Will My Varicose Veins Go Away After Treatment?

In this blog post, we will discuss common questions patients have about varicose vein treatment, including:

• Will all my veins go away?
• Once the procedure is done, will my veins ever come back?
• Will I have any veins left after treatment?

You finally decided to seek treatment for your varicose veins – good for you! You are excited, a bit nervous as you’re not sure what to expect, and worried that the veins might return. After all, your grandmother had her veins surgically removed and years later, they came back… with a vengeance. Before we discuss what happens to your veins after treatment, let’s talk about the history of vein treatment and how modern vein procedures work.

The history of vein treatments

The good news is that modern surgical and noninvasive vein treatments, along with the use of ultrasound has greatly improved varicose vein treatments in the last decade. Long ago, veins were surgically tied off in a procedure called ligation – the first recorded ligation procedure dates back to 600 A.D.! Later, surgeons began adding a second type of procedure called vein stripping where they would remove the remaining portions of the tied off vein and any branches they could visualize. This combination of surgical procedures was the treatment of choice for several hundreds of years even though these approaches often led to more pronounced varicose veins, and veins returning, often, as mentioned before, with a vengeance.

Modern vein procedures

These days, phlebologists (physicians who specialize in the diagnosis and treatment of vein disease) have a myriad of tools available to provide customized vein treatment approaches for their patients. The options are divided into two categories: surgical and noninvasive. Surgeons perform ambulatory phlebectomy, also known as microphlebectomy to surgically remove bulging varicose veins using tiny incisions. In skilled hands, this procedure yields excellent outcomes and has little to no revascularization (veins coming back) and low neovascularization rates (new veins forming in the area of removed or treated veins.) Essentially, you walk in with bulging varicose veins, and you walk out with no varicose veins. Let me mention that, after treatment, your legs will be bandaged and you will need to wear compression stockings, but this is true for all vein procedures.

How does vein treatment work?

With noninvasive vein procedures, chemicals, heat, or glue are used to damage the inner lining of the vein wall causing the vein to collapse and divert blood to other healthy veins. Some of these procedures are used to treat the source of the varicose vein disease which then cause varicose veins to form. These are called “truncal veins”. Think of a tree; first, phlebologists treat the trunk of the tree (i.e. “truncal veins”), then the branches (i.e. “varicose veins”), and then move on to treating the leaves (i.e. reticular and spider veins).

Will your veins go away, or ever come back, after treatment?

The success rates for these procedures is also very high, with low risk of revascularization (or veins coming back) in patients to complete the treatment course, as well as low pronounced neovascularization rates (or new veins forming in the area of removed or treated veins.) Success rates depend on treating all diseased veins, and, based on continued symptoms, providing surveillance using ultrasound to continue to close veins that are stubborn so they do not re-open, and preventing new vein growth.

The bottom line is that varicose vein disease, also called chronic venous insufficiency is a chronic, progressive, and often inherited disease process. Vein treatment is not a cure, but a way to manage it. Additional veins may form, regardless of treatment performed. However, under the care of a dedicated phlebology healthcare team, patients are provided with a customized treatment plan, surveillance using ultrasound, and additional procedures as needed. The goal is to help you feel, and look better.

So what are you waiting for?