What are varicose veins?
Varicose veins are enlarged, twisted veins that often appear on the legs as bulging, rope-like cords. They form when the small valves inside the veins stop working properly, allowing blood to pool instead of flowing efficiently back to the heart. This pooling is called venous reflux, or venous insufficiency.
Varicose veins are common, especially after age 50, and they often become more noticeable over time. For many patients they are more than cosmetic — they cause real discomfort that affects daily life.
Common symptoms
- Aching, heaviness, or fatigue in the legs
- Throbbing, cramping, or burning
- Swelling in the lower legs or ankles
- Itching or restlessness in the legs
- Skin discoloration near the ankles
- Bulging, rope-like veins on the legs
Causes and risk factors
Several factors can contribute to varicose veins:
- Family history of vein disease
- Pregnancy or hormonal changes
- Prolonged standing or sitting at work
- Increasing age
- Excess body weight
- Prior leg injury or surgery
When varicose veins may be medical
Varicose veins may be considered medical — rather than purely cosmetic — when they are accompanied by symptoms such as pain, heaviness, swelling, itching, skin changes, or ulcers near the ankle. In those cases, an ultrasound is typically used to look for venous reflux.
How ultrasound evaluates venous reflux
A duplex ultrasound is a painless, non-invasive scan that lets your physician see how blood is moving through the veins in your legs. It identifies which veins are refluxing and helps guide a treatment plan tailored to your anatomy.
How EVLT works
During EVLT, a thin laser fiber is placed inside the affected vein using ultrasound guidance. Local anesthesia is used to keep you comfortable. Gentle heat from the laser closes the vein from the inside, and your body naturally reroutes blood through nearby healthy veins. The treated vein is reabsorbed over time.
Before, during, and after treatment
Before
We review your medical history, examine your legs, and perform an ultrasound. We explain the plan and answer your questions.
During
EVLT takes about 30–60 minutes in our office. Local anesthesia keeps you comfortable. You remain awake and can walk immediately afterward.
After
You'll wear a compression stocking, walk regularly, and avoid heavy exercise for a short period. Most patients return to normal activity quickly.
Recovery and aftercare
Most patients walk the same day and return to normal activity within 24–48 hours. Mild soreness, bruising, or a feeling of tightness along the treated vein is common and usually resolves over a few weeks. We provide clear, written aftercare instructions and remain available if questions come up.
Insurance and medical necessity
EVLT may be covered when symptoms and ultrasound findings support medical necessity. Many plans require documentation of conservative therapy — such as a trial of compression stockings — before approving treatment. Our team helps verify your benefits and walks you through what is typically needed. See our insurance page for details.