The treatment recommended by The National Institute for Health and Clinical Excellence (NICE) is endothermal ablation where the troublesome veins are sealed off using heat delivered by a laser (EVLA) or a radiofrequency catheter (RFA). These 2 keyhole techniques can be carried out under local anaesthetic on a “walk in walk out” basis, and have been shown to be around 97% effective. Another minimally invasive option is foam sclerotherapy which uses a chemical foam injected into the vein to cause it to become inflamed and then collapse. The chemical used to make the foam has been used to treat varicose veins by injection for over 50 years, but it is a fairly recent innovation to make a foam with it, and this seems to make varicose vein injections more effective than in the past.

The more ‘old-fashioned’ and invasive option is called ‘stripping’. NICE recommend that this is only used where other options are unsuitable. Stripping must be performed under a general rather than local anaesthetic and consequently has a far longer recovery time. This invasive surgical approach to the treatment of varicose veins is believed to have a higher risk of the veins coming back, and very few patients require to have their veins treated this way.