To continue with this education and information series regarding frequent vascular diseases, a topic of great interest to the general public is often treatments for varicose veins: How varicose veins can be removed, and what are exactly these treatments?
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; which is their ACTUAL 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 already have available a good number of different treatments for varicose veins. As usual, when many different options are available, this means that unfortunately none of them is the definitive and 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.
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 may say that conservative treatments for varicose veins are of three types:
- Pharmacological (the so-called venotonics).
- A group of measures and exercises that we’ll name postural hygiene measures.
- 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. In contrast, none of them is really able to remove the varicose veins by themselves.
There are a number of drugs (generically called venotonics) whose activity aims to improve venous insufficiency, either by reducing the caliber of the veins or by “improving circulation“ through unexplained 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. They rarely cause side effects, and it is true that a small percentage 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 improvement it’s better to stop it, why taking a drug that is not offering you any improvement?
Something important: when mentioning that some patients feel improvement, I’m referring exclusively to a perceived improvement in symptoms. In any case none of these drugs are able to cure or even reduce varicose veins. None of them.