Varicose Vein Treatment: Everything You Need to Know

Do your legs have visible blue and purple veins that run behind your knees or over your calves and thighs? If so, you’re not alone. More than 23% of all adults in the United States have varicose veins. (17)

Varicose veins are more than just cosmetic. They can cause significant discomfort. (16) People who have varicose veins are also more likely to develop deep vein thrombosis (DVT), blood clots, peripheral artery disease, and chronic skin ulcers on their legs. (7)(19)

As serious as this sounds, there are ways to help prevent their formation or, if you already suffer from varicose veins, provide relief. But before we explore varicose vein treatments, let’s take a look at why they form in the first place.

What are varicose veins?

Your body has two types of circulatory vessels: the arteries, which channel blood from the heart to the extremities, and the veins, which bring blood from the extremities back to the heart. Of all the veins in your body, leg veins have the hardest time carrying blood back to the heart. To accomplish this difficult task, your legs are equipped with one-way valves that keep the blood moving in the right direction. But, if these valves fail to close properly—or your veins become damaged and the valves leak—blood can pool in the legs, causing swelling and injury to the vein’s walls. Over time, this can cause varicose veins. (25)(30)

Varicose veins affect 22 million women and 11 million men between the ages of 40 and 80. (17) Of those, only about two million people will experience significant symptoms of chronic venous insufficiency (CVI)—a condition that increases the risk of varicose veins and severe circulatory problems. (17)(23)

Did you know? Spider veins are a mild form of varicose veins and consist of clusters of broken capillaries that appear like jagged red, blue, or purple lines on the surface of the skin. Spider veins are painless and do not pose a health risk. (22)

Women are more likely to develop varicose veins than men.

Risk factors for varicose veins

A number of things can put you at risk of varicose veins. While some factors like sex or a family history are beyond your control, others can be due to lifestyle choices. Risk factors include:

• Advancing age
• Being female
• Contraception or hormone replacement therapy (HRT) use
• Family history
• History of DVT
• Lack of exercise
• More than two pregnancies
• Obesity
• Prolonged sitting and/or standing
• Smoking
• Tall height (3)(10)(17)

Did you know? Varicose veins that occur during pregnancy usually go away by themselves within two to three weeks after giving birth. (29)

Varicose vein symptoms

Depending on their severity, varicose veins may cause the following symptoms:

• A burning sensation in the legs
• Dry, irritated skin (varicose eczema)
• Itching
• Leg cramps
• Limb heaviness and fatigue
• Painful legs
• Skin discoloration (hyperpigmentation)
• Skin ulcers
• Swelling (17)(25)

How to prevent varicose veins

You can’t always prevent varicose veins, but there are ways to reduce your risk. These same strategies may also help prevent varicose veins from worsening and ease discomfort if you already suffer from the condition.

For those who are overweight or obese, losing weight can reduce the risk of varicose veins by improving blood flow and reducing the amount of pressure that’s placed on the veins. It’s also important to stay physically active because moderate exercise helps to pump blood through the veins. However, the National Heart, Lung, and Blood Institute notes that vigorous exercise may worsen existing varicose veins. (31) If you do have the condition, it’s wise to avoid prolonged standing or sitting and to elevate your legs when possible. (17)

The National Institutes of Health also advises avoiding tight clothing, especially around your waist, upper thighs, and legs. The exception to this is the use of compression stockings. (4) These stockings exert gentle pressure on the legs and may help relieve pain, swelling, and other symptoms. (31)

How to treat varicose veins

Although lifestyle changes can help prevent or minimize symptoms, severe cases may require medical varicose vein treatment. These can include in-office treatment, outpatient procedures, or surgery. Here are three of the most commonly used treatments.

1. Endovenous ablation

Endovenous ablation uses radiofrequency or lasers to cauterize and close varicose veins. Generally safe and less invasive than surgery, the procedure leaves virtually no scars. Endovenous ablation is usually performed by a specially trained interventional radiologist on an outpatient basis. (33)

During sclerotherapy, a chemical irritant is injected in veins, causing them to shrink and disappear.

