As there’s no cure for varicose veins, there is also no guarantee one treatment will fix the problem for life. The earlier you treat varicose veins, the more successful the outcome.
Your first port of call should be your GP, who can refer you to a phlebologist, vascular specialist or other surgeon who practises phlebology. An ultrasound “map” of your blood vessels will provide an overview of how they’re functioning and where the problems lie, and what the future holds if you choose to do nothing.
Treatment may require several stages. For severe varicosities, the first stage is usually to treat the root of the problem: the saphenous veins. The reflux in these veins affects the tributary veins that run from them. Once the saphenous veins have been fixed, affected perforator and tributary veins can then be treated. Spider veins are almost always associated with deeper vein problems, so further investigation is needed to identify the cause (which should be treated first).
Most treatments are done in an office or clinic setting with local or no anaesthetic. Ligation and stripping takes place in hospital and may require general anaesthetic.
After any treatment, you must wear compression stockings all day and night for about two weeks to assist the process of sealing veins and preventing clots. Regular walking is an important part of healing, although you may have to avoid more strenuous exercise for a while. The physician will conduct an ultrasound examination soon after the treatment to ensure there are no clots.
Managing varicose veins without surgery
If your varicose veins aren't too severe, or you are trying to slow down their recurrance, the following strategies may help.
- Regular exercise, a low-fat diet with plenty of fruit and vegetables, and keeping your weight at a healthy level can help prevent varicose veins becoming problematic.
- Elevating your legs when possible can also provide relief, as can compression stockings, which are elastic stockings that use graduated pressure to squeeze your veins and stop blood from pooling or flowing backwards.
- A large review of clinical trials of horse chestnut tablets containing escin found it reduced pain, itching and swelling, at least in the short term. It appears to be safe, although it may interact with some medicines (check with your doctor), and its long-term effectiveness hasn’t been established.
- Some cosmetic creams claim to reduce the appearance of spider veins, but there’s no evidence they have anything more than a minor effect.