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Treatment of varices depend on their size


In patients with varicose veins, if there is an underlying venous insufficiency, it should be treated first with endovenous laser, radiofrequency and MOCA, etc., and then the varices themselves must be treated. If the patient does not have venous insufficiency, then varicose veins may be treated directly.


Sclerotherapy is the most commonly used method in the treatment of varicose veins. Sclerotherapy is the injection of some medications into the varicose veins via tiny needles that make varicose veins shrink and disappear over time. The liquid drug used in sclerotherapy, if mixed with air, turns into foam like a detergent and is more effective on the vessel wall (foam sclerotherapy). 










In small varicose veins and spider varices, sclerotherapy is performed by using needles as thin as a hair under a magnifying glass. This type of sclerotherapy is called "microsclerotherapy". Microsclerotherapy is an extremely effective form of treatment for small-capillary veins if applied correctly and carefully in experienced hands, but its results are highly dependent on the practitioner. In spider veins, transdermal laser treatment performed in beauty centers is generally less effective and more painful, but may be recommended for very tiny spider veins that are not suitable for microsclerotherapy.


Sclerotherapy is generally ideal for the treatment of small and medium varices. As the vessel diameter increases, the efficacy of sclerotherapy decreases and the healing time is prolonged. If sclerotherapy is performed on varices larger than 5-6 mm in diameter, these vessels may remain hard and dark for a  long time. This hardness and darkness can sometimes last for 1-2 years and may disturb the patient. Therefore, sclerotherapy alone is not recommended in large varices. The ideal treatment for such varices is miniphlebectomy. Miniphlebectomy is the removal of large varicose veins through the pin holes in the skin. This procedure is performed under local anesthesia, no incision or suture is used and no scarring occurs on the skin.


In conclusion, the treatment of varicose veins is varied and sometimes it may be necessary to use more than one method. The type and order of methods to be used must be determined individually in each patient by the doctor who has sufficient knowledge and experience in all diagnostic and treatment methods

 Video: How do we treat varicose veins nonsurgically? 

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