Home | What’s the Best Way to Treat Varicose Veins?

What’s the Best Way to Treat Varicose Veins?

Varicose veins can not only be unsightly, they are a source of pain and discomfort for many. They occur whenever the valves in a person’s veins become weakened or damaged. Blood begins to pool in the veins when it is unable to be pumped back to the heart, resulting in vivid or swollen veins and discomfort and swelling in the surrounding tissue. They tend to appear on the lower legs and feet where blood has to work the hardest against gravity to travel to the heart.

While not usually damaging to your overall health, they can be a source of embarrassment as well as discomfort for many. In some cases, varicose veins can cause pain and cramping when lying down which in turn can disrupt sleep. Varicose veins cannot be prevented, although regular exercise can help to mitigate your risk. While they technically cannot be cured, there are a number of treatments that can reduce the symptoms and appearance of varicose veins and restore healthy blood flow.

Here, we will examine some of the most popular treatments for varicose veins, and how they help to reduce the unsightly appearance and discomfort associated with this condition.

Is treatment necessary for varicose veins?

There are many who do not seek treatment for their varicose veins. They are rarely a major impediment to healthy blood flow, nor are they an immediate threat to a person’s overall health and wellbeing. For some, varicose veins are little more than an unflattering inconvenience.

However, if you find that your varicose veins cause you undue pain or discomfort, you should consider seeking treatment. It is also important to seek treatment if your varicose veins lead to complications like swelling, discolouration of the skin or leg ulcers.

Different types of varicose vein treatment available

Readers may have mixed feelings about treating their varicose veins. They may worry about having to undergo invasive surgeries to treat the condition, and worry about whether the side effects of the treatment cause more discomfort than the varicose veins themselves.

However, as technologies have evolved they have given rise to a wide range of non-surgical treatments for varicose veins. These typically involve using a minimally invasive procedure to close off the affected vein, enabling the body to redirect blood flow and ease the symptoms associated with varicose veins. Once the vein has been closed off, the body will slowly start to break it down and absorb it over the course of weeks and months. Non-surgical treatments are generally fast, effective and require only a locally-applied anaesthetic.

Non-surgical treatment options include:

There are also surgical procedures used to treat varicose veins. However, most doctors and clinicians will not attempt these unless the above options are not viable.

Surgeries to treat varicose veins include:

  • Ligation and stripping
  • Transilluminated powered phlebectomy

The names of these treatments may seem baffling to the casual reader. As such, we will break down each treatment option available. It’s important to note that some are much more common, and widely available, than others.


Microsclerotherapy is generally the most common and popular method of treating varicose veins. The affected vein is first treated with a local anaesthetic, before being injected with a sclerosant agent. This is a chemical that causes scar tissue within the blood vessel, causing it to collapse and stick together, eventually closing. This resulting scar tissue prevents more blood from circulating through the affected vein.

The procedure is only effective for veins 1-3mm in size and therefore will not be effective on larger vessels. Most cases require only one treatment session, although there are some instances where multiple treatments may be needed to achieve the desired results.

Endothermal ablation

Endothermal ablation is another common method used to treat varicose veins. This is where the affected veins are sealed by energy, rather than the injection of a chemical agent.

There are two different kinds of endothermal ablation— radiofrequency ablation and endovenous laser treatment.

  • Radiofrequency ablation uses radiofrequency energy to seal the walls of the blood vessel, accessing the vein via a small incision made just above or below the knee. A probe attached to a catheter is guided into the vein via an ultrasound scan. The probe then emits radiofrequency energy, which heats up the vein, sealing it shut.
  • Endovenous laser treatment is much the same, except a tiny laser is attached to the catheter that is guided into the affected vein. The laser is guided via ultrasound through the length of the vein, emitting short bursts of energy to seal the entire length of the affected vein shut.

Endothermal ablation is usually carried out under a local anaesthetic, although it can be done under a general anaesthetic.

Ultrasound guided foam sclerotherapy

This is similar in technique to both endothermal ablation and microsclerotherapy. Like endothermal ablation, it uses ultrasound to guide the treatment to the affected vein, and like microsclerotherapy it uses a scarring agent to seal the affected veins shut.

In this case, a special foam is injected into the affected veins. This foam causes scarring of the walls of the blood vessel and the resulting scar tissue seals them shut. This method is effective for treating multiple damaged veins at the same time and is particularly well suited to patients who have experienced a Deep Vein Thrombosis (DVT) before. Usually one treatment is all that is required, although some patients may need several treatments before the affected vein fully disappears.

Patients who undergo ultrasound guided foam sclerotherapy may experience side effects including:

  • Headaches
  • Blurred vision
  • Fainting
  • Blood clots in surrounding leg veins
  • Temporary brown patches on the skin over the affected area (hyperpigmentation)

Cyanoacrylate glue occlusion

A new non-surgical treatment available is cyanoacrylate glue occlusion, commonly known as Venaseal. Here, a strong adhesive is injected into the affected veins, sealing them shut and preventing them from filling with blood. As with other varicose vein treatments, the body redirects blood flow and symptoms are mitigated.

