Varicose vein patients ask me one question almost every day: “Sir, if you close the vein, where will the blood go?”
It is the right question to ask. On this page I will answer it, explain why varicose veins happen, who needs treatment and who doesn't, and how laser treatment works without an operation.
हिंदी में समझें: नसें फूलती क्यों हैं और इलाज कब ज़रूरी है?
पैर में दो तरह की नसें होती हैं। अंदर की deep veins, जो highway की तरह पैर का ज़्यादातर खून दिल तक ले जाती हैं, और ऊपर की नसें, जो चमड़ी के ठीक नीचे एक छोटी service lane जैसी होती हैं।
Varicose veins में ऊपर की नसों के वाल्व खराब हो जाते हैं। खून ऊपर जाने की बजाय नीचे गिरकर पैर में जमा होने लगता है। इसीलिए पैर में भारीपन, सूजन, दर्द और उभरी हुई नसें दिखती हैं।
Laser (EVLA) से इलाज: एक पतला laser fibre नस के अंदर डालकर उसे अंदर से बंद कर दिया जाता है। बिना चीरा, बिना टांके। खून अपने आप deep veins से दिल तक चला जाता है। ज़्यादातर मरीज़ उसी दिन घर चले जाते हैं।
इलाज से पहले Doppler test ज़रूरी है। अपनी Doppler report WhatsApp कीजिए: 95200 77033
What are varicose veins? Highway and service lane
Your leg has two sets of veins. The deep veins run inside the muscles, like a highway, and carry most of the leg's blood back to the heart. The surface veins lie just under the skin, like a small service lane.
Inside the veins are one-way valves that keep blood moving up against gravity. In varicose veins, the valves of the surface veins fail. Blood falls back down and pools in the leg, so the veins stretch, twist and bulge.
Symptoms: 5 signs you should not ignore
- Heavy, tired legs by evening, better in the morning or when you put your feet up
- Swelling around the ankles
- Bulging, twisted, blue veins, or fine spider veins
- Itching, cramps at night, or aching after standing for long
- Darkening of the skin near the ankle, or a wound that does not heal
Varicose veins are common in people who stand for long hours, such as teachers, shopkeepers, police and security staff, surgeons and nurses. They also run in families and often appear after pregnancy.
Do you need treatment?
Honestly, not everyone with visible veins needs a procedure. Ask yourself:
- Do my legs ache, swell or feel heavy enough to affect daily life or work?
- Is the skin near my ankle darkening, itching, or has a wound formed?
- Does the Doppler scan show leaking valves in the main surface vein?
How laser treatment (EVLA) works
First, a Doppler ultrasound. It is painless, with no needles, and it checks that your deep veins are healthy and shows which vein is leaking.
Then, under local anaesthesia, a thin laser fibre is passed into the faulty vein through a pinhole, guided by ultrasound. The laser seals the vein from inside. In some patients, medical glue is used instead of laser. Small leftover veins can be treated with injections (sclerotherapy).
No cuts, no stitches. You walk out the same day and return to normal routine within a day or two.
Laser or glue vs open surgery
| Laser / glue (non-surgical) | Open surgery | |
|---|---|---|
| Cut and stitches | No, only a pinhole | Yes, cuts in the groin and leg |
| Anaesthesia | Local | Usually spinal or general |
| Hospital stay | Home the same day | Usually 1 day or more |
| Back to routine | Usually in 1–2 days | Usually 1–2 weeks |
| Scars | Practically none | Small scars |
Which method suits you depends on your Doppler scan, so we decide that together.
Compression stockings: do they really work?
Yes, if used correctly. Stockings press harder at the ankle and less higher up, which helps push blood upwards. Three rules:
- Wear them in the morning, right after getting out of bed, before the swelling starts.
- Use the correct pressure and size. A loose stocking is just a tight sock.
- Replace them every 3–6 months. The elastic weakens, and an old stocking stops doing its job.
But remember: stockings control symptoms and help recovery after a procedure. They do not repair a failed valve.
3 myths my patients believe
Myth 1: “Varicose veins mean a heart problem.” No. It is a problem of valves in the leg veins and has no relation to the heart.
Myth 2: “A clot in these veins will cause a heart attack.” The bulging veins on the surface rarely cause serious clots. The real danger is a clot in the deep veins (DVT), which is a different condition. Sudden swelling of the whole leg, or breathlessness or chest pain, is an emergency.
Myth 3: “My leg is turning black, it will have to be amputated.” Absolutely not. In advanced cases a wound can form, but it heals with treatment of the vein and proper dressing, such as a four-layer dressing. It takes time, but this disease is treatable.
Mistakes to avoid at home
- Massaging a leg that has suddenly become swollen, red and painful. It could be a clot, so get it checked first.
- Wearing the same old stockings for years.
- Buying “varicose vein patches” or oils that promise to dissolve veins.
- Ignoring a wound near the ankle that is not healing.
Watch: explained by Dr. Amol
Questions patients ask me
Where does the blood go after the vein is closed?
Into the deep veins. They carry most of the leg's blood to the heart anyway. The faulty surface vein was sending blood backwards, so closing it improves circulation.
Is laser treatment for varicose veins painful?
It is done under local anaesthesia, so you feel only small pricks. Mild tightness or bruising along the treated vein for a few days is normal.
How soon can I walk and go back to work?
You walk out the same day. Most people return to their normal routine within a day or two. Walking is encouraged right after the procedure.
Can varicose veins come back after treatment?
The treated vein stays closed in most patients, but new veins can become varicose over the years, especially if you stand for long hours. Follow-up and stockings help.
Do I need a Doppler test before treatment?
Yes. A Doppler ultrasound is painless and shows which vein is leaking and confirms that the deep veins are healthy. Treatment is planned on this scan.
Is varicose vein treatment covered by insurance?
Yes, it is covered by health insurance.
Varicose veins ka ilaj bina operation ho sakta hai?
Haan. Laser (EVLA) ya glue se nas ko andar se band kiya jaata hai. Na chira, na taanke. Zyaadatar mareez usi din ghar chale jaate hain.
Kya varicose veins se heart attack ho sakta hai?
Nahi. Varicose veins pair ki nason ke valve kharab hone se hoti hain, dil se iska koi lena-dena nahi. Lekin agar poora pair achanak sooj jaaye ya saans phoolne lage, toh turant doctor ko dikhaayein.
In short
- Varicose veins are caused by failed valves in the surface veins. Blood pools, and the legs feel heavy and swollen.
- Closing the faulty vein does not harm circulation. Blood takes the deep veins to the heart.
- With a Doppler scan first, laser or glue treatment fixes it without a cut or stitches, and you go home the same day.
Have bulging veins or heavy legs? Send your Doppler report or a photo of your legs on WhatsApp and I will guide you.
WhatsApp 95200 77033
Written by Dr. Amol Srivastava
MBBS, MD (UCMS), PDCC (Interventional Radiology). Consultant Interventional Radiologist, Lucknow. OPD Monday to Saturday, 9 am to 7 pm.
Last reviewed: November 2026. This page is for information and does not replace a consultation.