Varicose veins – more than just a beauty problem

Many people initially see varicose veins as a cosmetic nuisance. However, the bluish protruding veins can mean much more: they are a sign of venous disease and can lead to serious health problems if left untreated.

In this article, you will find out what varicose veins actually are, why treatment is important and which modern treatment methods – from laser to vein glue to radiofrequency – are available in Berlin and Frankfurt today.

Our VenaZiel vein center offers patients of all insurance types and even internationally the most modern vein therapy – medical, professional and at the same time patient-friendly.

What are varicose veins?

Definition: Varicose veins (medically varices or varicosis) are permanently enlarged, tortuous superficial veins, usually on the legs. Due to a weakness in the venous valves, the blood no longer flows back to the heart efficiently and accumulates in the leg veins – the result is visible, often nodular accumulations of veins under the skin.

Very small superficial varicose veins are called spider veins, while larger trunk or side branch varicose veins are more prominent.

Frequency: Varicose veins are widespread – a real widespread disease. According to the Bonn Vein Study II, over 60% of adults show signs of weak veins, and around 20% will develop varicose veins requiring treatment in the course of their lives. Women are around three times more likely to be affected than men, but many men also suffer from varicosis – often without realizing it. (In fact, one in five men has varicose veins, often without realizing their significantly increased risk of thrombosis and pulmonary embolism).

Causes and risk factors

Why do varicose veins develop? In most cases, a hereditary weakness of the connective tissue and veins plays the main role – if parents have varicose veins, their own risk is significantly increased. Many risk factors also have a favorable effect:

• Age: Over the years, vein walls lose elasticity; damage adds up over time.
• Genetics: A family predisposition to weak connective tissue or venous valve insufficiency increases the risk.
• Lack of exercise: Sitting or standing for long periods reduces the muscle pump in the calves – the blood accumulates more easily in the leg veins.
• Occupational stress: Standing or sedentary activities (e.g. salesperson, office) promote varicosis due to the lack of movement stimulus.
• Pregnancy: Hormonal changes and the pressure of the growing uterus on pelvic veins lead to temporary varicose veins in many women. They often disappear after the birth, but can reappear if the pregnancy continues.
• Overweight: Excessive body weight increases the pressure in the leg veins; fatty tissue in the abdomen can also impede venous return.
• Hormones & lifestyle: Female hormones (e.g. the contraceptive pill) can loosen the connective tissue. Smoking also damages the vascular walls and promotes venous disease. Large body size and chronic constipation are also discussed as risk factors.

Varicosis usually develops as a result of a combination of several factors over a period of years. Good to know: Many of these risks can be influenced.

Regular exercise, a healthy weight and avoiding long periods of standing or sitting can help to prevent varicose veins (see FAQ).

Symptoms and complaints

Varicose veins are not always immediately painful. Often there are no symptoms at first and the tortuous veins are only visually noticeable. However, as venous insufficiency progresses, various symptoms can occur:

• Heavy, tired legs: Especially after standing for a long time or in the evening.
• Feeling of tension and pressure: in the lower legs or calves.
• Pain and pulling: sometimes also nocturnal calf cramps.
• Swelling of the ankle: Water retention (edema) that increases during the course of the day.
• Itching or burning: on the skin over varicose veins.
• Tingling or throbbing: restless, nervous legs (so-called restless legs feeling).

The symptoms often worsen in warm weather (e.g. in summer) and towards the evening. Important: Varicose veins can be a nuisance even without pain, as many sufferers find the visible veins disturbing and avoid wearing short clothing out of shame. However, any visible indication of weak veins should be taken seriously – even small varicose veins can cause discomfort.

Why have varicose veins treated? Risks & complications

Varicose veins may be annoying from a cosmetic point of view – but the real problem lies deeper. If left untreated, varicose veins can progress and lead to serious complications.

