What Causes Varicose Veins to Recur After Treatment?

Many people assume that once treated, varicose veins are gone forever. Although this may well be the case, varicose veins can become a chronic condition returning after a successful treatment in some cases. Knowing why varicose veins recur can help you prevent it.

Advancements in the treatment of varicose veins have led to several highly successful, minimally invasive therapies that eliminate the pain and unsightly appearance of varicose veins. However, for some people, varicose veins can be a chronic condition that unfortunately might re-emerge even after a procedure.

Studies reported recurrence rates as low as 10% and as high as 60% (in one study) after 5 years. But that shouldn’t deter you from seeking relief from the pain, swelling, heaviness, and cramping from varicose veins. Understanding why varicose veins sprout up again after treatment will help prevent a recurrence.

Why Varicose Veins Return

Varicose veins develop when tiny valves inside the veins lose their ability to close (become incompetent). Those valves normally allow the blood to move towards the heart and prevent it from “falling” backwards towards the feet. This valve incompetence (or reflux) leads to a gradual enlargement of the veins, eventually resulting in the varicose veins that commonly appear on the legs and feet .

Effective procedures to address varicose veins include laser ablation, radiofrequency ablation, closure with glue (cyanoacrylate- Venaseal), microphlebectomy and sclerotherapy. Laser and radiofrequency ablation seal the vein, using the heat from a laser or radiofrequency energy to collapse the vein from within. In the Venaseal technology, glue is deposited inside the vein to close it. A microphlebectomy consists of removal of varicose veins through micropunctures (about 1/16” inch). During sclerotherapy a special medicine (sclerosing agent) is injected inside the vein, creating a reaction of inflammation which leads to clotting and slow fading of that vein.

There are specific indications for each procedure, which have all been used for many years with a high success rate. Yet even after initially successful treatment, varicose veins may still return. Although it can be frustrating and disappointing, there are several reasons why a recurrence happens:

Not All Varicose Veins Were Treated

Any treatment of varicose veins without the use of a diagnostic ultrasound beforehand will lead to a recurrence rate of over 50-60%. So, in the planning of your treatment, your vein specialist should do a thorough ultrasound to locate the problematic veins. It can be very helpful for your physician to see those veins himself when the ultrasound is completed. However, your body contains many veins of varying sizes; therefore, an ultrasound may not detect small early malfunctioning veins. Those untreated veins may progress and eventually cause new varicose veins with or without symptoms. In that case, you may require more than one procedure to treat all your varicose veins.

New Veins Form

Veins are part of our own tissues, and as such, our body has the ability to create new veins in areas of previous treatment; those veins are typically very small but may lead to the enlargement of existing veins. This process is known as neovascularization. It’s the same principle that allows the skin to heal after an injury. Likewise, a treated vein can recanalize (open up again), leading to a recurrence of varicose veins.

It’s in Your Genes

Varicose veins tend to run in families. There’s not much you can do to change your genetics, but you can make lifestyle changes to lessen your risk of developing varicose veins or stem a recurrence. Managing your weight and staying active may prevent the onset or return of varicose veins. The use of medical compression stockings on a regular basis may also be beneficial.

You Didn’t Change Your Lifestyle

If you want to avoid a recurrence of varicose veins, you must follow a healthy lifestyle and make other lifestyle changes. Obesity raises the risk of varicose veins. Losing weight with diet and exercise goes a long way in preventing varicose veins. A sedentary lifestyle is another factor. Working at a desk or standing all day increases your chances of developing varicose veins. To counteract this, move as much as possible or exercise regularly to engage your calf muscles to boost circulation in the legs. Wearing compression stockings and elevating your legs are effective, at-home methods to reduce varicose vein symptoms — or a recurrence after treatment.

Although treatment doesn’t necessarily guarantee your varicose veins will never return, you should undergo the procedure if the jagged, bulging veins cause symptoms and interfere with your quality of life. A procedure based on a good diagnostic ultrasound has a very high chance of solving your problem for a long time. Also keep in mind that, in some cases, varicose veins left untreated may lead to more serious health issues, such as blood clots and skin ulcers. Your vein specialist will discuss your treatment options and your specific risk of complications; that is also an opportunity to receive a few tips to maintain healthy veins and lessen your odds of recurrence.

Don’t Delay — Get Treatment Now

Center for Vein Restoration proudly serves the people in New Hampshire at two locations in the state, Salem and Nashua. Dr. Normand Miller, MD, FACS, RPVI, RVT, a board-certified vascular surgeon with over 25 years of experience in the treatment of vein disease, is the lead physician for both offices. He can help you decide on the right therapy to improve and maintain your vein health. Contact us today for a consultation.

224 Main Street, Suite 1-D, Salem, NH 03079

400 Amherst Street, Suite 402, Nashua, NH 03063