DPM

Varicose vein treatments reduce symptoms, prevent complications such as leg pain, blood clotsthe wounds (ulcers), and sometimes they eliminate them.

For some people, varicose veins cause no symptoms and treatment is aimed at improving their appearance. While conservative treatments can help improve symptoms and prevent varicose veins from worsening, procedures are usually required to eliminate varicose veins.

This article discusses different ways to treat varicose veins, including home remedies, lifestyle changes, medication, and surgery.

Home remedies and lifestyle changes

For some people, home remedies and lifestyle changes may improve symptoms and keep varicose veins from getting worse. Home remedies and lifestyle changes that may improve varicose veins include:

• Wearing compression socks

• Elevating your feet several times a day for about 15 minutes

• Avoiding sitting or standing for long periods

• Enough exercise

• Avoiding high heels or tight clothing, especially around the waist, thighs and legs

While home remedies and lifestyle changes can improve symptoms and prevent new varicose veins, they cannot eliminate existing ones.

Compression stockings apply gentle pressure to the leg to reduce swelling and prevent blood pooling. The three types are:

• Support tights: Provide minimum pressure

• Over-the-counter (OTC) compression hose.: Apply some pressure

• Prescription-strength compression hose: Provide the greatest amount of pressure and usually need to be placed by a trained employee at a medical supply store or pharmacy

OTC and prescription treatments

Phlebotonic They are natural flavonoids and are sometimes used to treat varicose veins. Phlebotonics are usually sold as dietary supplements. Diosmiplex and horse chestnut seed extract are phlebotonics that treat varicose veins.

While there is evidence that some phlebotonics can reduce edema (swelling) and other symptoms, research shows that the majority have little or no effect on improving quality of life. There is no research on how safe and effective most are for treating varicose veins.

Diosmiplex

Vasculera (diosmiplex) has been the only prescription phlebotonic formula available in the United States for years venous insufficiency, a blood circulation disorder that leads to varicose veins and other conditions. It is derived from orange peels and is categorized as a medical food and not a medicine.

Diosmiplex improves symptoms such as leg swelling, pain and night cramps. It is also effective in healing wounds smaller than 10 cm.

Diosmiplex is usually prescribed at a dose of one 630-milligram tablet per day, and it may take anywhere from four weeks to several months to see improvement in symptoms. The most common side effect is gastrointestinal upset. serious side effects are rare.

Horse chestnut seed extract

Horse chestnut seed extract (HCSE) has been shown to improve symptoms such as calf cramps, pain, fatigue and swelling in the legswith the effects believed to be due to HCSE’s active ingredient, ascine.

Research has shown that HCSE is safe, well tolerated, and as effective as compression therapy in relieving varicocele symptoms. The typical dose used for HCSE is 300 milligrams twice a day for two to 16 weeks.

Surgeries and specialized procedures

Various methods are used to treat varicose veins, including non-invasive procedures, laser therapy and specialist-led surgery.

Sclerotherapy

Sclerotherapy is the most common procedure for varicose veins. It treats both varicose veins and small varicose veins. During the procedure, a chemical is injected into different areas of the veins using ultrasound imaging for guidance. The chemical irritates the walls of the veins, causing them to stick together so that blood can no longer flow through the vein.

This procedure is usually done in an office without anesthesia, and most people return to work and other activities the next day. Daily walks and wearing compression stockings for two to three weeks are required to prevent possible side effects.

Complications from sclerotherapy include changes in skin color and, in rare cases, blood clots, nerve damage, severe allergic reaction, or stroke.

Intravenous ablation

In intravenous excision, guided by ultrasound imaging, the healthcare provider inserts a fiber or electrode into the vein through a small incision. Radio frequency or laser energy is then used to heat the container, causing it to close.

The procedure can be done on larger varicose veins and is usually done on an outpatient basis under local anesthesia. Normal activities can usually be resumed immediately after the procedure, although compression stockings may need to be worn during recovery. It can take up to a year for the vein to disappear.

Common side effects of IV ablation include bruising, pain, and changes in skin color. Serious side effects such as numbness, skin burns and blood clots are rare.

Laser treatment

Laser therapy was once used only for treatment spider veins in the face, but newer technology has
made it an effective treatment for smaller varicose veins. During the procedure, laser light is applied to the skin in the area above the vein. The laser light then obliterates the vein without damaging the skin.

Small spider veins may disappear immediately after treatment, while varicose veins usually darken and take one to three months to disappear. It may take three or more treatments to get full results.

Surgery

Surgical options are usually only used for people with severe varicose veins who are not candidates for other treatments. While serious side effects are rare, varicose vein surgery can have complications that include infection, nerve damage, bruising, pain, and changes in skin color.

Ligation and stripping are the most well-known surgical procedures for varicose veins and involve surgically tying and then removing veins through incisions in the skin. The surgery is on an outpatient basis (you go home the same day of the operation) and uses general anesthesia. Full recovery takes one to four weeks. Although ligation and stripping were once common treatments, the procedures are now done only in severe cases.

Microphlebectomywhich uses special tools inserted through small incisions to remove the varicose vein
veins, is also sometimes done alone or with vein stripping. Microphlebectomy can be used on small branches of varicose veins that do not respond to other treatments or require additional treatment.

Summary

The treatment of varicose veins has improved significantly thanks to modern technological advances. While at home, over-the-counter and prescription treatments can improve symptoms and prevent varicose veins from getting worse, sometimes sclerotherapy or intravenous ablation is needed to eliminate varicose veins.

Although surgeries were once common treatments for varicose veins, they are now used only in extreme cases. This is mainly because they require a longer recovery than less invasive interventions and have more potential side effects.