Exploring different treatments to get rid of varicose veins

Varicose veins are enlarged, twisted veins that often appear just under the skin, primarily in the legs and feet.

Published by Dr Alex Vesey

Date posted — 7.10.24

What are varicose veins?

Varicose veins are enlarged, twisted veins that often appear just under the skin, primarily in the legs and feet. They can be blue, purple, or flesh-coloured and are often raised, giving a bumpy or rope-like appearance on the skin’s surface. These veins develop when the valves in the veins that regulate blood flow become weakened or damaged, causing blood to pool and the veins to enlarge.

While varicose veins are generally more common in older adults, women, and those with a family history of the condition, factors such as prolonged standing, obesity, and pregnancy can increase the risk.

What are the symptoms of varicose veins?

The symptoms of varicose veins can range from mild to severe. Some people may experience aching, heaviness, or cramping in the legs, particularly after standing or sitting for extended periods. The affected area might also feel itchy or develop a burning sensation.

In more severe cases, varicose veins can lead to swelling, throbbing, and even skin changes, such as discolouration or the development of ulcers near the ankles. The condition is not only a cosmetic concern but can also cause discomfort and, in some cases, lead to more serious circulatory problems.

Best treatment to get rid of varicose veins

The best treatment options for varicose veins depend on the severity of the condition, the symptoms experienced and the anatomy of the problematic veins. A detailed clinical review by an expert vascular surgeon along with a detailed ultrasound scan will delineate the optimal treatment.

For mild cases, lifestyle changes can be effective in managing symptoms. These include regular exercise to improve circulation, elevating the legs when resting, and wearing compression stockings, which help to reduce swelling and discomfort by improving blood flow in the affected veins. Weight management and avoiding prolonged periods of standing or sitting can also alleviate symptoms and prevent the condition from worsening.

For more severe cases or when lifestyle changes are insufficient, medical treatments may be necessary. Sclerotherapy is a common procedure where a solution is injected into the varicose veins, causing them to collapse and eventually fade. This is most suitable for smaller veins, just below the surface of the skin.

The next level of treatment is endovenous treatment, which means operating inside the problematic veins to cause them to collapse. Traditionally this has been done using either laser or radiofrequency energy to close the affected blood vessels down.

More recently, the VenaSeal™ procedure has been introduced. This is an even less invasive option which uses a special glue to close the veins down.

In cases where these treatments are ineffective or unsuitable, invasive surgical options like vein stripping or phlebectomy may be recommended to remove or tie off the affected veins.

Consulting with an expert vascular surgeon is essential to determine the most appropriate treatment plan based on your individual needs and the severity of your condition.

Expert Video

Dr Alex Vesey is our expert consultant vascular surgeon who heads up our varicose vein team. Listen to him explain your options for varicose vein treatment.

Treatment to get rid of varicose veins on the legs

Varicose veins can theoretically happen anywhere on the body, but most commonly affect the veins on the legs. To specifically target and remove varicose veins in the legs, several treatments are available.

Endovenous laser treatment (EVLT) and Radiofrequency ablation (RFA) are minimally invasive procedures that remain very popular because they avoid the need for traditional surgery. Both procedures are performed under local anaesthetic and involve inserting a thin tube inside the vein and destroying the vein by delivering heat to close the vein down. Both of these treatments offer a high success rate with less discomfort and scarring than traditional surgery.

The newer VenaSeal™ procedure causes even less discomfort by closing the vein using glue, rather than heat. This allows patients an even more rapid return to normal activities, without the need to wear compression stockings.

For veins that are not suitable for these treatments, sclerotherapy is a widely used option, especially for smaller varicose veins or spider veins in the legs. During sclerotherapy, a solution is injected directly into the vein, causing it to collapse and gradually be absorbed by the body. Multiple sessions may be required depending on the extent of the varicose veins.

An alternative treatment for smaller veins is a minor surgical procedure called microphlebectomy. This involves making tiny incisions under local anaesthetic to remove problematic veins. While slightly more invasive than sclerotherapy injections, microphlebectomy can be very effective because it physically removes the vessels which means they cannot come back.

Consulting with an expert vascular surgeon is essential to choose the most appropriate treatment based on the specific characteristics of the varicose veins in the legs.

Treatment to get rid of spider veins

Spider veins are small, web-like veins often associated with varicose veins. To treat these, several effective treatment options are available.

Sclerotherapy is the most common and widely used method. In this procedure, a solution is injected directly into the spider veins, causing them to collapse and fade over time. The body gradually absorbs the treated veins, leading to an improved appearance. Sclerotherapy is minimally invasive, typically requires no anaesthetic, and can be done in the outpatient clinic. Multiple sessions may be needed depending on the size and number of spider veins.