Doctors therefore emphasize: “Vein problems and varicose veins are not cosmetic blemishes, but serious conditions that need to be treated.” . Here are some reasons why timely treatment is important:

• Chronic venous insufficiency: Varicose veins are an expression of chronic venous insufficiency, which can continue to worsen without treatment. The diseased veins become increasingly dilated and other vessels can also be affected.
• Inflammation of the veins (thrombophlebitis): Blood flows more slowly in dilated veins, which favors inflammation. Painful vein inflammation with redness and hardened vein strands directly under the skin occur relatively frequently in untreated varicose veins.
• Blood clots and thromboses: Larger varicose veins in particular increase the risk of a blood clot forming. This can block the vein (deep vein thrombosis) and, in the worst case, even lead to a pulmonary embolism if the thrombus travels to the lungs. Although the risk is not present with every varicose vein, it increases with the severity of the vein disease.
• Skin changes: Prolonged venous insufficiency leads to poor circulation in the skin. This can turn brownish, dry out or become eczematous (stasis dermatitis). Such skin damage is a warning sign that an open leg is imminent without treatment.
• “Open leg” (leg ulcer): In advanced stages, it can lead to poorly healing, open wounds on the lower leg – commonly known as an open leg. These ulcers are caused by chronic undersupply of the tissue and are a considerable, protracted burden for those affected.
• Bleeding: In rare cases, superficial varicose veins directly under the skin can burst or bleed heavily if injured. Due to the high venous pressure, even a small tear can lead to considerable blood loss – another reason to treat varicose veins in good time.

To summarize: Varicose veins are not a harmless beauty problem. If left untreated, the disease can progress continuously and lead to pain, inflammation, thrombosis, skin ulcers or other complications. Therefore, do not hesitate to consult a vein specialist if you suffer from varicose veins.

Early treatment not only improves the quality of life, but often also prevents a lifetime of suffering from consequential damage.

Modern varicose vein treatment methods

The good news is that varicose veins can now be treated gently and effectively. Thanks to modern treatment methods, costly operations are usually unnecessary – most treatments are minimally invasive, outpatient and require a short recovery time.

Which method is best suited to the individual case depends on the extent and location of the varicose veins. In many cases, endovenous procedures (from inside the vein) can close the diseased vein so that the blood flow is redirected.

Below is an overview of the most modern vein therapies at VenaZiel in Berlin and Frankfurt:

VenaSeal™ (vein adhesive) – “Gluing instead of cutting”

In this innovative vein glue procedure, the varicose vein is closed using a special medical adhesive. The doctor uses a tiny catheter to insert a cyanoacrylate adhesive into the vein, which glues the vein walls together from the inside.

Advantages: The treatment does not require heat or extensive anesthesia – in contrast to laser or radio wave therapies, numerous anesthetic injections along the leg are not necessary. The procedure is therefore often particularly comfortable for patients.

In addition, no compression stockings need to be worn afterwards. Studies show success rates of over 94% of closed veins after 1-3 years, comparable to radiofrequency ablation.

The complication rate is low and there tends to be less bruising or pain than with heat-based procedures. You can leave the clinic immediately after the procedure – ideal for working people and people with little time.

Endovenous laser therapy – treating varicose veins with light energy

Laser treatment of varicose veins is a gentle procedure that has been tried and tested for years. A thin laser fiber is inserted into the diseased vein via a puncture site.

The vein wall is heated by targeted laser energy from the inside and the varicose vein closes. The body then gradually breaks down the closed vein.

Advantages: Endovenous laser therapy does not require a surgical incision – only a small puncture for the catheter is necessary. It is performed under local anesthesia (tumescent local anesthesia) and is practically painless. The success rate is very high (over 90 % closure rate) with a low recurrence rate compared to conventional surgery.

After the outpatient procedure, the patient can go home the same day. Light activity is permitted immediately, and normal everyday activities and work can often be resumed the very next day.

Radiofrequency ablation (radio wave therapy)

Radiofrequency therapy works – similar to laser – with heat from the inside. However, instead of laser light, high-frequency electric current is used to heat the vein wall to approx. 120 °C.

A catheter with a special probe is inserted into the vein; the radiofrequency energy emitted thermally obliterates the vein and causes it to close permanently.

Advantages: Radiofrequency ablation (often known as VNUS-Closure™) is also minimally invasive and extremely effective. Studies show closure rates equivalent to laser (>90 %).

