Varicose veins affect nearly one in every two individuals around the world, causing unattractive cords and twists beneath the skin, dark, visible veins, and in the most severe cases, pain and swelling that makes living a normal life a true challenge. Varicose veins take place for a variety of reasons, including genetic predispositions to vein wall issues, obesity, pregnancy, and strenuous occupations that require ample time spent on the feet each day. While there are at-home remedies prescribed to help ease the discomfort associated with varicose veins, some turn to professional help when symptoms reach a debilitating level. Surgery, foam sclerotherapy, and endovenous laser treatment are all options for the treatment of varicose veins, but each has advantages and risks that should be considered prior to selecting one over another as the optimal course of treatment.

Research Points to Laser Treatment

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A study completed in August of 2016 highlights the recurrence of varicose veins after the three most common types of treatment: surgery, foam sclerotherapy, and endovenous laser treatment, also known as EVLT. Out of 214 individuals who underwent treatment for deep varicose veins, patients experienced the most effective results in removing varicose veins and their symptoms with the help of surgery and EVLT. While 51% of patients had not experienced a recurrence of varicose veins after foam sclerotherapy, the positive results from surgery and EVLT were far higher, at 97%.

Eddie Chaloner, the first surgeon in London to use EVLT laser treatments, explains that “foam sclerotherapy can work quite well, but there are a couple of disadvantages in larger veins. Recurrence rate is quite high (about 30% of patients get their veins back within 2 years of treatment), and some patients get a brown mark on the leg called ‘skin staining’ that can take several months to go away. Foam sclerotherapy is, however, useful for treating smaller varicose veins that might remain after EVLT.”

The recent study supports Chaloner’s statement: for those with deep varicose veins, both surgery and EVLT are more effective as a form of treatment for the long term.

Differences in Treatment Options

The most significant difference in the treatment of varicose veins between surgery, foam sclerotherapy, and EVLT is the nature of each procedure. With surgery, individuals are required to go under general anesthesia which in and of itself comes with a varied degree of risk. Through this treatment option, incisions are made into the skin of the leg so the varicose vein can be easily accessed. The problem veins are then shut off and removed through the incisions. Recovery time varies for each patient, but generally, individuals can return to normal activities within four weeks after surgery. Permanent scarring, pain in the legs, damage to nerve tissue and inflammation may all result from varicose vein surgery.

Foam sclerotherapy is a non-invasive procedure in which the doctor injects a chemical liquid into the vein by way of a needle. As the chemical enters the vein, it creates swelling which ultimately causes the vein to shut completely. In the process, blood flow is stopped, turning the vein to scar tissue. Within a few weeks, the vein fades, although treatment may need to be repeated more than once to achieve the desired effect. Foam sclerotherapy may cause stinging or irritation at the injection site, along with red patches or bruising on the skin.

EVLT using laser technology to shut off veins just beneath the skin’s surface. The procedure does not require cutting, and therefore only local anesthesia is necessary. Through EVLT, the problem vein is heated to the point it closes off, allowing healthy veins in the surrounding area to continue the normal flow of blood. Veins typically shrink shortly after treatment, and there is usually minimal bruising and pain that comes as a result of the procedure. Most patients are done with EVLT within 30-40 minutes, and any subsiding side effects fade after a few weeks.

While there are multiple options for treatment of varicose veins, some work better than others in the long run. Both surgery and EVLT are more commonly used for the treatment of deep varicose veins, while foam sclerotherapy can be a viable option for smaller veins. If you’re considering varicose vein treatment, above and beyond what may be recommended at home, EVLT presents a strong, non-invasive alternative to traditional varicose vein surgery with fewer risks and similar results.