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Can varicose veins come back after treatment?

After going through a venous health assessment, the selection of a treatment, and the treatment itself, you’d like to be sure that your varicose veins are gone for good.

But might they come back? Unfortunately, it is possible, and the two main reasons they come back are using an aggressive treatment technique such as surgery or progression of the disease itself.

Here’s three things you need to do in order to reduce the chance of your varicose veins coming back to the absolute minimum.

Have a proper venous health assessment with duplex ultrasound

Effective venous health assessments today include at least 3 components: a detailed medical and family history, a careful visual examination of your legs, and a thorough duplex ultrasound scan of your legs. This assessment process should not be rushed, and should take about an hour. The medical and family histories are important to understanding your personal risk profile for varicose veins, which can help with detecting diseased veins and selecting strategies to prevent recurrences in the future. The ultrasound examination should take at least 20 minutes per leg, to be sure all abnormal veins are detected. Missing an abnormal vein during the visual or ultrasound examination can lead to not treating all of the diseased veins.

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Be sure your vein doctor is skilled in the most effective vein closure techniques

Not all treatment techniques are equal. The newer, less invasive techniques are generally more effective and pleasant than the older surgical procedures such as vein stripping. In fact, in up to 50% of cases, surgery causes “neogenesis”, or the generation of new varicose veins in the region of surgery. Not only do the veins grow back, but they grow back without any valves inside them at all, which means they are in worse shape than the veins that were there originally. This may not occur to all patients but certainly some patients can develop more severe symptoms than before their surgery.

The most modern, minimally invasive techniques such as endovenous (“inside the vein”) radiofrequency and laser ablation, have been shown to be slightly more effective, with permanent closure rates around 95% over 5 years. These techniques rarely fail or cause “neogenesis”. Other techniques such as foam sclerotherapy are not as reliable with reopening rates up to 50% over two years.

Maintain a healthy lifestyle to reduce your risk for varicose veins

Once your vein doctor has treated your veins, you can play a part in helping prevent your varicose veins from coming back. Certain lifestyle factors contribute to the likelihood of developing varicose veins, such as being overweight or obese, maintaining a sedentary lifestyle, standing or sitting for many hours at a time, and smoking. Based on your medical and family history, your vein doctor can work with you to develop strategies to help you lose weight, maintain a regular exercise programme, avoid sitting or standing for too long, and quit smoking. All of these efforts can go a long way toward keeping your vascular system healthy and preventing the recurrence of varicose veins.

If you have any questions, please call our office at 02 8021 2569. We will be happy to set up an appointment for a venous health evaluation.



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The Vein Institute,

227 Elizabeth street, ground floor, Corner of Elizabeth and Bathurst street, Sydney, NSW, 2000


Varicose veins are leg veins which do not pump blood effectively back to the heart and can be often seen as bulging veins just underneath your skin on either leg. These varicose veins have valves in them which are not working effectively so that blood which is meant to be pushed towards the heart, leaks downwards toward the legs. There are other leg veins which are still working, so blood does eventually arrive through other routes to your heart. However, varicose veins do exert added pressure on your circulatory system. Read More.

Endovenous Laser Ablation is a Varicose Veins Laser Treatment performed in our clinic under local anaesthetic. This new procedure is an excellent treatment option for most patients with varicose veins and is considered slightly more effective than surgery but without the need for hospitalization. Read More.

This is an endovenous treatment (meaning treating the vein on the inside). It is generally accepted to be associated with less pain and bruising than endovenous laser ablation. It is a “gold standard” form of treatment for large varicose leg veins treatment as the procedure requires no hospitalization or time of work yet is at least as effective as surgery. Read More.

Venaseal™ or ‘superglue’ treatment by Sapheon is the latest surgery free procedure that uses a medical adhesive to safely and effectively treat varicose veins. Unlike other treatments, Venaseal™ does not require tumescent local anaesthetic around the vein, so there is usually only one local anaesthetic injection. The Venaseal™ non surgical treatment procedure also eliminates the use of heat (or thermal energy) so there is virtually no risk of nerve or skin injury or any major reaction to the anaesthetic. Read More.

Ultrasound Guided Foam Sclerotherapy allows our doctors to visually guide and monitor a needle to the exact source of the incompetent vein (valve) to be injected. By using ultrasound we can treat more quickly and safely larger and deeper veins that once required more invasive surgical treatment. Foam sclerotherapy is the new form of delivering the sclerosing agent that allows us to treat larger varicose veins that might be unsuccessfully treated with conventional sclerotherapy. The foam solution has the consistency of ‘shaving cream’, which improves treatment in two distinct ways. Read More.

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