Varicose Vein Treatment In Turkey

What Are Varicose Veins?

Varicose veins are a condition that develops in the veins of the legs, which carry deoxygenated blood back to the heart (the venous system). In this condition, the veins enlarge, blood flow is impaired, and symptoms such as pain may occur. Varicose vein treatment can vary depending on the type of varicose veins, the severity of symptoms, and the patient’s overall health.

What Causes Varicose Veins?

Varicose veins occur when the valves in the leg veins do not function properly, causing blood to flow backward and pool within the veins. Normally, these one-way valves ensure that blood returns to the heart against gravity. When the valves weaken or become damaged, blood can flow backward, veins enlarge, twist, and develop into varicose veins.

Risk factors for varicose veins include advancing age, female gender, pregnancy, obesity, prolonged standing or sitting, and a family history of varicose veins. Other contributing factors include hormonal changes, a history of deep vein thrombosis, or congenital abnormalities in vein structure.

Subheadings for Varicose Vein Treatment

• Types of Varicose Veins
• How Is Varicose Vein Treatment Performed?
• What Are the Methods of Varicose Vein Treatment?
• Varicose Vein Treatment in the Legs
• Best Varicose Vein Treatment
• Duration of Varicose Vein Treatment
• Recovery After Varicose Vein Treatment
• Which Doctor Performs Varicose Vein Treatment?

Types of Varicose Veins

Varicose veins are a common vascular condition characterized by the enlargement and twisting of subcutaneous veins, most frequently seen in the legs. They occur when the valves in the veins, which prevent backward blood flow, weaken or become damaged. The main types of varicose veins are:

Spider Veins (Telangiectasias)

Spider veins are small, thin vein enlargements, usually located very close to the skin surface, with diameters less than 1 mm. They are typically red, purple, or blue and have a web-like appearance. The formation of telangiectasias is generally associated with increased pressure in microveins and mild valve dysfunction.

Genetic predisposition, hormonal changes (especially pregnancy and use of birth control pills),and prolonged standing contribute to the development of telangiectasias. Clinically, they usually do not cause pain or serious complications, and treatment is often sought for cosmetic reasons. Sclerotherapy or laser treatment are the most commonly used methods to eliminate telangiectasias.

Reticular Veins

Reticular veins are larger (1–3 mm) than spider veins and located at the subcutaneous level. They appear blue or purple and are commonly concentrated on the sides and back of the legs, around the knee and calf regions. Reticular veins are associated with moderate increases in venous pressure and valve insufficiency.

Symptoms such as pain, a feeling of heaviness, and cramps in the legs may be related to reticular veins, though serious health risks are rare. Sclerotherapy and laser treatments are effective in treating reticular veins. Reticular veins can also serve as an early indicator of larger varicose veins.

Deep Vein Varices (True Varicose Veins)

Deep vein varices are enlarged, bulging, and twisted veins with diameters of 3 mm or more. They usually develop due to valve insufficiency in the larger veins and impaired blood flow. Deep vein varices pose not only cosmetic concerns but also significant health risks.

Over time, complications such as skin discoloration, swelling, leg pain, itching, and chronic venous insufficiency may occur. Management of large varicose veins can include surgical removal, endovenous laser ablation, or radiofrequency treatment. These varices are often associated with genetic predisposition and lifestyle factors such as prolonged standing, obesity, and pregnancy.

Varicocele

Varicocele is the enlargement of veins that supply the testes and is the most common testicular vein disorder in men. It is most often found in the left testicle due to anatomical angles and pressure differences where the left testicular vein drains into the left renal vein. Varicocele has been associated with infertility in young men and may sometimes present with testicular pain, asymmetry, or testicular shrinkage. Clinically, it can be palpated and confirmed with Doppler ultrasound. Treatment options include surgical ligation, microsurgery, and endovascular embolization.

What Are the Symptoms of Varicose Veins?

