Treatments for varicose veins (I): overview and medications

A topic of great interest for general public is often treatments for varicose veins: How varicose veins can be removed, and what are exactly these treatments?

Varicose veins

Along the following weeks I will be posting a series of articles explaining which are the treatments for varicose veins, or similar situations (like spider veins), that are currently available; what are exactly those treatments; what is their REAL efficacy; in which cases every type of treatment should be chosen; and which results we should expect from every one in the long term.

In the 21st century, we have a good number of different treatments available for varicose veins. As usual, when many different options are available, this means that unfortunately none of them is definitively the best one, suitable for every patient and every condition. As always, your vascular surgeon is the one who can advice you best regarding this issue.

Generally speaking, we’ll differentiate two types of treatments for varicose veins: conservative treatments and invasive procedures.

Spider Veins

Usually, when in Medicine we are talking about “conservative treatments”, we mean those that do not involve surgery or any invasive or aggressive approach against the body. They are also named “medical treatments” as opposed to “surgical treatments“. As an introduction we might say that conservative treatments for varicose veins are of three types:

  1. Pharmacological (the so-called venotonics).
  2. A group of measures and exercises that we’ll name postural hygiene measures.
  3. And, of course, the elastic compression stockings.

The beauty of all these conservative treatments is that they do not cause any irreversible action against the body, so we can also use them not only as treatment by themselves, but also as preventive measures against the development of varicose veins; or also as complementary to any of the invasive treatments aimed to remove them. On the other hand, none of them alone is really able to remove the varicose veins.

There are a number of drugs (generically called venotonics) which claim to improve venous insufficiency, either by reducing the caliber of the veins, or by “improving circulation“ through unclear means. Most of them provide scientific studies that supposedly prove their effectiveness, although the truth is that the quality of these studies usually does not show the same rigor and reliability than those that are usually required for other drugs whose handling is more delicate. The reality we see every day in the clinic are patients who have been changing from one to another, trying several of them and explaining that they found no improvement with any of them.

Most of these venotonics are made from natural plant extracts, such as diosmin (which is extracted from orange’s rind), sweet clover, rutosides or buckeye (and others). They rarely cause side effects, and it is true that a small percentage (around 10%) of patients report some improvement when taking them. So my best advice is:

  • The medicines of any type whatsoever, always under medical prescription, and
  • If you feel improvement of your symptoms with one of them, then take it; if you do not notice any, it’s better to stop it. Why taking a drug that is not offering you any improvement?

To end with, something important: when mentioning that some patients feel improvement, I’m referring exclusively to a perceived improvement in symptoms. Under any circumstances, none of these drugs is able to cure nor even reduce the varicose veins. None of them.

Should you be interested in getting to know this disease better, and its causes, consequences, how to treat them, and, even better, what can we do to prevent them, you can find it all well explained in the ebook VARICOSE VEINS: Truth & myths.

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Treatments for varicose veins (II): SEVEN (7) useful postural hygiene measures
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What is Angiology and Vascular Surgery all about, besides Varicose Veins?

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