Seven ways to treat varicose veins

Varicose veins are enlarged, twisted veins that most commonly occur in the lower legs. They can be unsightly and many people seek treatment for cosmetic reasons. Varicose veins can cause pain and discomfort and in some cases, can lead to more serious problems. Thankfully, there are treatment options available without any lengthy recovery.

What causes varicose veins?

Varicose veins occur when the one-way valves in your veins become weak or damaged, allowing the blood to flow backwards. The extra blood puts pressure on the walls of your veins and over time, the walls weaken and bulge, forming varicose veins.

Some women develop varicose veins during pregnancy but these usually disappear without treatment three to 12 months after giving birth.

What are the symptoms?

Varicose veins are usually dark blue or purple in colour and can appear swollen or enlarged and sometimes twisted. Telangiectasia varicose veins, more commonly known as spider veins, can be red or blue in colour and are a milder form of varicose veins as they do not bulge beneath your skin.

Sometimes varicose veins cause pain and discomfort. You should seek medical advice if you experience any of the following:

• Aching, heavy feeling legs
• Itchy skin around your varicose veins
• Pain after sitting or standing for a long time
• Skin discolouration near your varicose veins
• Throbbing and/or swelling in your lower leg

How to manage your symptoms

There are a number of things you can do to relieve the pain and discomfort caused by varicose veins and help prevent new varicose veins forming. Try to:

• Avoid standing, sitting or lying down in the bath for long periods of time 
• Gently massage your legs with oil working from the toe up to the knee — this will not reduce your varicose veins but can reduce pain and swelling
• Maintain a healthy weight and exercise regularly
• Sleep with your legs raised on a pillow

If your legs still feel tired or painful, your doctor may recommend wearing compression stockings — you will first need to have a test to check your blood circulation. Compression stockings help your blood move more efficiently back to your heart by applying gentle pressure around your legs. Ask your doctor for guidance when choosing stockings to make sure you get the right size.

Treatment options

If home treatments and compression stockings have not worked or if your varicose veins are getting worse, make an appointment with your GP.

Treatments for varicose veins have changed in recent years. Less invasive treatments are now available that can be completed as outpatient procedures and have shorter recovery times.

Treatments include:

Sclerotherapy

This is the most common treatment for varicose veins and can be done at your GP’s surgery as you won’t need anaesthetic. Your varicose veins will be injected with a special foam that closes and seals the vein. Sometimes a vein needs a second treatment but sclerotherapy is generally very effective. After treatment, you will need to wear compression stockings for two to three weeks and take daily walks. Circulation in your treated leg will gradually improve and any swelling will reduce. Over the next 12 to 16 weeks, the treated varicose veins will begin to fade.

Laser treatment

Lasers can be used to close small varicose veins. After treatment, the varicose veins will begin to fade and eventually disappear. Sometimes several treatments are needed and you may need to wear compression stockings for several weeks. The treated area should be protected from the sun for at least three to four weeks.

Endovenous laser treatment (EVLT) and radiofrequency ablation (RFA)

These are two newer treatments: EVLT is for spider veins and small varicose veins and RFA is for larger varicose veins. Both are performed under a local anaesthetic. A laser fibre (for EVLT) or fine catheter (for RFA) is inserted into the varicose vein. The tip of the vein is then heated using laser energy or radiofrequency energy. The heat destroys the vein, causing it to collapse and seal. Compression stockings must be worn for one to two weeks and you will need to take daily walks.

Vein stripping

This procedure can be carried out as an outpatient procedure for most people. A small incision is made and the vein is carefully tied at a point before it joins a deep vein. The vein is then removed. This does not affect circulation in your leg as there are other, deeper veins that carry blood throughout your leg.

Ambulatory phlebectomy

This procedure is performed as an outpatient procedure under local anaesthetic. Tiny holes are made into the skin around your varicose veins through which the varicose veins are removed. Scarring is usually minimal.

Endoscopic vein surgery

If other treatments are unsuccessful or in advanced cases with complications such as leg ulcers, endoscopic vein surgery may be recommended.

It is an outpatient procedure and involves inserting a thin, flexible tube with a tiny camera on the end into your leg via a small cut. This allows your surgeon to examine your varicose veins. Surgical tools are then inserted through other small cuts to close up and remove the varicose veins.

If you’re worried about your varicose veins, there are many treatments to help, so make an appointment to see a doctor.