Varicose veins can range from mild cosmetic concerns to serious medical problems. The most common symptom is the presence of visible, enlarged, and twisted veins in the legs. Patients may also experience heaviness, pain, burning, swelling, or cramps in the legs, which often worsen after prolonged standing.

Over time, skin changes such as discoloration, dryness, or eczema may develop, and in advanced cases, venous ulcers can form due to chronic venous insufficiency. Less common complications include bleeding from superficial veins, thrombophlebitis, and progression of venous insufficiency.

How Is Varicose Vein Treatment Performed?

The goal of varicose vein treatment is to relieve symptoms, improve blood circulation in the veins, and prevent complications such as chronic venous insufficiency or ulcers. In mild cases, conservative measures such as exercise, leg elevation, weight control, and wearing compression stockings are recommended. These methods are particularly beneficial in the early stages of the disease or for patients not suitable for interventional treatment.

For patients with more advanced varicose veins or persistent symptoms, minimally invasive procedures are considered the gold standard today. Endovenous thermal treatments, such as laser or radiofrequency ablation, have largely replaced traditional surgical vein removal due to their high success rates and faster recovery times.

Other effective options include sclerotherapy (injecting a solution to close the vein),mechanochemical ablation, or vein closure using tissue adhesives (cyanoacrylate). Surgical interventions are typically reserved for more complex cases or when other methods are not suitable.

Varicose vein treatment can be performed using sclerotherapy, foam therapy, or laser treatments. Importantly, varicose veins cannot be treated externally with creams or medications.

In the past, varicose vein surgeries involved physically removing the affected veins, whereas today, modern methods focus on closing and treating the veins without surgical excision.

What Are the Methods of Varicose Vein Treatment?

1. Sclerotherapy for Varicose Veins
2. Laser Treatment for Varicose Veins
3. Endovenous Laser Ablation (EVLA) for Varicose Veins
4. Surgical Treatment for Varicose Veins
5. Venous Stent

1. Sclerotherapy for Varicose Veins

Sclerotherapy has been used as a varicose vein treatment method for over 80 years.

In sclerotherapy, very fine needles are used to inject a sclerosing agent directly into the varicose veins. This intentionally damages the inner lining of the affected vein. Following this controlled damage, the vein collapses and closes.

This method, widely used in varicose vein treatment, allows early-stage varicose veins to be effectively treated in a large portion of patients. Once the vein adheres and closes, blood no longer flows through it, preventing the recurrence of varicosity in that vein. The closed veins are eventually absorbed and eliminated by the body.

A common question regarding sclerotherapy is whether the closed or eliminated veins have any negative impact on the body. The answer is simple: varicose veins are non-functional veins, so closing them does not harm the body; rather, it is beneficial. The deeper veins continue to function normally.

Another frequently asked question is about the duration of the procedure. At our clinic, a sclerotherapy session lasts approximately 30–45 minutes. After the session, patients can walk out of the clinic and continue with their work or return home.

After sclerotherapy, patients are advised to wear low-pressure compression stockings for about three days to help the treated veins adhere and close. It is safe to take a bath the day after treatment.

Mild burning or redness may occur at the treated sites. All necessary precautions are taken to prevent the sclerosing solution from leaking into surrounding tissues. However, minor leakage may occur during treatment, which could cause small sores. Although this is rare, any such sores will heal over time. Sclerotherapy sessions are usually scheduled 1 day to 1 week apart.

Sclerotherapy treats approximately 60–80% of all varicose veins. Spider veins typically disappear within 3–6 weeks, while larger varicose veins may take 3–4 months to resolve.

2. Laser Treatment for Varicose Veins

Laser treatment of varicose veins is a safe and effective method for treating affected veins. Scientifically, this procedure is called endovenous laser ablation (EVLA). Under the effect of the laser, the vein wall of the affected vessel “sticks together,” causing the vein to close and disappear without leaving scars. This procedure does not affect blood flow to the legs, as the deeper veins maintain normal circulation. Therefore, it not only corrects a cosmetic concern quickly but also treats a condition that could lead to serious complications in the future.