Many phlebologists appreciate the fact that this method can be somewhat gentler on the tissue – there is often even less bruising than with laser, and patients report minimal post-operative pain.

The treatment is performed on an outpatient basis with local anesthesia; after a short recovery period, you can go home. In most cases, you will be fully functional again within 1-2 days.

Sclerotherapy (sclerotherapy)

Sclerotherapy is a classic procedure that is mainly used for smaller varicose veins and spider veins. The doctor injects a sclerosing agent – either in liquid form or as a fine-pored foam – directly into the affected vein.

This agent causes a deliberate local inflammation of the inner wall of the vein, causing the vein to stick together and be broken down by the body. Advantages: Sclerotherapy does not require surgery – only needle pricks are necessary. It is particularly suitable for reticular varicose veins and side branches as well as for cosmetically disturbing spider veins.

The procedure is very short (often only a few minutes per vein) and virtually painless; anesthesia is usually not required. A compression bandage or stocking is often recommended for a few days afterwards to ensure the success of the treatment.

Several sessions may be necessary to achieve an optimal result in all affected areas. Sclerotherapy is often carried out in addition to the methods mentioned above in order to remove fine residual varicose veins.

Surgical procedures (stripping surgery) – when is it still necessary?

Stripping surgery – the surgical removal of the truncal vein – used to be the standard treatment for varicose veins. Nowadays, it is performed much less frequently thanks to gentle endovenous procedures.

A surgical procedure under partial or general anesthesia may nevertheless be advisable in exceptional cases, for example in the case of very tortuous vein sections that are inaccessible for a catheter, or if there are already multiple recurrences.

At VenaZiel, the focus is clearly on minimally invasive methods. However, if surgery is necessary, we will provide you with comprehensive advice and can guarantee the appropriate vascular surgical treatment.

In general, studies show that endovenous therapies are at least as successful as stripping, but are associated with fewer risks and faster recovery. Traditional surgery is therefore only indicated in selected cases today.

Treating varicose veins in Berlin and Frankfurt am Main

VenaZiel is your specialized vein center with locations in Berlin and Frankfurt am Main.

Our experienced team of phlebologists, vascular surgeons and vein specialists offers you modern, gentle varicose vein treatment procedures at both locations – individually tailored to your needs.

As an officially recognized vein competence center, we attach great importance to sound diagnostics and high-quality treatment according to the latest medical standards.

Locations: In Berlin you will find us centrally located in Berlin-Mitte (Friedrichstraße), in Frankfurt in a central location in Frankfurt am Main. Both vein centers are equipped with the latest technology and are easily accessible.

For all patient groups: All patients are welcome at VenaZiel – we treat statutory and private patients, self-pay patients and international guests.

As an MVZ (medical care center), we can treat patients with statutory health insurance; many of our therapies are reimbursed by health insurance companies (see FAQ on costs).

We support international patients with a multilingual service: our team will be happy to advise you in German, English, Russian or Arabic so that you feel completely understood.

Your advantages with VenaZiel: Personal care, short waiting times and comprehensive advice are our top priorities. We rely on minimally invasive therapies such as VenaSeal™ adhesive technology, endovenous laser and radio wave, which generally do not require general anesthesia or hospitalization.

Thanks to gentle methods, you can usually go home straight after the treatment and are quickly fit for everyday life again.

Our aim is to achieve medically optimal and at the same time aesthetically pleasing results – for healthy legs and satisfied patients in Berlin, Frankfurt and beyond.

Advice and appointments

Would you like to have your varicose veins treated and would like an individual consultation? Do not hesitate to contact us!

VenaZiel Berlin & Frankfurt am Main is there to help and advise you – from a no-obligation vein check to comprehensive treatment planning.

You are welcome to make an appointment online or contact us by phone to book a consultation in Berlin-Mitte or Frankfurt am Main.

FAQ – Frequently asked questions about varicose veins and their treatment

How does modern varicose vein treatment work?