Although this treatment has proven effective and safe, relatively few clinicians are trained in its application. As such, this treatment is much less common.

Ligation and stripping

Ligation and stripping is the most common surgical procedure for the treatment of varicose veins. Two 5cm incisions are made, one near the groin at the top of the affected vein and another close to the knee. The top of the vein is tied and sealed (ligation), and a thin length of wire is passed through the bottom of the vein and then gently removed via the lower incision in the leg. The procedure is usually carried out under a general anaesthetic, although it can be performed under a local anaesthetic.

Recovery times for this procedure can take several weeks, and patients may experience pain, bruising and bleeding after the surgery. Patients may also be expected to wear compression stockings for up to a week following the surgery.

Complications are very rare, but can be serious. They include thrombosis (blood clots) forming in the deep veins of the legs and potential nerve damage.

At one point, this procedure was the only option for those who sought treatment for their varicose veins. However, as non-surgical treatments were developed, this surgery became less common.

Transilluminated powered phlebectomy

This is a relatively new and uncommon surgical procedure. It is not recommended by the National Institute of Health and Care Excellence (NICE) because comparatively little is known about how safe or effective a procedure it is when compared to the alternatives.

Here, a small incision is made in the leg and a tiny light called an endoscopic transilluminator is placed beneath the skin to illuminate the affected vein/s. These are then cut out and removed through the incision with a suction device.

This procedure can be carried out under general or local anaesthetic, and patients may experience bruising and bleeding after the surgery.

Who to go to for treatment

Unless your varicose veins are causing other complications that could endanger your health, you are unlikely to receive treatment for varicose veins on the NHS. Although varicose veins can be a source of discomfort and even pain, their treatment or removal is still classed as a cosmetic procedure.

As such, the vast majority of people with varicose veins seek treatment at private clinics. However, it’s worth discussing any pain caused by your varicose veins with your GP to determine whether or not there are additional complications caused by them.  Especially if they are causing you a lot of pain and / or causing you to lose sleep.

Discuss your concerns with our varicose vein treatment specialists to see how we can help resolve your varicose veins.

The cost of treatment for varicose veins

The cost of treatment for varicose veins varies, depending on the type of treatment that you elect to undertake. Your clinician will go through your options with you, explaining the cost of each available procedure along with the potential risks and benefits.

While prices will vary from one practice to the next, and the extent of the patient’s varicose veins, these are the average price ranges you can expect to pay for each type of treatment:

  • Microsclerotherapy— Prices range between £300 and £1,500 depending on location and the extent of the treatment needed
  • Endothermal ablation— Both radiofrequency ablation and endovenous laser ablation are similar in price range, at around £1,500-£2,000
  • Ultrasound guided foam sclerotherapy— From around £400-£500 per treatment
  • Cyanoacrylate glue occlusion— Venaseal treatments are more expensive than the alternatives starting at around £2,300 for one leg or £2,500 for both legs
  • Ligation and stripping— These surgical treatments are generally more expensive at up to £3,000 including consultation
  • Transilluminated powered phlebectomy— Costs are generally similar to ligation and stripping at around £3,000+

How varicose vein treatments have changed over the years

Up until fairly recently, surgery was the only option for those who wanted treatment for their varicose veins. Ligation and stripping was (and is) an effective way of removing varicose veins, but with the benefits of this procedure come a number of caveats.

The procedure is invasive and usually done under general anaesthetic with patients often needing to be kept on-site overnight. Furthermore, recovery times tend to be fairly long, with patients needing to take up to three weeks away from work to recuperate.

This is not only a costly option, but one that’s difficult to integrate with a busy lifestyle.

In recent years, however, non-surgical treatments have become much more readily available and affordable. Most of these treatments can be performed without the need for general anaesthetic, and some can be carried out within around half an hour. What’s more, recovery times are minimal and in most cases patients can return to work and normal life very quickly.

This makes them much more compatible with our hectic 21st century lifestyles.

So, what’s the best way to treat varicose veins?

This depends largely on you, your budget, your lifestyle, and the extent of your varicose veins. For most people a non-surgical treatment is a better option. Not only is it more affordable, it’s also easier to integrate into a busy professional life and lifestyle.

If you have extensive varicose veins in one or both legs, you may find that you need several treatments, and this should be factored into your budget and them much more compatible with our hectic 21st century lifestyles. In some cases, surgery may be a more decisive treatment where the benefits outweigh the caveats.

A clinician will be able to outline your treatment options and help you to decide upon the right treatment for your individual case.

Get in touch with HHC Clinics today to find out more about our varicose vein treatments.