Treatment Overview
For many people, varicose veins are far more than a cosmetic concern. They bring a daily sense of heaviness, aching, and fatigue to the legs that can make standing for long periods difficult. The bulging, twisted blue or purple veins can also cause itching and burning, leading to discomfort that persists even while resting. While some individuals manage these symptoms quietly, others find that the condition significantly limits their activity levels and wardrobe choices due to self-consciousness.
Treatment is essential to relieve these nagging physical symptoms and prevent the condition from worsening. Without intervention, varicose veins can lead to more serious complications, such as skin changes, stubborn ulcers, or blood clots. Because the severity of venous disease ranges from small spider veins to large, painful ropes, treatment plans are highly individualized. Doctors assess the health of the underlying valves in the legs before recommending a specific course of action (National Heart, Lung, and Blood Institute, 2022).
Overview of treatment options for Varicose Veins
The management of varicose veins often involves a combination of lifestyle adjustments, mechanical support, and medical intervention. While compression stockings are a standard first step to improve blood flow, they do not repair the damaged veins. To treat the veins themselves, medical procedures are typically required.
Pharmacological treatment for varicose veins is unique compared to other conditions. It primarily involves injectable medications used during procedures to close the veins (sclerotherapy) and oral medications used to manage the symptoms of swelling and pain. While surgical removal (stripping) was once common, modern care favors minimally invasive techniques using heat or chemical medications to seal the veins shut.
Medications used for Varicose Veins
The most direct medication-based treatment involves sclerosing agents. These are liquid or foam medications injected directly into the affected vein. Common examples include polidocanol and sodium tetradecyl sulfate. These drugs are the active agents in sclerotherapy, which is widely used for spider veins and smaller varicose veins. Clinical experience suggests that foam formulations are particularly effective for larger veins because they fill the vessel space more completely than liquids.
For symptom management, doctors may recommend Venoactive Drugs (VADs), also known as phlebotonics. While the availability and FDA status of these vary, micronized purified flavonoid fractions (MPFF) often containing diosmin and hesperidin are widely used globally to reduce leg heaviness, pain, and swelling.
To address the inflammation and acute pain associated with superficial vein issues, non-steroidal anti-inflammatory drugs (NSAIDs) like ibuprofen or naproxen are frequently advised. These are particularly helpful if a patient develops superficial thrombophlebitis, a painful inflammation of the vein (Mayo Clinic, 2023).
How these medications work
Sclerosing agents work by intentionally damaging the inner lining of the problematic vein. When injected, the chemical irritates the vessel wall, causing it to collapse and stick together. Over time, the body turns this collapsed vein into scar tissue, which eventually fades and is absorbed. Blood flow is naturally rerouted to healthier veins deep in the leg.
Venoactive drugs (flavonoids) work by improving the tone of the vein walls and protecting the microcirculation. They help reduce the “leakiness” of the small capillaries, which decreases fluid buildup (edema) in the surrounding tissues. By strengthening the venous tone, they alleviate the sensation of heavy, tired legs. NSAIDs function by blocking the enzymes responsible for inflammation, providing temporary relief from pain and swelling.
Side effects and safety considerations
Injectable sclerosing agents may cause injection site side effects like bruising, redness, temporary brown skin staining (hyperpigmentation), or rarely, tiny blood clots. Allergic reactions and foam traveling are small risks, which doctors monitor.
Oral venoactive drugs generally cause only mild digestive upset (nausea, abdominal pain). NSAIDs risk stomach irritation and require caution with kidney issues or high blood pressure. Varicose vein treatment is usually postponed during pregnancy as issues often resolve post-childbirth. Patients should seek immediate medical attention for sudden shortness of breath, chest pain, or severe swelling in one leg, which could signal a deep vein clot (MedlinePlus, 2021).
Since everyone’s experience with the condition and its treatments can vary, working closely with a qualified healthcare provider helps ensure safe and effective care.
References
- National Heart, Lung, and Blood Institute. https://www.nhlbi.nih.gov
- Mayo Clinic. https://www.mayoclinic.org
- MedlinePlus. https://medlineplus.gov
- Society for Vascular Surgery. https://vascular.org
Medications for Varicose Veins
These are drugs that have been approved by the US Food and Drug Administration (FDA), meaning they have been determined to be safe and effective for use in Varicose Veins.