Another popular treatment for spider veins is laser therapy. This approach uses focused light energy to target and heat the affected veins, causing them to collapse and eventually disappear. Laser therapy is particularly effective for small, delicate veins that may not be suitable for sclerotherapy. The treatment is non-invasive, and while some patients may experience mild discomfort during the procedure, it generally requires no downtime. In addition to these treatments, maintaining healthy lifestyle habits, such as regular exercise, weight management, and avoiding prolonged periods of standing, can help prevent the development or worsening of spider veins.

Interested in treating varicose veins?

If you’d like to find out which varicose veins treatment is the right treatment for you, the first step is to fill out our online consultation form. From there, our team will be able to arrange an initial consultation and ultrasound scan and we can work together to create a treatment plan that is tailored to your needs.

Dr Alex Vesey

Our vascular surgery service is led by Dr Alex Vesey. Alex is a highly skilled vascular surgeon with extensive experience in diagnosing and treating a wide range of vascular conditions. With a focus on minimally invasive techniques, Dr. Vesey is dedicated to providing patients with the most advanced and effective treatments for venous diseases, with a particular interest in the treatment of varicose veins.

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Thank you so much to our incredible patient for allowing us to share her picture. 

This patient had a challenging problem, with some pretty deep lines all around the mouth. To tackle a problem like this, we need to take a combined approach - no one treatment on its own is going to cut it. We did some laser resurfacing to smooth the surface of the skin, and added in a little volume to take out the deeper folds. 

This is her a couple of months out and looking and feeling great. What do you think?
Some Friday night reading fun! 

This is a letter I sent to Jenni Minto this week, in response to her suggestion that her job is to balance protecting the public with protecting the business interests of beauty salons. 

There is no other way to describe it: she is simply wrong. I sent this letter to her earlier this week, and have been talking to the Herald about the issues. I just cannot get my head around her logic. In no other area of regulation would you consider relaxing standards to protect business interests knowing full well that those relaxed standards harm the public? 

You can read the full story in the Herald at the link in our bio. 

What do you think?
Laser season continues and I thought you might like to see behind the scenes of a full field laser resurfacing treatment. 

This is our wonderful patient Carol who kindly allowed us to film her procedure from start to finish. Carol is pretty typical of patients we treat with this procedure - she's a former smoker who has also spent a lot of time in the sun as well as using sunbeds, so she's picked up quite a lot of skin damage over the years.

I treated her full face, with particular focus on the lines around her lips, and she is absolutely over the moon with her results! Watch for Carol's full procedure and an insight into the recovery process. 

If you're thinking about getting a laser treatment, now is the time to do it while the days are darker and social calendars are still a bit quieter. Send us a message if you'd like to find out if you'd be suitable for this treatment.
We're often asked about threads in the clinic and why we don't offer them. Here's our Medical Director Dr Rhona explaining what threads are, why we don't use them, and why fillers are a much more reliable option for people looking for non-surgical rejuvenation. 

Before anyone says "Ah, but I don't want a big fat face" - Dr Rhona has filler in pretty much every part of her own face, and I think we can agree she does not have a fat face! The key to non-surgical rejuvenation is addressing the anatomy, not following the trends! 

What do you think?

#threads #dermalfiller #threadsvsfillers
The power of the chin! Improving a recessed chin with some filler is one of the most effective ways of reducing the appearance of jowls, without surgery. 

This is an example of one of Dr Rhona's patients who had this done recently. 

The patient was delighted with the result. What do you think? 

#fillers #chinfiller #jowls #nonsurgical
As most of you will know, I’ve been campaigning for years for regulation of aesthetic procedures in Scotland. It’s something that I feel extremely passionate about. There are too many people in this country who are harmed from cosmetic procedures and the government has chosen to look the other way. 

The government have finally agreed to bring in regulations, but in my view, they are too little too late and I’ve been writing about it in the Herald this morning (read the article at the link in my bio) and talking about it on BBC Radio Scotland's Good Morning Scotland (you can listen here and on BBC Sounds). 

The proposed regulations will make a list of procedures medic only, but they have proposed to allow beauticians to keep injecting fillers in ‘Group 2'. This is the wrong approach and is all to do with politics, rather than patient safety. Filler injections are more invasive and more high risk than most of the procedures they are making medic only and its very clear fillers belong in Group 3, medic only. 

There is a consultation on the regulations live right now and I would urge all of our patients and followers to fill it in, pointing out the discrepancy of allowing beauticians to carry on doing fillers whilst banning them from much more benign procedures like PRP. This needs to be about patient safety, not politics. 

You can fill out a response to the consultation at the link in my bio. 

Thank you! 

(To all of our international followers struggling to get their head around this, in the UK we have a situation where yone - with no training and no regulation - can set up shop offering cosmetic procedures. We are campaigning to bring Scotland in line with every other country and ban this practice!)

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