Laser treatment is performed in a sterile environment. The patient lies on the operating table, and the treatment area is carefully cleaned and prepared with antiseptic. A radiologist marks the vein and the path of the varicose vessel. The procedure follows a specific algorithm:

• Under ultrasound guidance, the doctor punctures the vein using a special needle. The sensation is similar to a normal intravenous injection. A catheter is then inserted into the vein through this needle.
• An anesthetic is injected around the catheter to prevent pain and protect surrounding tissues from the laser.
• The laser fiber is placed inside the varicose vein via the catheter. Under ultrasound guidance, the doctor advances the fiber to the saphenofemoral or saphenopopliteal junction, ensuring maximum control over the procedure. The tumescent anesthesia around the vein prevents tissue burning during laser application. The procedure involves withdrawing the fiber while applying laser energy to close the vein.

After treatment, the laser fiber and catheter are removed, the puncture site is cleaned with antiseptic, and compression stockings or bandages are applied. The patient is encouraged to walk for at least 40–60 minutes immediately after the procedure to help redistribute blood through healthy veins and stimulate circulation via deep veins.

3. Endovenous Laser Ablation (EVLA) for Varicose Veins

EVLA is a minimally invasive surgical procedure used to treat varicose veins, particularly in large superficial veins (main veins). The procedure involves inserting a laser fiber into the vein and using laser energy to close the affected vessel.

• Patient Preparation: The patient is prepared under local anesthesia or sedation for comfort.
• Laser Fiber Placement: A thin laser fiber is guided into the varicose vein, usually under ultrasound guidance.
• Application of Laser Energy: As the fiber advances through the vein, laser energy heats the vein wall, causing the varicose vein to collapse and close.
• Closure of the Vein: The laser causes blood inside the vein to coagulate, effectively closing the varicose vein.
• Post-Procedure Care: Patients can usually resume daily activities immediately after the procedure. Compression stockings may be recommended for a period, after which normal activities can continue.

Advantages of Endovenous Laser Ablation:

• Minimally Invasive: No incisions or stitches are required.
• Fast Recovery: Patients typically return to normal activities the same day or within a few days.
• Effective Results: Closure of the vein alleviates varicose vein symptoms and improves cosmetic appearance.

4. Surgical Treatment for Varicose Veins

Surgical intervention may be required for large or deep varicose veins. This procedure typically involves either removal of the vein (phlebectomy) or tying it off (ligation).

5. Venous Stent

In advanced cases, a stent can be placed to keep large veins open and maintain proper blood flow.

Varicose Vein Treatment in the Legs

Varicose veins in the legs occur due to insufficiency of the venous valves, causing blood to flow backward. Over time, this can lead to pain, swelling, skin changes, and ulcers. The treatment plan is determined based on the stage of the disease, vein structure, and the patient’s overall health.

In early stages, compression stockings and lifestyle modifications—such as exercise, weight management, and avoiding prolonged standing—can help relieve symptoms. In more advanced stages, minimally invasive procedures are preferred due to faster recovery times and high success rates compared to traditional surgery.

Varicose veins in the legs cannot be treated effectively with home remedies, herbal treatments, creams, cupping therapy, leech therapy, or ozone therapy. Effective treatment requires intervention by an interventional radiologist using ultrasound-guided EVLA or foam sclerotherapy.

Best Varicose Vein Treatment

The optimal treatment depends on the patient’s clinical condition. Today, endovenous thermal ablation techniques (laser and radiofrequency ablation) are considered the gold standard because they are highly effective and have short recovery times.

Sclerotherapy and foam therapy are effective for smaller varicose veins or superficial vessels. Newer methods include mechanochemical ablation and vein closure with tissue adhesives (cyanoacrylate). Traditional surgery (stripping) is now mostly reserved for complex cases or when other methods are unsuitable.

