Varicose veins aren't 100% curable, but the veins you have now can be closed for good. Treatment shuts or removes the leaking vein, and blood reroutes through healthy veins. What treatment can't change is the tendency to form new ones. In a 5-year trial, new varicose veins appeared in 18.7% of legs after radiofrequency ablation. A varicose vein won't go back to normal on its own.
Highlights:
- A treated vein usually stays closed. After radiofrequency ablation, 5.8% of treated veins reopened over 5 years.
- New veins can still form. Vein disease is ongoing, so new varicose veins appeared in 18.7% to 38.6% of legs within 5 years, depending on the treatment.
- Varicose veins don't heal themselves. The valves inside the vein have failed, and they don't repair.
- Pregnancy veins are the exception. Veins that appear during pregnancy often shrink after delivery.
- Retreatment is usually simple. New veins can often be treated with an injection or another quick office procedure.
In this article
- Is varicose veins 100% curable?
- Can a varicose vein go back to normal?
- Why do new varicose veins form after treatment
- What treatment does fix
- Can varicose veins go away naturally?
- What if your varicose veins appeared during pregnancy?
- What if varicose veins come back after treatment?
- How to make your results last
- Frequently asked questions
Are varicose veins 100% curable?
No. Treatment can permanently close the varicose veins you have, but it doesn't cure the vein disease behind them.
Closing a leaking vein fixes that vein, but the reasons it failed, like your genes, age, and years of standing, are still there. Over time, other veins can weaken too.
The best long-term data comes from a randomized trial of 500 patients followed for 5 years after one of four treatments for the great saphenous vein, the most common source of leg varicose veins.
| Treatment | Treated vein reopened within 5 years | New varicose veins within 5 years | Legs treated again within 5 years |
|---|---|---|---|
| Radiofrequency ablation | 5.8% | 18.7% | 17% |
| Laser ablation | 6.8% | 38.6% | 18.7% |
| Foam sclerotherapy | 31.5% | 31.7% | 37.7% |
| Stripping surgery | 6.3% | 34.6% | 23.4% |
The treated vein stayed closed in more than 93% of legs after radiofrequency ablation, laser or surgery. But even with the best result, about 1 in 5 legs developed new varicose veins within 5 years. The authors noted that the higher recurrence after laser needs confirmation in other studies.
So a 100% cure isn't a realistic promise. What treatment can deliver is veins that stay closed, with new ones treated if they appear.
Can a varicose vein go back to normal?
No. Once a varicose vein forms, it doesn't return to normal on its own.
A healthy leg vein has one-way valves that keep blood moving up toward your heart. In a varicose vein, those valves no longer close, so blood flows backward, pools and stretches the vein. That backward flow, called reflux, is the root of chronic venous insufficiency.
The stretched vein wall and failed valves don't repair themselves. Exercise, leg elevation and compression stockings can ease the aching, but none of them close the leaking vein.
What can happen is that the vein disappears from view after treatment. Once it's closed, your body slowly absorbs it, and the bulge fades over weeks to months.
Why new varicose veins form after treatment
New varicose veins form because the conditions that caused the first ones are still present.
The 13-year Edinburgh Vein Study followed randomly selected adults and found nearly half of people with vein disease got worse over time. The factors most tied to progression were:
- Older age
- A family history of varicose veins
- A past deep vein clot
- Carrying extra weight
- Reflux in the superficial veins
Doctors have a label for veins that return after treatment: C2r, or recurrent varicose veins. The "r" was added to the international staging system in 2020 because recurrence is common enough to track on its own.
"We often hear from our medical peers that vein disease is 'just a cosmetic issue,' but what we'd like to hear more often is that cosmetic vein issues may be a sign of a more serious vascular problem," says Dr. Batra. Treating vein disease as a long-term condition, with follow-up, is how you stay ahead of it.
What treatment does fix
Treatment may not be a lifetime cure, but it fixes the problems most people come in for.
Aching, heaviness and swelling. In a UK trial of 798 patients followed for 5 years, people treated with laser ablation or surgery reported greater gains in quality of life than those treated with foam alone.
The leaking vein itself. Closure methods like radiofrequency ablation and VenaSeal shut the vein from the inside, and blood reroutes right away.
Leg ulcers. In a randomized trial of 450 patients, closing the leaking vein early healed venous ulcers in a median of 56 days, compared with 82 days when treatment waited.
Visible bulging veins. Microphlebectomy and ultrasound-guided sclerotherapy clear the branches you can see.
