Varicose Veins: Causes, Symptoms, and Treatment

Treatment Day & Up to Two Weeks Post-Procedure

  • You may resume normal activities immediately, but you might experience discomfort and bruising along the course of the treated vein. The bruising may be extensive in the thigh, but typically resolves in 1-2 weeks. If you need to take something for pain relief, we recommend starting with 400mg of Ibuprofen every 6-8 hours (taken with food). If you're unable to take non-steroidal anti-inflammatory drugs due to an allergy or other medical condition, it's acceptable to take Tylenol instead: up to 500mg every 12 hours. If the pain you're experiencing seems severe (i.e. you can't sleep or walk) and it's not alleviated with the aforementioned medications, please call our office or answering service for further assistance. Typically with the phlebectomy portion of treatment, lighter activity levels may be warranted due to discomfort, which is most likely to be experienced for the first 48 hours following treatment.
  • We recommend waiting 7-10 days before resuming a routine exercise such as running, weight lifting, or cycling, for example. We also recommend that you abstain from lifting anything over 20lbs for the same timeframe. Until then, a modified workout is recommended: walking is encouraged, treadmill use is fine, but no running or vigorous activity, and no weight bearing exercises specific to the legs and/or arms, as those will exert extra force onto the lower extremities. Because the vein is in the healing process, any additional force may cause the treated vein to reopen.
  • Our procedures are performed in a sterile environment in an effort to reduce the risk of infection. The risk of developing an infection as a result of these procedures is extremely low, however, to further reduce the risk, we ask that you abstain from soaking in pools, hot tubs, or bath tubs for 7-10 days after the procedure. Showering is fine, but we ask that you wait 24 hours after your procedure before you remove the ace wrap that we apply.
  • A sensation of tightness or pulling along the length of the treated vein is normal and to be expected. Prior to treatment, the veins are very flexible. However, once treated, the vein contracts and becomes scar tissue–typically perceived as a cord-like sensation. This can develop 1-4 weeks after treatment and resolves over time.
  • Areas of inflammation can be common after treatment. Typically, these areas are red, swollen, tender, and have a sensation of warmth. As the treated vein closes, it can cause an inflammatory reaction. This can occur within 1 week after laser or radiofrequency ablation treatment, or 3-6 weeks after foam sclerotherapy treatments.
  • Feeling hardened, tender knots in the areas of treatment is also normal, especially after having an ambulatory phlebectomy performed. We typically refer to this as “trapped blood”, and it occurs when blood is trapped within the treated vein and starts to clot. These aren't usually dangerous to your health, however, they can be tender and warm to the touch. To relieve discomfort and promote the healing process, we recommend applying a warm, moist compress a few times a day, along with gentle massage. This will help assist in the natural reabsorption of these areas. Without intervention this will still occur, but these recommendations will expedite the process. Dependent upon degree of discomfort, there's also the possibility of having a thrombectomy performed to produce immediate relief. This would require local anesthesia of the area and a stab puncture in the skin to express and squeeze out the trapped blood. If you notice warmth or redness in the leg that's associated with severe pain, fever, or increased swelling in one leg that's new, please reach out to us.
  • Skin discoloration can occur when the treated vein lies close to the surface of the skin. Once treated, the byproducts of the blood are absorbed by the overlying skin and they possess a staining component. Throughout the healing process this will lighten, though it can take several months depending on the size of the vein.
  • Some veins require multiple treatments to completely disappear. We'll reevaluate these veins at the one month follow-up to determine whether or not more treatments are warranted. Sometimes, insurance companies will pay for another round of visual sclerotherapy, but if this isn't an option, your CVR vein doctor will discuss other treatment options with you.
  • Some patients may experience a decrease and/or a loss of sensation localized to the treatment area, especially along the shin bone and/or ankle region. This is due to nerve irritation, and will resolve gradually throughout the healing process.