Duration of Varicose Vein Treatment

The treatment duration depends on the chosen method. Sclerotherapy and foam treatments typically take 15–30 minutes, while laser or radiofrequency ablation can be completed in about 30–60 minutes. Most minimally invasive procedures are performed on an outpatient basis, allowing patients to resume normal activities the same day.

Recovery After Varicose Vein Treatment

Recovery varies depending on the method used, but modern minimally invasive techniques allow a rapid return to daily activities. After endovenous laser ablation, radiofrequency ablation, or sclerotherapy, most patients can walk immediately and perform light daily activities on the same day.

To support venous circulation and reduce bruising, discomfort, or swelling, wearing compression stockings for 1–2 weeks is generally recommended. Mild tenderness, skin discoloration, or a feeling of tightness along the treated vein are common side effects but usually resolve within a few days to weeks.

Recovery after traditional varicose vein surgery or vein stripping may take longer, and patients are advised to avoid strenuous exercise for several weeks. In contrast, newer techniques are associated with less postoperative pain, lower complication risks, and faster recovery.

Long-term recovery involves lifestyle modifications—such as maintaining a healthy weight, regular exercise, and avoiding prolonged standing—to prevent recurrence. Follow-up ultrasounds may also be performed to confirm vein closure and monitor for rare complications such as deep vein thrombosis.

Which Doctor Performs Varicose Vein Treatment?

Today, varicose vein treatment is performed non-surgically by interventional radiologists using ultrasound guidance. In the past, varicose vein surgeries were performed by cardiovascular surgeons, but modern techniques developed by interventional radiologists have largely eliminated the need for traditional surgery. Therefore, if you are deciding between surgical and non-surgical varicose vein treatment, you should consult an interventional radiologist for non-surgical procedures.

Varicose Veins Are Not Just a Cosmetic Problem!

Varicose veins can remain asymptomatic for years, causing no complaints other than their appearance. However, over time, they can become painful, cause swelling in the legs, and eventually lead to chronic venous insufficiency.

Blood clots can form in varicose veins, a condition known as thrombophlebitis, which may cause pain, swelling, and redness in the leg. In severe cases, the clot can travel to the lungs, resulting in embolism or even death. There are essentially two main approaches to varicose vein treatment:

• Surgical Treatment: Since it is not possible to repair or restore damaged leg veins, surgical treatment involves removing these veins from the leg tissue. This is the oldest known method for treating varicose veins. While this method has certain limitations, more detailed information can be found on our website.
• EVLA (Endovenous Laser Ablation): This minimally invasive procedure closes the varicose vein without cuts or stitches using a needle similar to a blood draw. The patient can walk to the clinic and leave walking afterward.

Do Compression Stockings Work for Varicose Veins?

As explained earlier, varicose veins are like overexpanded plastic hoses that cannot carry blood to the heart. Compression stockings apply external pressure to these dilated veins and help blood flow back to the heart. However, they do not cure varicose veins—they only alleviate associated symptoms.

Can Varicose Veins Be Treated with Medication?

Unfortunately, varicose veins cannot be cured with medication. Most products marketed as “varicose vein medicines” only help reduce swelling temporarily. They do not permanently shrink or restore the dilated veins. Therefore, expectations from such medications should be limited.

Can Varicose Veins Be Treated with Creams?

Varicose vein creams are among the most frequently asked-about products. However, just like medications, creams cannot cure varicose veins. Many patients who come for treatment have previously tried various creams without success. Products such as horse chestnut cream, red vine leaf cream, Varicose Vein Defense Cream, or herbal varicose vein creams have no scientifically proven therapeutic effect.

What Happens if Varicose Veins Are Left Untreated?

