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Varicose veins are abnormally swollen veins that are visible beneath the skin.  They are very common and over 50,000 operations are performed in the UK annually for their treatment.  Varicose veins do not cause any significant risk to your health and most people seek treatment for cosmetic reasons.  However, in some people, especially those who have to stand for long periods as part of their job, varicose veins can cause inflammation, pain and discomfort.  

The treatment options

• Living with your veins - if your veins are not painful, you may wish to avoid or delay treatment.
• Compression stockings - your consultant will be able to give you advice on this non-surgical treatment option.
• Surgery - the traditional treatment for varicose veins which involves surgically removing all the varicose veins, leaving only the normal vessels, and usually carried out by using minimally-invasive techniques. 
• Injection sclerotherapy - used mainly in small varicose veins or spider/thread veins with no major valve problems.  An outpatient treatment which involves injecting a chemical substance into the vein that causes their walls to glue together and the veins to shrivel up.
• Laser treatment (EVLT® or ELVeS® - suitable for some patient groups, this procedure is a quick, often walk-in/walk-out procedure with no general anaesthetic required.
   

Endovenous Laser Treatment (EVLT)

Endovenous laser is a recent advance in the treatment of varicose veins and can be performed under local anaesthestic.  It involves passing a probe into the varicose vein which is then sealed from within with the user of a specialised laser.  The procedure takes between 30-45 minutes per leg and can be performed as a daycase procedure.  Nearly 70% of patients who have not had previous varicose vein surgery are suitable for EVLT.  Once the probe is removed the leg is bandaged.

The advantages of EVLT compared to surgery are:

• EVLT is performed using local anaesthetic.
• The procedure can normally be done as an outpatient, taking 30-45 minutes per leg.
• You should be able to resume your normal activities straight away and return to work the following day.
• It avoids the incisions (scars) required for a normal operation and therefore complications such as wound infection.
• Patches of numbness on the skin are rare.
• There is very little discomfort or pain after the procedure.

Your recovery

Varicose vein surgery, either by conventional surgery or EVLT, is a very safe operation. The majority of operations carried out for varicose veins are entirely straightforward and considering the large numbers of operations performed; serious complications are rare.  However, all patients notice some bruising, in particular along the inner thigh.  You may also experience pain and soreness following the operation but this will settle over the next two weeks.  Occasionally, small sensory nerves in the skin, which are close to the vein may be damaged during the operation leading to small areas of numbness or pins and needles near the incision.  These often recover but, rarely, permanent numb areas remain.