1 Month Post-Procedure

  • Healing is still occurring, therefore continued improvement in your symptoms will take place. It's likely that some swelling may be visible but should diminish more within the next 3-6 months.
  • Some patients continue to feel a “tight” sensation in the treated vein, which is still normal at this point in the healing process, though it should start to gradually resolve.
  • Residual knots/trapped blood areas are possible, but you may notice the tenderness you initially felt in the area is starting to decrease. This is normal, and continuing with warm compresses and gentle massages is recommended, as previously indicated.
  • Around this point in time, you may be scheduled to come in for your one month post-procedure follow-up scan. New findings may be revealed on the ultrasound study, as this is the chronic nature of venous insufficiency. Whether or not further treatments are needed will be determined based on each patient’s individual symptoms and ultrasound study findings. All of this will be discussed with you in a consultation after your scan.

6 Months Post-Procedure

  • Most people find any residual symptoms from the procedures, such as numbness, discoloration, and hardened areas, will have resolved, or been significantly reduced, at this point in the healing process.
  • If you notice these symptoms are worsening in any way, or if new symptoms appear, such as aching pain, swelling, heaviness, or fatigue, we recommend you make a follow-up appointment, as this could indicate underlying venous disease that may need to be treated.

Beyond 6 Months Post-Procedure

Venous insufficiency is considered a chronic and progressive disease process, therefore we eliminate those veins that are initially seen to be refluxing–in other words, not moving the blood properly. In time, however, other veins may become dysfunctional, which is why we provide a surveillance and monitoring service to our patients. We recommend reevaluation at the one month, six month, and one year points post-procedure. After the first year is complete, you'll need annual follow-up appointments. If at any time throughout the process you develop new or worsening symptoms, you should contact the CVR office to make an appointment for evaluation.

Post-Procedure Care for Laser & Radiofrequency Treatments

Although the healing time for laser and radiofrequency treatments is minimal, we do advise following several steps after your procedure to ensure there are no complications with your recovery.

  • Avoid prolonged sitting or standing.
  • Refrain from strenuous activities and heavy lifting for 2 weeks.
  • Compression stockings will help with the closure procedure. The more you wear them, the better you'll feel. However, wearing them for 3 days after the procedure is mandatory. (You can take them off at night.)
  • Schedule your follow-up Duplex (ultrasound) scan within 3-7 days after your procedure.
  • If you plan on sitting for more than 3 hours, try to get up and move around every hour. The use of baby aspirin is highly recommended.
  • You may shower, but no tub baths, swimming, or hot tubs for the first week.
  • In rare occasions, bleeding through the bandages may occur. Lie down, elevate your leg, and apply direct pressure until the bleeding has stopped. If the bleeding persists, please call your CVR physician.
  • It's normal to experience some tenderness and possibly some bruising along the areas where local anesthesia was administered.

Post-Procedure Care for Ultrasound-Guided Foam Sclerotherapy

Like laser and radiofrequency treatments, the healing process for ultrasound-guided foam sclerotherapy is easy. With that being said, it's still extremely important to follow our post-procedure instructions to have the best vein care experience possible.

  • Compression will promote clearance of the medication in the vein and reduce straining. Therefore, it's best to wear your compression stockings at all times for the next 3 days. You may remove them temporarily to shower.
  • After the first 3 days, continue to wear your compression stockings daily except for showering and sleeping for the next 2 weeks. Following this period, they may be worn at your discretion.
  • Avoid very hot showers and avoid tub baths, hot tubs, and swimming for one week. Pat the skin dry after showering. Soothing aloe vera gel or cool packs may be used to ease any discomfort, and Tylenol or ibuprofen may also reduce any post-treatment irritation. However, please avoid the use of aspirin.

Post-Procedure Care for Ambulatory Phlebectomy

Because they heal quickly, after 6-12 months the small slit-like incisions made during an ambulatory phlebectomy should be practically imperceptible. Recovery time is immediate, however, temporary bruising or swelling may occur after the procedure. Ambulation after this surgery is encouraged, and a post-operative bandage is kept in place for 24 hours before being replaced with daytime compression stockings for 1-2 weeks.

Post-Procedure Care for Visual Sclerotherapy

Following the injections that occur during visual sclerotherapy, a compression stocking needs to be worn to help keep the vein closed. Otherwise, normal daily activities can commence immediately after treatment.

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