How Are Varicose Veins Treated?

By the end of a long day on your feet, they can make themselves known — twisted, bulging veins, usually on the legs, with an ache that eases once you sit down and put your feet up. The short video above, "Varicose Veins" (just under three minutes), explains what they are: gnarled, enlarged veins, most often in the legs and feet, because standing and walking upright raises the pressure in the veins of the lower body. For some people they're mostly a cosmetic nuisance; for others they ache. Either way, if you're wondering what treatment actually involves, here's the path it usually takes.

It starts with an examination, not a procedure

Expect your clinician to look at your legs while you're standing, ask about aching, heaviness, swelling or skin changes, and — if treatment is being considered — arrange a painless ultrasound scan. That scan maps which veins are letting blood flow the wrong way, and it's what turns a vague "bad veins" into a specific plan: which vein, which method, or whether you need a procedure at all. It's also how a clinician checks there isn't something else going on in the deeper veins — one reason it's worth reading up on deep vein thrombosis (blood clots) if leg swelling is one-sided or sudden.

The everyday measures come first

Plenty of varicose veins are managed without any procedure at all. The everyday measures are unglamorous but genuinely useful: keep moving and avoid long stretches of standing or sitting still, raise your legs when you rest, stay active to keep calf muscles pumping blood upward, and wear compression stockings if your clinician advises them — they gently squeeze the leg and help blood move back toward the heart. These steps won't make a bulging vein disappear, but they often settle the aching and heaviness, and for mild veins they may be all that's recommended.

Procedures close the vein, or remove it

When veins are troublesome, the modern approach is usually to close the faulty vein so blood simply reroutes through healthier ones. In sclerotherapy, a solution is injected into the vein, which then fades over the following weeks — the site's "Ultrasound Guided Sclerotherapy for Varicose Veins" video shows how ultrasound is used to guide exactly that kind of treatment. Larger surface veins may instead be sealed from the inside using heat delivered through a fine catheter, or, in some cases, removed through small incisions in a surgical procedure. Most of these treatments are done in a clinic setting rather than as major surgery, and people are typically up and walking the same day — your clinician will explain which option fits the veins your scan showed.

Afterwards, walking is part of the treatment

Recovery is usually measured in days of taking it sensibly rather than weeks in bed. Walking is actively encouraged, compression may be continued for a while, and a follow-up scan sometimes checks the treated vein has closed as planned. Treated veins fade gradually rather than overnight, and new varicose veins can appear over time, so think of treatment as dealing with the veins that trouble you now — not a lifetime guarantee. Do get checked promptly if a leg becomes suddenly swollen or painful, if skin over a vein breaks down, or if a varicose vein bleeds.

Frequently Asked Questions

Do varicose veins always need treatment?

No. If they don't cause symptoms, many people simply watch them and use everyday measures such as activity, leg elevation and compression if advised. Treatment is usually considered when veins ache, swell, affect the skin, bleed, or bother you enough that you want them dealt with.

Is varicose vein treatment major surgery?

Usually not. Many modern treatments — such as sclerotherapy injections or sealing a vein from the inside with heat — are clinic procedures, and people are typically walking the same day. Surgical removal through small incisions is still an option for some larger veins; your clinician will explain which approach fits your scan.

Can varicose veins come back after treatment?

A successfully treated vein stays closed or removed, but new varicose veins can develop in other veins over time, because the tendency toward weak vein valves remains. Follow-up appointments help catch new problem veins early.

MedicalVideos.com has published trusted medical videos since 2007. The site was founded by Dr. Mohamed Ibrahim, MD, PhD — physician-scientist.

Educational only — this article is general information about varicose vein treatment, not medical advice and not a diagnosis. If leg veins are painful, changing, or worrying you, discuss them with your own clinician.