Leg Varicose Veins and Treatment Methods

Leg varicose veins are a widespread health issue caused by the enlargement and loss of function in the veins, leading to pain, a feeling of heaviness, and swelling in the legs. With the advancement of medical technologies, you can get rid of this problem permanently and comfortably through non-surgical varicose vein treatment options that do not require a hospital stay. Taking precautions early on not only resolves aesthetic concerns but also prevents serious vascular complications that may arise in the future.

Varicose veins are enlarged blood vessels caused by blood pooling in the legs.
Standing for long periods, genetic predisposition, and pregnancy are the primary risk factors.
Pain, a feeling of fatigue, night cramps, and skin color changes are common symptoms.
The most reliable diagnostic method is a color Doppler ultrasound performed while standing.
Non-surgical methods such as laser, radiofrequency, medical adhesive, and foam stand out in treatment.

What Are Leg Varicose Veins?

Known colloquially as varicose veins, venous insufficiency is the deterioration of the veins that carry deoxygenated blood from the legs back to the heart. Normally, these veins contain one-way valves that prevent blood from flowing backward against gravity. When these valves are damaged for various reasons, blood begins to pool in the legs. Over time, the increasing pressure causes the veins to widen, become twisted, and bulge prominently from the surface of the skin.

Seen in approximately twenty percent of adults in Western societies, this condition is not just an aesthetic problem but a progressive vascular disease. The process, which may start as cracked capillaries (spider veins), can turn into large, greenish, or purple clusters of veins as thick as a finger if left untreated. Although the severity of the disease varies from person to person, the underlying mechanism is generally the same.

Causes and Risk Factors

There are many factors that lead to the deterioration of vein valves. The most prominent risk factor is a genetic predisposition; individuals with a family history of varicose veins have a much higher chance of developing this disease. In addition, being female increases the risk due to hormonal changes. Pregnancy, in particular, is one of the most significant periods that trigger the formation of leg varicose veins, due to both increased blood volume and the pressure the uterus exerts on the veins.

Lifestyle also directly impacts vascular health. People who stand or sit in a fixed position for long periods, such as teachers, surgeons, hairdressers, or desk workers, have an increased likelihood of blood pooling in their legs. Excess weight and obesity accelerate the deterioration of the valves by increasing the load on the leg veins. Furthermore, wearing tight clothing, spending long periods in excessively hot environments, and leading a sedentary lifestyle are among other factors that aggravate the condition.

What Are the Symptoms of Varicose Veins?

In the early stages of the disease, only fine red or purple spider web-like capillaries may be noticeable on the skin surface. However, as the disease progresses, varicose vein symptoms begin to directly affect your quality of life. The most frequent complaint patients voice is a feeling of heaviness and fatigue in the legs, which particularly worsens later in the day. This is often accompanied by throbbing pain and leg cramps that wake you up from sleep at night.

In advanced stages, prominent swelling (edema) appears in the legs and ankles. The high pressure inside the veins disrupts the nourishment of the skin tissue, leading to thinning, a shiny appearance, and brownish-purple color changes (pigmentation) on the skin. If no intervention is made at this stage, itching, eczema-like rashes, and highly difficult-to-heal varicose ulcers (open sores) can develop.

How Are Varicose Veins Diagnosed at the Hospital?

A detailed physical examination and radiological imaging are essential for accurate and effective treatment planning. Your physician will first listen to your complaints and examine your legs while you are standing to evaluate the visible vein enlargements. However, externally visible signs alone are not enough to understand the actual underlying problem.

The gold standard method for a definitive diagnosis and mapping out a treatment plan is Color Doppler Ultrasonography. It is of critical importance that this examination is performed while the patient is standing and by radiology specialists who have received specific training in this area. Through ultrasonography, the deep and superficial vein systems within the leg are examined, any leakage (reflux) in the valves is detected, and vein diameters are measured. The resulting map determines which method will be applied to which vein.

Treatment Methods for Varicose Veins

The treatment for each type of varicose vein (capillaries, medium-sized reticular veins, or large main vein varicose veins) is different. Traditionally known compression stockings or oral medications do not completely eradicate the disease. These methods are only used to alleviate symptoms such as pain, swelling, and cramps. For a permanent solution, the diseased vein must be physically closed or removed.

Non-Surgical Varicose Vein Treatments

In traditional surgical methods, the diseased vein was cut and removed from the body. However, in current medical practice, this method has largely been replaced by non-surgical techniques. These procedures are performed by entering the vein with a thin catheter or needle under ultrasound guidance.

Laser, Radiofrequency, and Adhesive Treatments

Heat-based ablation methods, namely laser varicose vein treatment and radiofrequency applications, are the most frequently preferred and effective options today. During the procedure, laser or radiofrequency energy is delivered through a thin fiber inserted into the vein. This heat causes the diseased vein to shrink and close. Over time, the body naturally eliminates this closed vein, and blood flow is redirected to healthy veins.

