Varicose Veins
Treatment Overview
The goals of varicose vein treatment are to reduce symptoms and prevent complications. For some, the goal may be improved appearance. Home treatment—especially exercising, wearing compression stockings
, and elevating the legs—is the first and often best approach.
If home treatment does not help, there are treatment options. Vein surgery, called ligation and stripping, is a standard treatment for problem varicose veins. However, laser or radiofrequency vein treatments are likely to give good results with less risk, less pain, and a shorter recovery time.3 Because these are fairly new treatments, long-term results aren't yet known. If you have laser or radiofrequency treatment, look for a doctor with a lot of experience.
- Ligation and stripping. Incisions are made over the varicose veins, and the vein is tied off (ligated) and removed (stripped).
- Sclerotherapy. A chemical (sclerosant) is injected into a varicose vein to damage and scar the inside lining of the vein, causing the vein to close. This usually works best for small veins.
- Laser treatment. Laser energy is used to scar and destroy varicose veins. This is called ablation. Endovenous laser therapy uses a laser fibre inserted into the vein. Laser ablation inside the vein makes the vein close up.
- Radiofrequency treatment. Radiofrequency energy (instead of laser energy) is used inside a vein to scar and close it off. It can be used to close off a large varicose vein in the leg. This ablation treatment is an alternative to endovenous laser therapy. It is not yet widely available in Canada.
Treatment may be necessary to remove the damaged veins, treat complications, or correct an underlying problem that is causing the varicose veins. The size of your varicose veins affects your treatment options. Generally, larger varicose veins are treated with surgery (ligation and stripping), endovenous laser, or radiofrequency treatment. In some cases, a combination of treatments may work best. Smaller varicose veins and spider veins are usually treated with sclerotherapy or laser therapy on your skin.
Some people may want to improve how their legs look, even though their varicose veins are not causing other problems. In these cases, surgery, sclerotherapy, or laser or radiofrequency treatment may be appropriate—as long as there are no other health problems that make these treatments risky. In Canada, not all treatments for varicose veins are covered by provincial health insurance plans. Talk to your doctor about which treatment options may be covered under your health plan. For more information, see:
What To Think About
Doctors recommend home treatment as a first step for varicose veins. This may be all you need to relieve symptoms. However, you may still want surgery or vein treatment if you are not satisfied with their appearance or your symptoms are not well controlled.
If you are thinking about having surgery or a vein treatment, you may want to know which treatment is best for you. No single approach is best for treating all varicose veins. Sclerotherapy, endovenous laser, or radiofrequency treatment may be best for smaller veins. Surgery may work better for larger veins, though laser or radiofrequency treatment may also work well (long-term studies are not yet done). Talk to your doctor about your choices.
Many treatment methods—including all types of surgery, sclerotherapy, laser, and radiofrequency ablation—can scar or discolour the skin.
People whose deep veins are also damaged or who have problems with perforating veins, which connect the deep and superficial veins, may not be able to treat their varicose veins with conventional therapy, such as surgery or sclerotherapy. Tests, such as Doppler ultrasound, may help your doctor determine whether your varicose veins can be treated.
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| Author: | Douglas Dana Kathe Gallagher, MSW | Last Updated: May 10, 2006 |
| Medical Review: | Adam Husney, MD - Family Medicine Kathleen Romito, MD - Family Medicine David A. Szalay, MD - Vascular Surgery | |
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