Recovery is short. In the same 500-patient trial, people returned to normal activity in a median of 1 day after radiofrequency ablation.
Can varicose veins go away naturally?
No. There's no natural remedy that closes a failed vein valve.
- Walking and calf exercises pump blood upward and ease symptoms, but don't shrink the vein.
- Weight loss lowers pressure on leg veins, and extra weight is tied to vein disease getting worse, but existing veins stay.
- Compression stockings relieve aching while you wear them. National guidelines recommend vein treatment over stockings for people who are candidates.
- Creams, massage and supplements stay near the skin's surface and don't fix the valves deeper in the vein.
These steps are worth doing whether or not you get treatment. They just won't make a varicose vein go back to normal.
What if your varicose veins appeared during pregnancy?
Pregnancy veins are the one case where varicose veins can shrink on their own.
Hormones and the extra blood volume of pregnancy widen leg veins. A 2010 study of pregnant women published in the Jornal Vascular Brasileiro found varicose veins in 72.7% of participants and noted that they tend to regress rapidly after delivery. The authors linked the high rate to rising estrogen and progesterone.
So if your veins showed up during pregnancy, it makes sense to wait several months after delivery. If they're still there, or they ache and swell, a vein ultrasound will show whether a leaking vein is keeping them open. Treatment generally waits until after pregnancy.
What if varicose veins come back after treatment?
Returning veins are common and usually easy to treat.
In the 5-year trial, 17% of legs treated with radiofrequency ablation needed another treatment. That second treatment is often smaller than the first: an injection for a branch vein, or closure of a different vein that started leaking.
If your veins come back, start with a new ultrasound. It shows whether the original vein reopened, whether a new vein is leaking, or whether the visible veins are small surface branches. Each has a different fix.
How to make your varicose veins results last
You can't control your genes, but a few choices help results last longer.
- Get a full duplex ultrasound first. Treating the vein that feeds the visible veins, not just the surface veins, lowers the chance they come back.
- Choose the right method for your vein. In the 5-year trial, foam alone reopened far more often than heat-based closure for the main vein.
- Keep your follow-up visits. They catch reopened or new veins while they're small.
- Stay active. Walking keeps your calf muscle pumping blood out of your legs.
- Manage your weight. Extra weight was one of the factors tied to vein disease getting worse.
- Move during long days on your feet or at a desk. Short walks and ankle flexes help.
Frequently asked questions
Do varicose veins ever go away completely?
A treated varicose vein can go away completely. Once it's closed, your body absorbs it and blood reroutes through healthy veins. Untreated varicose veins don't go away on their own, except some that appear during pregnancy and shrink after delivery. New varicose veins can still form in other veins over time.
Can you live a long life with varicose veins?
Many people live with varicose veins for years, but they tend to get worse and can lead to skin damage, ulcers and blood clots. In a 13-year study, nearly half of people with vein disease worsened. Treating the leaking vein relieves symptoms and lowers the pressure that causes those complications.
How long do varicose vein treatment results last?
The treated vein usually stays closed for good. In a 5-year randomized trial, 5.8% of veins reopened after radiofrequency ablation. New varicose veins formed in 18.7% of legs in that group over the same period, so follow-up visits help keep results on track.
Can weight loss make varicose veins go away?
No. Weight loss lowers pressure on your leg veins and may ease aching, but it doesn't repair the failed valves inside an existing varicose vein. Closing the leaking vein is the only way to remove it.
Is it better to remove varicose veins or leave them?
For veins that cause symptoms, treatment is usually the better choice. The 2022 national guidelines from the Society for Vascular Surgery, American Venous Forum and American Vein and Lymphatic Society recommend vein treatment over compression stockings for patients who are candidates. Treatment happens in the office, and most people are back to normal activity within a day or two.
What to do next
Start with a standing duplex ultrasound. It shows which vein is leaking, whether it can be closed, and what your realistic long-term results look like.
At Texas Vascular Institute, our vein specialists are led by Dr. Dev Batra, a double board-certified vascular and interventional radiologist. A self-pay consultation with ultrasound is $350, and we accept most major insurance plans.
We treat varicose veins at three North Texas locations:
- Dallas: 8330 Meadow Rd, #100, Dallas, TX 75231
- Plano: 4716 Alliance Blvd, Suite 180, Plano, TX 75093
- Hurst: 809 West Harwood Rd, Suite 101, Hurst, TX 76054
Call 972-646-8346 to book.