Introduction
Varicose veins and spider veins are common, especially in people who stand for long hours or have hereditary predisposition. These conditions not only affect appearance but may also cause symptoms such as pain, tightness, heaviness, swelling, and even chronic ulcers.
Image shows varicose vein in the calf area
Modern treatments have advanced significantly. Large operations are no longer necessary. Current popular treatments include:
• Endovenous Laser Ablation (EVLA)
• Sclerotherapy
• Laser treatment for spider veins
All are outpatient procedures with minimal pain and fast recovery.
A common question from patients is:
“Will it be cured permanently?”
“Will it come back?”
EVLA for Varicose Veins
EVLA is the gold standard for large varicose veins (such as GSV and SSV reflux). A laser fiber is inserted into the vein and heat energy seals it permanently.
Research shows a **90–95% success rate at 3–5 years**, with very low recurrence of the treated vein.
However, this does *not* mean the disease is completely cured—varicose veins are a chronic condition. Other veins may develop reflux later if risk factors persist.
Image shows laser beam at the tip of the laser catheter
Sclerotherapy and Laser for Spider Veins
Spider veins and small reticular veins are treated with sclerotherapy or laser.
Sclerotherapy uses agents such as polidocanol or STS to collapse the vein wall.
Laser therapy targets tiny superficial veins, producing results within 2–4 weeks.
Image Left image shows sclerotherapy right image shows cutaneous laser
The treated veins disappear permanently, but new veins may appear later—especially in those with hormonal changes or prolonged standing.
Why Can Varicose Veins Reappear?
• **Genetics** – Strongest risk factor
• **Hormonal changes & pregnancy**
• **Lifestyle** – Standing long hours, obesity, inactivity
• **Incomplete treatment** – Residual branches (or perforators) may continue to reflux
• **Neovascularization** – New vein formation, common after surgical stripping, less common after EVLA
The Truth: Are They Cured?
• The *treated* vein is permanently closed → **that vein is cured**
• The *disease* is chronic → **new veins may appear**
Post‑Treatment Care (Important)
• Wear compression stockings for 1–2 weeks
• Maintain healthy weight
• Exercise regularly
• Avoid prolonged standing or sitting
• Follow-up ultrasound to detect new reflux
Good post-treatment care can avoid the return of varicose vein/spider vein after treatment
FAQ
Q: Does EVLA work permanently?
A: The treated vein stays closed permanently, but others may become abnormal later.
Q: Will spider veins come back after injection?
A: The treated veins will not return, but new ones may form.
Q: How many sessions are needed?
A: Some need only one. Spider veins may require touch‑ups.
Q: How long to wear stockings after treatment?
A: Usually 1–2 weeks.
Conclusion
Modern treatments—EVLA, sclerotherapy, and laser—offer excellent long-term results. Treated veins disappear permanently, but the overall disease may still progress.
Correct understanding:
**“Treated veins are permanently gone, but new veins may still form in the future.”**
Proper self-care and regular follow-up with a vascular specialist provide the best long-term outcome.