When potential patients first contact us about having their varicose veins treated, one of their initial questions is “Which is the best varicose veins treatment option?”. In this article, we provide a quick overview of the current approved non-surgical procedures and how to approach choosing the right treatment for you.
What are non-surgical treatments for varicose veins?
Non-surgical treatments are walk-in-walk-out procedures that improve the appearance and symptoms of varicose veins. They tend to be less painful than surgery and have a shorter recovery time, allowing you to return to normal activities quickly. In many cases, patients can have their consultation and treatment on the same day.
There are three common types of non-surgical treatment, all of which can be performed under local anaesthetic. Each procedure uses a different method to block the affected veins without damaging the circulation in your legs. You may need more than one treatment to resolve your varicose veins successfully.
Endothermal ablation is an effective technique that applies heat to the inside of the vein to make it collapse and close off. This procedure uses either radiowaves (radiofrequency ablation) or a laser (endovenous laser ablation) to create the heat. The National Institute for Health and Care Excellence (NICE) recommends endothermal ablation as the first-line treatment for varicose veins. The procedure is not suitable for everyone, so you may need to explore alternative treatments with your consultant.
Radiofrequency ablation (RFA)
This technique typically causes less bruising and less post-treatment discomfort than laser and has a lower risk for perforation. RFA can also be used alongside ultrasound-guided foam sclerotherapy (UGFS) to treat more troublesome superficial varicose veins.
Learn more about this procedure in our Guide to Radiofrequency Ablation article.
Endovenous laser ablation (EVLA)
EVLA is a relatively new treatment, so there is limited evidence for long-term effectiveness. It can be a more painful procedure than RFA and it may not be very effective at treating thread veins in the legs.
Ultrasound-Guided Foam Sclerotherapy (UGFS)
Foam sclerotherapy involves injecting a chemical foam into the affected vein to damage the lining and cause the vein to close off. It is a quick and cost-effective treatment for trunk varicose veins and reticular veins. NICE recommends using UGFS when endothermal ablation is unsuitable.
Learn more about this procedure in our Guide to Foam Sclerotherapy article.
Veinlite Transilluminated Microsclerotherapy (VTM)
Microsclerotherapy is the most effective treatment for small reticular veins and thread veins. It takes less than an hour to perform. The surgeon uses a light to make the problem vein translucent and easy to locate and then injects a liquid (sclerosant) into the vein, which helps the body absorb the vein naturally.
One in three patients with thread veins will have underlying problems with the major vein in the legs. When this is the case, the major vein has to be treated in order for the VTM to be more
Learn more about this procedure in our Guide to Microsclerotherapy article.
Verdict on the best varicose veins treatment option
There is no one-size-fits-all treatment for varicose veins. The best procedure for you will depend on your diagnosis, your medical history, and your circumstances and preferences. For this reason, every treatment journey should begin with a thorough consultation that includes:
- An in-depth and detailed look at the history of your problem
- A clinical examination
- Non-invasive investigations, including a duplex scan if appropriate
- Discussing treatment options
- Recommending your next steps
- Taking the time needed to discuss fully any issues or concerns you have
Would you like to know more?
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