Treatment - Varicose veins

Varicose veins do not always need treatment. If they are not causing you discomfort, you may not need to have treatment.

Treatment is usually needed:

• to ease symptoms that are causing you pain or discomfort
• to treat complications – such as leg ulcers, swelling or skin discolouration
• for cosmetic reasons

Self-management treatment

Your GP may first tell you to manage the condition yourself at home.

They might ask you to try the following for up to 6 months:

• Use compression stockings.
• Exercise regularly.
• Avoid standing up for long periods.
• Raise the affected area on a pillow when resting.

Read more about self-management for varicose veins

Procedures for varicose veins

Your varicose veins may need further treatment.

The type of treatment will depend on:

• your general health
• the size, position and severity of your veins
• if they're causing complications

A vascular specialist will be able to tell you what treatment is best for you.

Procedures include:

• endothermal ablation
• radiofrequency ablation
• endovenous laser treatment
• sclerotherapy
• ligation and stripping

Endothermal ablation

This involves using energy to seal the affected veins. A specialist will use either high-frequency radio waves or lasers to do this.

The procedures are:

• radiofrequency ablation
• endovenous laser treatment

Radiofrequency ablation

Radiofrequency ablation involves heating the wall of your varicose vein using radio waves.

A specialist will access the vein through a small cut above or below the knee.

They'll guide a narrow tube called a catheter into the vein. An ultrasound scan helps guide it in.

They'll then put a probe into the catheter. This sends out radiofrequency energy. This heats the vein until its walls collapse and stick together, closing it and sealing it shut. Once the specialist seals the vein shut, your blood will go to your healthy veins.

Radiofrequency ablation treatment is done under either local or general anaesthetic.

The procedure may cause some short-term side effects, such as pins and needles. This is also known as paraesthesia. After the procedure you may need to wear compression stockings for a week.

Endovenous laser treatment

Endovenous laser treatment involves heating the wall of your varicose vein using a laser delivering a short burst of energy.

A catheter with a tiny laser is inserted into your vein. An ultrasound scan guides it into position.

The laser heats up the vein and seals it closed. The laser is slowly pulled along the vein. This allows the specialist to close the entire length of the vein.

Endovenous laser treatment is done under either local or general anaesthetic.

After the procedure you may feel some tightness in your legs. The affected areas may also have bruises and be painful. Nerve injury is also possible, but it's usually only temporary.

Ultrasound-guided foam sclerotherapy

Some people cannot have endothermal ablation treatment. If you cannot have it, you'll usually have a treatment called sclerotherapy instead.

This involves injecting special foam into your veins. The foam causes inflammation in the vein walls. This seals them closed.

This type of treatment may not be suitable if you've had deep vein thrombosis.

An ultrasound scan guides the injection to the vein. It's possible to treat more than one vein at the same time.

Foam sclerotherapy is usually done under local anaesthetic.

Your varicose veins should begin to fade after a few weeks. Normal veins will take over the role of the veins that have been treated. 

You may need treatment more than once before the vein fades. There's also a chance the vein may reappear. Although sclerotherapy is effective, it's not yet known how effective it is in the long term.

Side effects of sclerotherapy

Side effects can include:

• blood clots in other leg veins
• headaches
• changes to skin colour – for example, brown patches over the treated areas
• fainting
• temporary vision problems
• deep vein thrombosis (DVT)

After having a sclerotherapy:

• you should be able to walk and return to work immediately
• you'll need to wear compression stockings or bandages for up to a week

In rare cases, sclerotherapy has serious potential complications such as mini-strokes

Surgery for varicose veins

Other treatments may be unsuitable for you. If they are, you'll usually be offered a surgical procedure. Ligation and stripping is the name of this procedure. It will remove the affected veins.

Ligation and stripping

This involves tying off the vein in the affected leg and then removing the varicose veins.

You can usually go home the same day, but an overnight stay in hospital is sometimes needed.

This content is a general guide to varicose veins treatment. Your doctor will help you to understand any specific issues about your surgery.