If left untreated, varicose veins can lead to venous ulcers in the legs and increase the risk of blood clots. These clots can travel from the leg to the heart and then to the lungs, causing potentially serious complications. For these reasons, varicose vein disease should be treated promptly.

Frequently Asked Questions About Varicose Vein Treatment

Varicose Vein Treatment Should Be Done Without Delay!

If varicose vein complaints are ignored, they can worsen over time, leading to more severe problems that are harder to treat. Using various creams or ointments initially does not provide any effective results at any stage of the disease.

Varicose veins affect about 1 in 4 women and 1 in 5 men. They usually appear as bluish, twisted, raised veins of varying sizes under the skin of the legs.

Varicose Veins Cannot Be Treated in Beauty Centers!

Spider veins visible on the skin are often considered a cosmetic issue and are sometimes treated at beauty centers. However, attempting to remove them this way can do more harm than good. If spider veins are present, it is recommended to consult a radiology specialist for a proper varicose vein examination.

Can Varicose Veins Resolve on Their Own?

Varicose veins are similar to plastic hoses that have ballooned under high pressure. Once veins are dilated or expanded, they cannot return to their original state. Therefore, treatment is necessary if varicose veins have developed.

Some may believe that vein valves can be repaired, but in venous systems, this is not possible. If the valves are dilated, the vein is also expanded and must be treated or closed.

What Is the Fastest Varicose Vein Treatment?

The fastest treatments are EVLA (Endovenous Laser Ablation) and foam sclerotherapy. These procedures can often be performed on the same day as the examination, without hospital admission, general anesthesia, or spinal anesthesia.

Does Everyone Get the Same Varicose Vein Treatment? How Is the Choice Made?

Not everyone receives the same treatment. The method is chosen based on the patient’s examination and venous mapping.

Can Varicose Veins Be Completely Cured?

Varicose veins can be completely treated. However, due to genetic predisposition, small veins may appear again after intense exercise, weight gain, or pregnancy. Typically, large veins do not recur.

Can Varicose Veins Cause Blood Clots?

If a clot forms inside a varicose vein, the vein can become blocked. The clot can travel to the lungs, causing a pulmonary embolism. However, arteries that carry clean blood are not affected.

What Is a Compression Stocking and What Does It Do?

A compression stocking supports varicose veins before treatment and aids recovery afterward. After EVLA, it is usually worn for up to one month, while after foam sclerotherapy, 3–4 days is sufficient.

What Helps with Varicose Vein Pain?

Varicose vein pain occurs because blood pools in the legs. Elevating the legs to allow blood to drain and wearing compression stockings during prolonged standing can relieve pain. However, the definitive solution is treating the varicose veins with EVLA or foam sclerotherapy.

Does Weight Gain Cause Varicose Veins?

If there is a genetic predisposition to varicose veins, weight gain can increase their development.

Which Professions Increase the Risk of Varicose Veins?

Prolonged standing or sitting without movement can contribute to varicose veins. Professions such as teachers, police officers, soldiers, barbers, waiters, and others are at higher risk if there is also a genetic predisposition. Varicose veins can also be seen in athletes.

Are Varicose Veins Dangerous?

Like any disease, varicose veins can be dangerous if left uncontrolled.

• If a blood clot forms, it can cause leg pain and may travel to the lungs, leading to pulmonary embolism and potentially death.
• Non-healing wounds can develop near the ankles, which are often painful and reduce the patient’s comfort. These wounds can become infected and cause serious complications.
• Uncontrolled bleeding may occur, which can lead to discomfort and hypotension in the patient.

Can Varicose Veins Occur at Any Age?

Yes, varicose veins can occur at any age. The youngest patient I have treated was 15, and the oldest was 82.

Are Varicose Veins Genetic?

Varicose veins are 70–80% genetic. Environmental factors can accelerate their development.

Why Do Varicose Veins Appear at a Young Age?

There is a genetic predisposition, and if triggering activities are present, varicose veins may develop even at a young age.