Treatment is usually carried out on an outpatient basis in our practice. First, the vein is carefully examined and marked using ultrasound. Then, depending on the method, a fine catheter is inserted into the affected vein (under local anesthesia if necessary).

The actual treatment (laser, radiofrequency or vein glue) often only takes 15-45 minutes. Thanks to local anesthesia, you will not usually feel any pain. Once the vein has been closed, the access is removed and a small bandage is applied. You can get up immediately afterwards and go home after a short period of monitoring.

General anesthesia is not required (and is not needed for our gentle procedures).

How quickly will I be fit again after the treatment?

Very fast – that is the advantage of minimally invasive procedures. Downtime is minimal: you can usually walk normally and carry out light activities on the same day.

Most patients can return to work the very next day (office work immediately, physically strenuous jobs after one to two days of rest).

Sporting activities such as light jogging or cycling are often possible again after just a few days. You should only avoid very strenuous sports (e.g. strength training of the legs, marathons) for about 1-2 weeks so that the vein can heal properly.

Overall, experience has shown that our patients recover significantly faster than after conventional varicose vein surgery with an incision.

Do I have to wear compression stockings after the treatment?

This depends on the method. After laser or radiofrequency treatments, we usually recommend wearing a medical compression stocking (class II) on the treated leg for a few days to two weeks.

This supports the healing process and reduces any swelling or bruising. However, the wearing time is significantly shorter than it used to be with stripping surgery. With the VenaSeal™ adhesive method, we can usually dispense with compression stockings altogether, as the vein closure does not cause any thermal irritation. Your doctor will tell you exactly whether and for how long compression is advisable in your case.

Does health insurance cover the costs of treatment?

The diagnostic clarification and medically necessary treatment of varicose veins is covered by statutory health insurance in many cases.

Many patients with health insurance are also reimbursed for modern endovenous therapies (laser, radiofrequency) if they have varicose veins that require treatment – we will advise you on this and, if necessary, submit a cost application to your health insurance company.

Innovative methods such as VenaSeal™ (vein glue) are still relatively new; many private health insurers already reimburse these, but statutory health insurers often do not yet reimburse them regularly. Please talk to us about the costs during your consultation!

Can varicose veins return after treatment?

With careful treatment, the diseased vein sections are permanently eliminated – the closed or removed veins themselves “do not come back”.

However, if the patient is predisposed to this, there is still a general weakness of the veins. This means that new varicose veins can develop in other veins over the years (so-called recurrent varicosis).

Studies show that the recurrence rate after modern procedures is significantly lower than it used to be after stripping, but recurrence can never be completely ruled out.

Regular follow-up checks are important: at VenaZiel, we offer check-ups to detect new varicose veins at an early stage.

By taking preventive measures (see next question), you can help to counteract new varicose veins yourself. If varicose veins do appear years later, they can usually be treated again using minimally invasive methods.

What can I do to prevent new varicose veins?

You can do a lot for your own vein health! Here are some tips that – according to experts – help to prevent the recurrence of varicose veins:

• Movement: Regular sport and activity get the muscle pump going. Walking, cycling, swimming or gymnastic exercises for the legs (e.g. foot bouncing, tiptoe stand) are particularly suitable. Avoid sitting or standing for long periods of time – move around in between or elevate your legs.
• Keep weight in the normal range: Every kilo less relieves the leg veins. Make sure you eat a balanced diet with sufficient fiber (also prevents constipation) and drink enough to keep the blood “thin”.
• Compression if required: Don’t be afraid to wear compression stockings at the first signs of venous insufficiency, for example on long flights or when standing. Modern stockings are much more comfortable and less noticeable than in the past.
• Avoid vein-damaging substances: Avoid nicotine – smoking damages the blood vessels. Extreme heat (hot baths, saunas) dilates the veins; cool your legs with cold water afterwards. Tight clothing or very high heels can also impede blood flow and should not be a permanent condition.

These measures improve blood circulation and can reduce the risk of new varicose veins. However, they are no substitute for medical treatment if varicose veins are already pronounced.

In case of doubt: It is better to seek medical advice early on to prevent vein problems from becoming serious in the first place. Your legs will thank you for it!