1. Diagnosis
Your health care provider will do a physical exam, including looking at your legs
while you’re standing to check for swelling. Your provider might also ask you to
describe pain and aching in your legs.
2. Tests
– To diagnose varicose veins, a health care provider might recommend a test called a
venous Doppler ultrasound of the leg. A Doppler ultrasound is a noninvasive test that
uses sound waves to look at blood flow through the valves in the veins. A leg
ultrasound can help detect a blood clot.
– In this test, a health care provider moves a small hand-held device (transducer), which
is about the size of a bar of soap, against the skin over the body area being examined.
– The transducer transmits images of the veins in the legs to a monitor, which displays
the results.
3. Treatment
Treatment for varicose veins may include self-care measures, compression stockings,
and surgeries or procedures. Procedures to treat varicose veins are often done as an
outpatient procedure, which means you usually go home on the same day.
Ask your insurer if varicose vein treatment is a covered expense. If varicose vein
treatment is done only to improve the appearance of the legs (cosmetic reason), the
cost might not be covered by insurance.
* Self-care
Self-care — such as exercise, raising the legs when sitting or lying down, or wearing
compression stockings — can help ease the pain of varicose veins and might prevent
them from getting worse.
* Compression stockings
– Wearing compression stockings all day is often the first approach to try. The
stockings squeeze the legs, helping veins and leg muscles move blood more
efficiently. The amount of compression varies by type and brand.
– Compression stockings are available at most pharmacies and medical supply stores.
Prescription-strength stockings also are available and may be covered by insurance if
varicose veins are causing symptoms.
* Surgeries or other procedures
If self-care steps and compression stockings don’t work, or varicose veins are more
severe, a health care provider might recommend surgery or other procedures:
– Sclerotherapy. A health care provider injects the varicose veins with a solution or
foam that scars and closes those veins. In a few weeks, treated varicose veins should
fade. The same vein might need to be injected more than once. Sclerotherapy doesn’t
require anesthesia and can be done in a health care provider’s office.
– Laser treatment. Laser treatment sends strong bursts of light onto the vein, which
makes the vein slowly fade and disappear. No cuts or needles are used.
– Catheter-based procedures using radiofrequency or laser energy. This procedure is
the preferred treatment for larger varicose veins. A health care provider inserts a thin
tube (catheter) into an enlarged vein and heats the tip of the catheter using either
radiofrequency or laser energy. As the catheter is removed, the heat destroys the vein
by causing it to collapse and seal shut.
– High ligation and vein stripping. This procedure involves tying off a vein before it
joins a deep vein and removing the vein through small cuts. This is an outpatient
procedure for most people. Removing the vein won’t keep blood from flowing in the
leg because veins deeper in the leg take care of the larger volumes of blood.
– Ambulatory phlebectomy (fluh-BEK-tuh-me). A health care provider removes
smaller varicose veins through a series of tiny skin punctures. Only the parts of the
leg that are being pricked are numbed in this outpatient procedure. Scarring is
generally minimal.