Most people often understand that the symptom of “varicose veins” is not a major problem or harmful to health. However, in reality, allowing the symptoms to become chronic and progress to a severe stage, the varicose vein problem that is considered minor can lead to risks of complications that may be life-threatening. If we treat varicose veins while the symptoms are still mild, there are several treatment options. But for those who leave it until the symptoms become severe, options may run out… and it may be necessary to end with surgical treatment.
Treatment approaches for varicose veins are divided into 3 main methods according to the severity of the disease
Early-stage varicose veins: Symptom relief for early-stage varicose veins can be done by wearing specially designed stockings for those with varicose veins.
Advantages of wearing stockings to help treat varicose veins
- Helps improve venous circulation
- Helps reduce fluid retention in the legs
- Helps prevent deep vein thrombosis
- Relieves symptoms caused by chronic venous insufficiency
The working principle of stockings that relieve varicose vein symptoms is because… stockings help the calf muscles contract better, similar to elastic bandaging, resulting in the valves in the veins functioning normally again. Stockings for varicose veins come in 3 types: below the knee, thigh-high, and full-length (from the waist down to the feet). The choice depends on the location of the varicose veins.
Moderate varicose veins: Treatment for varicose veins at this stage involves injections to cause the varicose veins to shrink and gradually collapse. However, sclerotherapy injections have limitations; they must be used for small varicose veins, making it suitable for patients with early to moderate varicose veins, with vein size not exceeding 3 millimeters.
There are several types of medications used for injection. The doctor will decide the appropriate type. The most commonly used medication is AETHOXYSKLEROL, whose active ingredient is POLIDOCANOL, with concentrations ranging from 1-3% depending on the patient’s condition.
Possible side effects from varicose vein injection treatment
- The injection site may experience pain, swelling, and redness
- Bruising may occur but will disappear within 1-2 weeks
- Darkening along the injected vein may occur
Severe varicose veins: At this stage, treatment requires surgery, which has 2 types: the traditional surgery where the doctor removes the varicose veins (VENOUS STRIPPING). This removal does not affect the veins, and patients can live normally. The second, more popular method nowadays is endovascular treatment, which involves puncturing the vein instead of surgery, resulting in smaller wounds and faster recovery. The puncture method is divided into 2 types:
- Thermal method: using radiofrequency or laser to cause the vein to collapse
- Non-thermal method: using glue injected into the vein to press and close it
Side effects from varicose vein surgery
- Bleeding from surgery (generally not severe)
- Subcutaneous bruising (which will resolve on its own within 1-2 weeks)
- Visible scarring after surgery
Although after surgery… there is still a 10-20% chance of recurrence if the patient continues risky behaviors for varicose veins, it is still better than no treatment. Because it not only affects health and daily life, but if varicose veins rupture and lymph fluid leaks, it can become a chronic wound with a risk of infection.
Dr. Supachai Janwitan
General Surgery Specialist
Surgery Center, Phyathai 2 Hospital