2. Sclerotherapy

This in-office technique is used to treat spider veins and small varicose veins. During the procedure, a chemical irritant is injected into veins, causing them to shrink and disappear. Each session is followed by the use of compression stockings. Studies show that sclerotherapy significantly improves symptoms compared to compression stockings alone. (25) It’s also been found to improve the appearance of veins in 70% of patients. (17)

Did you know? Although sclerotherapy can be highly effective for spider veins, it will not prevent new spider veins from forming. (22)

3. Surgical stripping

Surgical vein stripping is used to remove or tie off a large vein in the leg called the superficial saphenous vein. It is often used in patients at risk of blood clots or chronic sores, or to relieve leg pain and heaviness. Typically performed under anesthesia in a hospital or surgical center, the procedure is generally considered safe. (32)

5 supplements for healthier veins

Combined with a healthy diet, these supplements have been shown to reduce the risk of the condition and may help to provide symptomatic relief for existing varicose veins.

1. Butcher’s broom

The root of this small evergreen shrub is a rich source of flavonoids and anti-inflammatory steroid saponins which have been shown to contract veins. (21) In one multi-center double-blind, randomized, placebo-controlled trial, researchers gave 148 patients with CVI either butcher’s broom or a placebo. By the end of the study, those taking the herbal supplement had less leg swelling and an improvement in the feeling of heaviness, tingling, and tension compared to the placebo group. (28)

2. Diosmin

This flavonoid, which is found in the peel of many citrus fruits, reduces inflammation in veins, improves blood flow, and reduces pain in people with CVI and varicose veins. (8) This natural compound has also been shown to reduce the pain and severity of varicose vein-related eczema. (20) Diosmin can be taken alone or in combination with another citrus-based flavonoid called hesperidin. Research shows that this pairing improves the elasticity of veins, reduces inflammation, inhibits free radical production, and accelerates skin healing in those with varicose veins. (2)(13)(18)

3. Hesperidin

Hesperidin is a flavonoid found primarily in oranges and tangerines. A synthetic form of a similar flavonoid called hesperetin is sometimes used instead of hesperidin because it produces faster effects. (11) Research shows that, compared to a placebo, pairing flavonoid-rich hesperidin with diosmin significantly decreased ankle or calf circumference and reduced pain, heaviness, cramping, and functional discomfort. This combo has also been shown to improve redness, swelling, and quality of life. (26)(34) In addition to supplements that combine hesperidin and diosmin, a small study involving 65 women found that a combination of hesperidin, vitamin C, and butcher’s broom also improves the symptoms of varicose veins. (1)

Horse chestnut has been shown to reduce swelling and strengthen blood vessels thanks to a compound known as escin.

4. Horse chestnut

Rich in antioxidants, horse chestnuts are also a good source of triterpenoid saponins called escin. (14)(24) Escin has been shown to benefit varicose veins by reducing swelling and strengthening blood vessels. (14) It’s also been found to reduce blood clotting, which can benefit those with varicose veins. (9) Findings in the journal Global Advances in Health and Medicine highlights horse chestnut’s ability to reduce inflammation, leg volume, and leg pain. (27)

5. Rutin

Sometimes called vitamin P, rutin is an important flavonoid found in apples, buckwheat, passion flower, and tea. It’s also found in the herb rue, which is where it got its name. (12) A potent antioxidant, rutin has been found to decrease the fragility of capillaries and improve the symptoms of varicose veins. (15) One small study found that supplementing with rutin improved swelling, heaviness, leg cramping, and restless legs in people with varicose veins and CVI. (5) A larger study reported that a proprietary rutin preparation was more effective than the combination of diosmin and hesperidin for easing the symptoms of varicose veins and improving the quality of life in patients. And it did so in as little as eight days. (6)

The bottom line

Varicose veins can be painful, negatively affecting an individual’s quality of life. Depending on their severity, medical varicose vein treatment such as sclerotherapy or surgery may be needed. However, people with small varicose veins or spider veins may benefit from lifestyle changes and supplements. These natural strategies have been shown to support vein health and reduce pain associated with varicose veins.

If you are concerned about the appearance of your varicose veins or are experiencing symptoms, it’s wise to consult your healthcare practitioner.