Which Is the Best Treatment for Varicose Veins?

Reviewed on 5/4/2021

Varicose veins are prominent veins because they are twisted and swollen, caused by weak or damaged vein walls and valves. There isn't a single best varicose vein treatment, although there are many options. Treatment can include home remedies, medication, exercise, laser treatment, surgery, and more.
Varicose veins are prominent veins because they are twisted and swollen, caused by weak or damaged vein walls and valves. There isn't a single best varicose vein treatment, although there are many options. Treatment can include home remedies, medication, exercise, laser treatment, surgery, and more.

Varicose veins are swollen and twisted veins just below the skin caused by weak or damaged vein walls and valves.

Varicose veins commonly develop in the veins in the legs, but sometimes they can form in other parts of the body such as the rectum (hemorrhoids), testicles (varicoceles), esophagus, stomach, or liver

There is no single “best” treatment for varicose veins. For some patients, home treatments may be sufficient. For other patients, improving the appearance of the varicose veins is of primary concern, while other patients may have pain or cramps and need treatment to alleviate symptoms. 

Home treatments for varicose veins in the legs includes:

  • Treatment to reduce swelling 
  • Don’t sit or stand in place for long periods 
  • Raise the legs above the level of the heart or 30 minutes at a time, 3 to 4 times daily
  • Point the toes and feet up and down several times each day
  • Treatment for dry or itchy skin 
  • Wash the legs daily with a gentle cleanser; avoid regular soap which can be drying
  • Use unscented moisturizer when skin is still damp
  • Lifestyle changes to prevent varicose veins from getting worse
  • Maintain a healthy weight/lose weight if overweight
  • Exercise regularly, but limit or avoid strenuous or vigorous exercise which might make varicose veins worse
  • Compression therapy using socks, bandages, or devices 
  • Coverings to help open sores heal

Medications to treat varicose veins in the legs include:

  • Diosmiplex (Vasculera), a medical food for people with veinous insufficiency
  • Antibiotics for skin infections
  • Creams or ointments for itchy skin

Procedures used to treat varicose veins in the legs include:

  • Laser treatment
  • Simple laser therapy for small veins close to the skin
  • Endovenous ablation to close off a varicose vein by inserting a laser fiber into the vein
  • Sclerotherapy uses a chemical injected into the vein to scar it and close it off 
  • Radiofrequency treatment uses radiofrequency energy inside a vein to scar it and close it off
  • Surgery to remove severe varicose veins
  • Ligation and stripping, in which incisions are made over the vein and the vein is tied off (ligated) and removed (stripped)
  • Phlebectomy (also called stab avulsion), in which small incisions are made into the skin to remove the varicose veins

What Are Symptoms of Varicose Veins?

Symptoms of varicose veins in the legs include:

  • Bulging, bluish veins in the legs
  • Leg or ankle swelling
  • Leg pain
  • Feeling of tiredness or heaviness in legs and feet, especially at the end of the day
  • Itching
  • Nighttime leg cramps
  • Swollen veins 
  • Skin color changes (red or red-brown, called stasis dermatitis)
  • Open sores (called venous ulcers), usually form at the ankle and can be painful and ooze

What Causes Varicose Veins?

Varicose veins are caused by increased blood pressure inside the veins. This increase in pressure may be caused by:

Risk factors for developing varicose veins include 

  • Older age 
  • Sitting or standing for long periods
  • An inactive lifestyle
  • A family history of varicose veins or deep vein thrombosis (DVT)

How Are Varicose Veins Diagnosed?

Varicose veins are diagnosed with a patient history and physical examination of the legs. 

Tests used to assess the veins and the overall health of the legs may include:

  • Ultrasound
  • Computed tomography (CT) scan
  • X-ray 

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Reviewed on 5/4/2021
References
https://www.uptodate.com/contents/varicose-veins-and-other-vein-disease-in-the-legs-the-basics?search=Varicose%20Veins&source=search_result&selectedTitle=1~150&usage_type=default&display_rank=1

https://www.nhlbi.nih.gov/health-topics/varicose-veins

https://stanfordhealthcare.org/medical-conditions/blood-heart-circulation/varicose-veins/treatments.html