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Varicose vein treatment without surgery and sclerotherapy
Surgery and sclerotherapy are not the only options for varicose veins. Newer methods treat them with less risk, and echotherapy needs no incision at all.
- Surgery and sclerotherapy work but carry real side effects.
- Newer thermal methods close the vein instead of removing it.
- Radiofrequency and laser still need a catheter inside the vein.
- Echotherapy treats from outside the body, with no incision.
- The best method depends on the vein, so discuss the options.
Varicose veins are a common sign of chronic venous disease, when veins can no longer carry blood back to the heart properly. Twisted and bulging, they are often a cosmetic concern, but as the disease progresses they can cause symptoms that need medical treatment. The good news: surgery is no longer the only option.
Why surgery and sclerotherapy are so often recommended
For many years, surgical stripping was the only treatment, and some doctors still see it as the default. Sclerotherapy, which injects a medication to destroy and close the vein, appeared about two decades ago as a quick, low-cost alternative. Both work, but both carry real side effects: surgery causes infection, bleeding, pain or skin discolouration in about 15% of patients, and rarely thrombosis or nerve damage. Sclerotherapy can cause clots in other veins, back pain, headaches, skin discolouration and even brief fainting or vision problems.
Today, though, gentler options exist, some without any incision at all.
Alternatives to surgery and sclerotherapy
In recent years several alternatives have been developed and tested, and endothermal ablation is now recommended by authorities such as the UK's NHS. Three ablation methods are available:
Radiofrequency ablation uses a catheter, inserted through a small cut, to heat the vein wall from inside until it collapses and closes. Endovenous laser works the same way, heating the vein through a catheter with bursts of laser energy.
| Treatment | How it works | Incision or catheter? | Chemical injected? |
|---|---|---|---|
| Surgery (stripping) | The vein is physically removed. | Yes, incisions | No |
| Sclerotherapy | A medication destroys and closes the vein wall. | Injection | Yes |
| Radiofrequency ablation | A catheter heats the vein from inside. | Yes, catheter | No |
| Endovenous laser | Laser energy heats the vein from inside. | Yes, catheter | No |
| Echotherapy (SONOVEIN) Recommended | Focused ultrasound closes the vein from outside the body. | None | No |
Echotherapy (HIFU)
Echotherapy (SONOVEIN) is the most recent innovation. Several intersecting ultrasound beams focus on the vein and raise its temperature until it closes, just like laser or radiofrequency, but from outside the body. No catheter is inserted, and no chemical is injected.
Curious how the ultrasound actually closes the vein? See how ultrasound works, and whether the treatment hurts.
Other alternatives
A few non-thermal options also exist, such as injecting a medical glue to seal the vein, or mechanochemical ablation, which combines physical action with a sclerosant. To weigh them all up, see our guide on how to get rid of varicose veins.
Wondering whether echotherapy is available near you? A growing network of centres is already equipped with the SONOVEIN.
Questions fréquentes
Can varicose veins be treated without surgery?
Yes. Several non-surgical options exist, including sclerotherapy, radiofrequency, laser and echotherapy, which is completely non-invasive.
What are the side effects of surgery and sclerotherapy?
Surgery can cause infection, bleeding, pain or skin discolouration in about 15% of patients. Sclerotherapy can cause clots, skin discolouration, headaches and, rarely, fainting.
What is endothermal ablation?
A group of methods (radiofrequency, laser, echotherapy) that close the vein with heat instead of removing it. It is recommended by authorities such as the UK's NHS.
How is echotherapy different from laser or radiofrequency?
Laser and radiofrequency heat the vein through a catheter inserted into the leg. Echotherapy uses focused ultrasound from outside the body, with no catheter and no incision.
Which varicose vein treatment is best?
It depends on the vein and your situation. A vein specialist can advise which method, invasive or not, is most appropriate.