Treating Varicose Veins: Options for Healthier Legs

Varicose veins are swollen, twisted veins that most commonly appear in the legs. While many people view them as a cosmetic issue, they can also cause aching, heaviness, swelling and, in severe cases, skin changes or ulcers. Fortunately, a range of treatment options—spanning conservative measures to minimally invasive procedures—can relieve symptoms and restore both function and appearance.

Signs and symptoms to watch for

Varicose veins vary from mild to serious. Common signs include:

1. Prominent veins that look blue or purple and are often twisted in appearance
2. A sensation of heaviness, aching, or fatigue in the legs, particularly after standing
3. Swelling in the lower legs, ankles or feet
4. Itching, burning, or tingling around the affected veins
5. Muscle cramps, frequently occurring at night
6. Skin discoloration, thickening, or open sores in advanced cases

If you experience persistent pain, swelling that worsens, or skin ulceration, seek medical evaluation. Early assessment helps prevent progression and guides appropriate treatment.

Treatment options: from conservative care to procedures

Choosing the right therapy depends on the severity of your veins, symptoms, medical history and personal goals. Common approaches include:

• Compression stockings: Specially fitted stockings apply graduated pressure that helps venous return, reduces swelling and relieves aching. They are often a first-line, noninvasive option.

• Lifestyle changes: Regular exercise, weight management, leg elevation when resting and avoiding long periods of standing or sitting can reduce symptoms and slow progression.

• Sclerotherapy: A solution is injected into smaller varicose or spider veins, causing the vessel walls to stick together and fade over time. It is effective for many surface veins and is commonly done in outpatient settings.

• Endovenous laser ablation (EVLA): A laser fiber is threaded into a diseased vein and delivers heat to seal it shut. Treated veins are gradually reabsorbed, and blood is rerouted through healthier veins.

• Radiofrequency ablation (RFA): This technique uses radiofrequency energy rather than laser to heat and close the problematic vein. Outcomes are comparable to EVLA and both are minimally invasive.

• Vein stripping and surgical options: Reserved for more extensive disease or when less invasive treatments are unsuitable. Surgery involves removing or tying off larger segments of damaged veins.

How endovenous laser ablation (EVLA) works

EVLA is a widely used, minimally invasive solution for larger varicose veins. The typical steps are:

1. Ultrasound maps the diseased vein to guide treatment.
2. The skin is numbed and a tiny incision is made to access the vein.
3. A thin fiber is inserted under ultrasound guidance and positioned along the affected segment.
4. Laser energy is delivered while the fiber is gradually withdrawn, heating the vein so its walls collapse and seal.
5. Over weeks to months the sealed vein is absorbed and symptoms usually improve as blood flow shifts to healthy veins.

Most EVLA procedures are done under local anesthesia as outpatient visits, with minimal scarring and quick recovery.

Advantages of laser and other minimally invasive therapies

Laser and radiofrequency ablation offer several benefits compared with traditional surgery:

• Less invasive: Small punctures instead of large surgical incisions mean reduced scarring and fewer wound-related issues.
• High success and durability: Many studies report excellent symptom relief and long-term closure rates.
• Faster return to daily activities: Recovery time is shorter than for vein stripping.
• Reduced pain and bruising: Patients often report less discomfort during and after the procedure.
• Cosmetic improvement: As treated veins fade, leg appearance typically improves.

What to expect before, during and after treatment

Procedures like EVLA or RFA usually take about 1–2 hours in a clinic. You’ll receive local anesthesia and perhaps a mild sedative. After treatment your provider will recommend wearing compression stockings for several days to weeks and advise on activity restrictions—walking is encouraged, but heavy lifting and strenuous exercise may be limited briefly.

Initial discomfort and bruising are common but generally mild. Symptoms and cosmetic improvements develop over weeks to months. Follow-up ultrasound exams confirm vein closure and identify any need for additional treatments, such as sclerotherapy for residual surface veins.

Costs vary by region, provider, and insurance coverage. The figures above are approximate and intended only as a general guide.

When to see a specialist

If varicose veins cause persistent pain, swelling, skin changes, or bleeding, schedule an appointment with a vascular specialist or vein clinic. A vascular ultrasound can assess the extent of reflux and guide a personalized treatment plan. Even for primarily cosmetic concerns, a specialist can explain realistic expectations and the range of alternatives.

Modern vein care offers many effective tools to reduce discomfort and improve leg appearance. Discuss your symptoms, lifestyle, and treatment goals with a qualified clinician to choose the safest and most appropriate approach for your situation.

This article is for informational purposes only and should not be considered medical advice. Please consult a qualified healthcare professional for personalized guidance and treatment.