What are some of the main medical treatments for varicose veins?

Medical treatments vary depending on the severity of the condition and patient preferences. People without symptoms or cosmetic concerns may not require any treatment. Mild to moderate cases may respond to conservative management, which includes using compression stockings (or socks) and certain lifestyle modifications, like avoiding prolonged standing or straining, performing exercise, wearing nonrestrictive clothing, reducing cardiovascular disease risk factors, losing weight, and elevating the affected leg(s). The goal of these strategies is threefold: to improve blood flow in the veins and prevent blood from pooling; to reduce venous swelling and inflammation; and to compress dilated veins. While conservative management may reduce symptoms, it usually does not drastically change the appearance of the veins. For example, a 2021 systematic review on the use of compression stockings as a first-line treatment for varicose veins found that stockings improved symptoms but did not reduce the progression or recurrence of the disease.^[1]

There are some medications that can help people with varicose veins. Diosmiplex (Vasculera) is a medical food derived from orange rinds and is used in the treatment of varicose veins. Topical steroid creams or ointments may be used to treat rashes that are secondary to varicose veins.

People with persistent symptoms, severe complications, or cosmetic concerns may opt for interventional treatments, like thermal ablation (endovenous or radiofrequency ablation), sclerotherapy, and surgery to remove affected veins. While each of these is effective, thermal ablation and sclerotherapy are less invasive and may be initially preferred over other surgical procedures.^[2]