Learn About Varicose Vein Treatment Options

Understanding Varicose Veins and Why Treatment Matters

Varicose veins are enlarged, twisted veins that typically appear on the legs and feet. They form when the one-way valves inside veins weaken or fail, causing blood to pool and the vein to enlarge. According to the American Academy of Dermatology, varicose veins affect between 20 to 25 percent of adults in the United States, making them a common condition many people experience.

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The condition develops gradually. Normally, veins have valves that prevent blood from flowing backward. When these valves malfunction, blood accumulates in the vein instead of moving upward toward the heart. The pressure from this pooled blood causes the vein walls to stretch and become visible through the skin. Varicose veins most commonly appear on the legs because these veins work against gravity to return blood to the heart.

Several factors increase the likelihood of developing varicose veins. Age plays a role, as valve function naturally decreases over time. Family history is significant—if parents or grandparents had varicose veins, the risk increases substantially. Pregnancy increases risk because the body produces more blood and hormonal changes can weaken vein walls. Prolonged standing or sitting reduces blood circulation, occupations requiring long hours on feet create additional risk. Obesity places extra pressure on veins, and hormonal changes from birth control or hormone replacement therapy may contribute.

Symptoms vary from person to person. Some people experience only cosmetic concerns, while others develop pain, heaviness, burning sensations, or swelling in the affected leg. Itching around the vein and skin discoloration may occur. In more serious cases, ulcers or blood clots can develop. Understanding these symptoms helps people recognize when exploring treatment options becomes worthwhile.

Practical Takeaway: Keep a record of any symptoms you experience, including when they occur (morning, evening, after standing) and what activities make them better or worse. Share this information with a healthcare provider when discussing treatment options.

Conservative Management and Lifestyle Approaches

Many people with varicose veins first try non-medical approaches to manage symptoms. These methods focus on improving circulation and reducing pressure on affected veins. While they may not eliminate existing varicose veins, they often reduce discomfort and can prevent the condition from worsening.

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Compression stockings represent one of the most commonly recommended conservative treatments. These specially designed garments apply graduated pressure to the leg, with the strongest compression at the ankle decreasing toward the knee or thigh. The pressure helps push blood upward toward the heart and reduces swelling. Medical-grade compression stockings come in different compression levels, ranging from mild (8-15 mmHg) to extra-firm (30-40 mmHg). A healthcare provider can recommend the appropriate compression level based on symptom severity. Studies published in medical journals show that consistent use of compression stockings reduces leg pain and swelling for many people.

Lifestyle modifications can significantly impact varicose vein symptoms. Regular movement and exercise improve leg circulation—walking for 20 to 30 minutes daily, swimming, or cycling all help. Elevating the legs above heart level for 15 minutes several times daily reduces swelling. Avoiding prolonged sitting or standing prevents blood from pooling; people in stationary jobs should shift positions frequently and take walking breaks. Weight management reduces pressure on leg veins. Limiting salt intake can help reduce water retention and associated swelling.

Dietary and hydration changes support vein health. Foods rich in fiber promote circulation and prevent constipation, which can worsen varicose veins. Staying hydrated keeps blood flowing smoothly—dehydration thickens blood and makes circulation harder. Limiting caffeine and alcohol, which can dehydrate the body, may also help. Some people report symptom improvement by avoiding tight clothing around the waist, groin, or legs, which restricts circulation.

Practical Takeaway: Start by implementing one or two lifestyle changes at a time rather than overhauling everything simultaneously. Track which modifications reduce your symptoms most noticeably, then build on those successes. This approach makes changes more sustainable long-term.

Sclerotherapy and Chemical Treatment Options

Sclerotherapy is a procedure in which a healthcare provider injects a chemical solution directly into affected veins. This solution irritates the vein lining, causing the vein walls to stick together and seal shut. Over time, the sealed vein fades and blood reroutes through healthier veins. The American Society of Plastic Surgeons reports that sclerotherapy remains one of the most widely used treatments for varicose and spider veins.

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The procedure works particularly well for smaller varicose veins and spider veins. During treatment, the provider uses ultrasound guidance to locate the vein and inject the sclerosant solution. Multiple injections may be necessary during a single session to treat all affected veins. The number of sessions required depends on how many veins need treatment and how they respond. Most people need between two to six sessions spaced weeks apart to achieve desired results.

Different sclerosant solutions exist. Sodium tetradecyl sulfate and polidocanol are liquid solutions commonly used. Foam versions of these solutions work by displacing blood from the vein before the sclerosant contacts the vein wall, potentially increasing effectiveness for larger veins. Sodium chloride is a hypertonic saline solution that works through osmotic action. Each type has specific uses, and providers select the most appropriate solution based on vein size and location.

Recovery from sclerotherapy is relatively quick. Most people return to normal activities the same day, though strenuous exercise may need to wait a few days. Temporary side effects can include bruising, itching, or slight tenderness at injection sites. Rare complications include allergic reactions, blood clots, or neovascularization (new vein growth). Compression stockings worn after treatment help compress the treated vein and improve results. Results typically become visible within three to six weeks, with full results visible after several months.

Practical Takeaway: Ask your provider which sclerosant solution they recommend for your specific veins and why. Understanding the approach planned for your particular situation helps you set realistic expectations for outcomes and recovery.

Ablation Procedures: Thermal and Non-Thermal Options

Ablation procedures use heat or other energy sources to damage and seal varicose veins from the inside. Unlike sclerotherapy, which involves injecting chemicals, ablation uses devices inserted into the vein. The vein walls collapse and seal, and the body eventually absorbs the closed vein. These procedures work particularly well for larger varicose veins and problematic saphenous veins that feed smaller varicose veins.

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Radiofrequency ablation (RFA) uses electrical energy to generate heat. A thin catheter is inserted into the affected vein under ultrasound guidance. As the catheter is slowly withdrawn, it heats the vein wall to approximately 120 degrees Celsius, causing the vein to collapse and seal. The procedure typically takes 30 to 60 minutes depending on vein length. Radiofrequency ablation has been used for two decades and has strong clinical evidence supporting its effectiveness. Studies show success rates between 85 to 95 percent for treating saphenous vein reflux.

Endovenous laser ablation (EVLA) uses laser energy instead of radiofrequency. A fiber optic laser is threaded through a catheter into the vein, and laser energy heats and damages the vein wall. Different wavelengths and power settings exist, allowing providers to customize treatment. Laser ablation may cause more post-procedure discomfort than radiofrequency, though both are generally well-tolerated. Research shows similar success rates between the two thermal methods.

Non-thermal, non-tumescent (NTNT) options represent newer alternatives. Mechanochemical ablation combines mechanical damage with chemical sclerosant injection, while cyanoacrylate (medical adhesive) procedures seal veins using a strong adhesive injected into the vein. These approaches may reduce post-procedure pain since they don't involve heat. However, they have shorter track records, and long-term outcomes require continued study. All ablation procedures require compression stockings during recovery and restrictions on strenuous activity for one to two weeks.

Practical Takeaway: Before choosing an ablation procedure, ask your provider