Another modern, non-heat-based method is adhesive (cyanoacrylate) treatment. In this technique, a medical adhesive is injected into the vein, causing the vein walls to stick together and close. Since no heat is used, it is a very safe alternative in terms of protecting surrounding tissues.

Foam Treatment

Foam treatment, also known as sclerotherapy, is generally used for the treatment of medium-sized green veins and capillaries, or as an adjunct to main vein treatment. It involves mixing a special medication with air to turn it into a foam, which is then injected into the vein using very fine needles. The medication irritates the inner lining of the vein, causing it to close.

Advantages of Non-Surgical Varicose Vein Treatments

Compared to traditional surgery, non-surgical methods offer many advantages for patients. These benefits make the treatment process much more comfortable and safer.

Anesthesia comfort: General anesthesia or a spinal block is not required. Procedures are completed painlessly under local anesthesia and relaxing medications given intravenously (sedation).
No hospital stay required: All these therapies are outpatient procedures. You can walk in for your treatment and walk back to your hotel or home a few hours after the procedure.
Aesthetic results: Since no incisions are made on the legs, there are no stitch scars; only small dots occur at the needle entry points, and these heal quickly.
High success rate: Because it is performed visually under ultrasound guidance, it is highly effective, and the likelihood of varicose veins recurring is much lower compared to classic surgeries.
Fast recovery: Patients can usually return to their normal daily lives and work within a day or two.

Complications and Risk Groups

Untreated leg varicose veins can lead to more complex health problems over time. The slowing of blood flow within the enlarged veins increases the risk of clot formation (thrombophlebitis). While clots in superficial veins cause painful redness, clots progressing to deep veins (deep vein thrombosis) can travel to the lungs and create a life-threatening emergency. Additionally, thinned skin tissue can lead to bleeding that is difficult to stop, even with a minor trauma.

Chronic pain and the poor aesthetic appearance of the legs can also cause individuals to withdraw from social life and suffer psychological wear and tear. A constant feeling of fatigue and a drop in sleep quality can eventually trigger mental health issues such as depression or anxiety. Keeping in mind that your mental health is just as important as your physical health, you can seek support from our hospital's Psychologist staff during such chronic processes and experience a holistic healing journey.

When to See a Doctor?

Although varicose vein symptoms generally progress slowly, in some cases, seeking medical help without delay is of vital importance. You should see a cardiovascular surgery specialist if you experience any of the following symptoms:

If the pain, swelling, and feeling of heaviness in your legs hinder your daily activities,
If color changes, hardening, or itchy rashes have started on the skin,
If non-healing or difficult-to-heal sores (ulcers) have formed around the ankle,
If bleeding occurs from an enlarged vein.

If you have a sudden onset of severe swelling, increased warmth, redness, and unbearable pain in your leg; and if this condition is accompanied by shortness of breath or chest pain, you should immediately call 112 or visit the nearest emergency room with the suspicion of deep vein thrombosis (a blood clot).

The Process at BHT CLINIC

At BHT CLINIC İstanbul Tema Hastanesi, varicose vein diagnosis and treatment processes are carried out by our expert medical staff using the latest technologies. When you apply to our hospital, after your detailed examination, a standing color Doppler ultrasonography is performed by our experienced radiology specialists, and the most appropriate treatment plan is created for you.

Our procedures are performed painlessly under sedation analgesia in rooms or operating theaters specially designed for the maximum comfort of our patients. After a short resting period following the treatment, our patients are discharged on the same day. You can book an appointment to take healthy steps once again.

Frequently Asked Questions

Do compression stockings work?

Compression stockings support the flow of blood back to the heart by applying external pressure to the legs. They significantly reduce complaints such as pain, swelling, and fatigue, but they cannot repair the damaged vein structure or completely eliminate the varicose veins. They are used to support treatment or after a procedure upon a physician's recommendation.

Is varicose vein treatment painful?

Modern non-surgical varicose vein treatment methods are extremely comfortable. Thanks to relaxing medications (sedation) given intravenously in addition to local anesthesia during the procedure, patients do not feel any pain or discomfort. Mild aches that may occur after the procedure are easily controlled with simple painkillers.

Can varicose veins be cured without surgery?

Yes, thanks to current medical technologies, most types of varicose veins, including large main vein varicose veins, can be treated with non-surgical methods. Methods such as laser, radiofrequency, adhesive, and foam therapy permanently close the diseased vein without the need for surgical incisions.

Do varicose veins recur after treatment?

The probability of varicose veins recurring in large veins treated with next-generation methods like laser and radiofrequency is extremely low. However, in individuals with a genetic predisposition, new capillaries or medium-sized varicose veins may develop in other veins in different parts of the leg in the following years.

How long does laser varicose vein treatment take?

Depending on the condition and extent of the vein, laser varicose vein treatment is generally completed in 30 to 45 minutes. After the procedure, patients rest in the hospital for 1-2 hours and are then discharged and can walk home or to their hotel.

This article is for informational purposes only; please consult your physician for diagnosis and treatment.