Why can I still see varicose veins after Endovenous Laser Ablation? | How long to see result?

If we only treated your varicose veins by Endovenous Laser Ablation alone, they probably would not go away. EVLA by itself is not enough. One lady from the USA contacted us at the Veincare centre to ask for advice. She had had EVLA by her specialist in the USA performed EVLA successfully but her varicose veins did not change. She contacted us to ask why.
Experts agree that endothermal ablation such as endovenous laser is the best treatment for varicose veins.
Superficial venous reflux – down flow of blood in the incorrect direction is the cause of varicose veins. First thing in the morning when we get out bed and stand up, gravity tends to pull the blood down the veins in the wrong direction. If the valves in the veins are not working, reflux occurs, filling visible side branches under the skin. Even when the reflux is abolished, these side branches will not disappear. Over time they have been stretched beyond their elastic recoil. After laser, they remain baggy and visible. That’s why an adjunctive procedure such as phlebectomy or foam sclerotherapy is required. Laser cannot treat these very superficial varicose veins under the skin for 2 reasons. Firstly, they are tortuous, and a straight laser fibre cannot be inserted along them and secondly laser energy might injure the skin. That’s why adjunctive procedures in addition to laser are needed to get the best results for varicose veins.
If you are having treatment just to relieve symptoms or to treat a complication such as varicose eczema, phlebitis or leg ulceration, then no further treatment is usually necessary. 
Most patients however wish also to improve the appearance of their veins and of these about 90% will require further treatment. The lumpy veins normally become less obvious after EVLA but rarely disappear completely.
Additional treatment for the visible lumpy varicose veins can be removed either by Phlebectomies or Foam Sclerotherapy. These additional treatments can be undertaken at the time of the EVLA or more usually after a delay of 4-6 weeks. If you have extensive varicose veins on both legs it is very unlikely that you will be able to have all the additional treatment undertaken at the time of the EVLA.
Phlebectomies are undertaken after a local anaesthetic solution has been injected around the veins to numb the area. Small incisions are made over the veins and they are gently extracted with a micro-instrument. You may require many small incisions but they heal quickly without stitches and they are hardly noticeable after 3-6 months.
Foam sclerotherapy in combination with Phlebectomy is the commonest means of dealing with varicose veins after EVLA
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