Varicose veins: what type of treatment is best for me?

18. Apr 2018

Enlarged, unsightly blood vessels as well as soreness, tingling and swelling in the legs are the most frequent symptoms of varicose veins. This is a common condition affecting some 40% of women and 30% of men.

The main contributing factors include genetic predisposition, weight gain, hormonal fluctuations and a sedentary lifestyle as well as standing for long periods (e.g. at work) and overall lack of physical activity. Expectant mothers should take special care of their legs because venous blood flow is slower during pregnancy, increasing the risk of developing varicose veins.

How to prevent varicose veins

There are a number of things you can do to minimise the risk of varicose veins. First, avoid standing and sitting for prolonged periods. Also, there are simple exercises that can provide relief. The benefits you can reap from regular physical activity (such as cycling, swimming, skiing and light, full-body workout routines) should not be underestimated. If you have a sedentary job, get up from the desk at least once an hour to walk around. If you have a predisposition to develop varicose veins, wear compressions stockings: these help direct blood flow to the heart and prevent it accumulating in the legs.

How to treat varicose veins

You might have heard unpleasant stories about how varicose veins are treated, thinking that suffering from the condition is a better option than surgery, but this is a common misconception. Due to advances in medical science, doctors no longer perform manual examinations, instead using a Duplex ultrasound to assess the venous system. This method provides a detailed overview of the condition and its severity, making it easier to choose the treatment method that will be most effective in each specific case.

Previously, varicose veins were treated by pulling out problematic veins using incisions. Following the removal of superficial vessels, veins deeper in the leg take over the blood flow and the problem disappears. However, this treatment method (known as ‘vein stripping’) is no longer recommended in developed countries because it poses a high risk of trauma and the recovery period is long. Despite this, the majority of varicose vein surgery performed in Estonia still employs this method.

One of the more modern methods is endovenous ablation, during which a fine catheter is inserted into a problematic vein and the interior lumen of the vein is cauterised using radiofrequency or laser energy. As a result, the collagen in the vessel walls shrinks and the vein collapses and eventually disappears. The procedure is performed under local anaesthesia, causes minimal pain and does not leave scarring. Compared to stripping, the recovery time is considerably shorter: patients have to wear compression stockings for just seven days. Many are able to return to work the day after undergoing the procedure.

Another common treatment method, used independently as well as in combination with endovenous ablation, is a mini-phlebectomy. During this procedure, superficial varicose veins are removed using tiny hooks and skin incisions measuring 2-3 mm. This procedure is also performed under local anaesthesia and the recovery period is relatively short.

If neither of the two methods is indicated, another option for closing veins is foam sclerotherapy. During this procedure, a special medical agent is injected into the vein, damaging its walls and causing it to disappear.

Bear in mind that effective treatment that brings good results is invasive. Widely advertised creams, pills and stockings do not resolve the underlying problem. At best, they slow the progression of the condition. In short, having your varicose veins treated with modern methods is like getting your teeth repaired: the procedure is performed under local anaesthesia, the recovery time is short and complications are minimal.

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