Does treatment prevent varicose veins coming back?
While modern medical procedures are highly effective at closing or removing existing varicose veins, they do not ‘cure’ the underlying tendency for your body to develop new ones. Clinical data suggests that while the specific vein treated is permanently sealed or removed, there is a recurring risk in other vessels. In the UK, vascular specialists estimate that approximately 10% to 30% of patients may see new varicose veins develop within three years of their initial treatment. Success in preventing recurrence depends on the precision of the initial procedure and ongoing lifestyle management.
What We will cover in this Article
- The difference between ‘treatment failure’ and ‘new vein formation’
- Recurrence rates for laser, foam, and surgical procedures
- Common causes of why veins might return
- Triggers that accelerate the development of new varicose veins
- Differentiating between different types of post-treatment veins
- How to prolong the results of your medical procedure
- Clinical data on long-term venous health outcomes
Comparative Recurrence and Success Data
The following table outlines the long-term effectiveness of the most common NHS-approved procedures.
| Procedure Type | 5-Year Success Rate (Vein stays closed) | Estimated Recurrence Rate (New veins) | Primary Reason for Return |
| Endovenous Laser (EVLT) | 93% – 95% | 5% – 10% | Neovascularisation or new valve failure |
| Radiofrequency Ablation | 90% – 94% | 7% – 12% | Incomplete closure of trunk vein |
| Foam Sclerotherapy | 75% – 85% | 15% – 25% | Recanalisation (vein re-opening) |
| Traditional Surgery | 85% – 90% | 15% – 20% | Growth of new veins in the groin |
Treatment failure vs. New disease
It is vital to differentiate between a ‘failed’ treatment and ‘progressive’ venous disease.
- Recanalisation (Treatment Failure): This occurs when a vein that was supposed to be sealed (by laser or foam) re-opens. This usually happens within the first year and may require a second procedure.
- Progression (New Disease): This is when the treated vein stays closed, but a different vein—which was healthy at the time of your operation—develops faulty valves and becomes varicose.
Because the human leg has a complex network of veins, closing one ‘trunk’ vein solves the immediate problem but increases the pressure on remaining veins. If those other veins already have weak walls, they may eventually become varicose themselves. This is why doctors refer to varicose veins as a ‘chronic’ condition rather than a one-time event.
Causes of post-treatment recurrence
The primary cause of recurrence is the ongoing genetic and physical predisposition of the patient. If the initial ‘trigger’ for your varicose veins such as high blood pressure, genetics, or obesity remains unaddressed, the circulatory system will continue to be under stress.
- Neovascularisation: This is a biological process where the body accidentally grows new, tiny, fragile veins in the area where a vein was surgically removed. These new veins often lack valves and can quickly become varicose.
- Incomplete Treatment: If a small ‘tributary’ vein was missed during the initial ultrasound-guided procedure, it can become the new path for high-pressure blood flow, eventually bulging.
- Pelvic Vein Reflux: In some patients, especially women who have had multiple pregnancies, the source of the pressure is actually in the pelvis. If this isn’t treated, leg veins will likely return.
Triggers that speed up recurrence
Certain lifestyle triggers can significantly increase the likelihood of new veins forming after you have successfully completed treatment. Managing these triggers is the only way to ‘protect’ the results of your surgery.
| Trigger | Impact on Recurrence | Prevention Strategy |
| Pregnancy | High (Hormonal/Pressure changes) | Wear Class 2 compression throughout |
| Weight Gain | Medium (Increased venous pressure) | Maintain a healthy BMI |
| Static Standing | High (Blood pooling) | Use the calf muscle pump (walk/flex) |
| High-Impact Sport | Low (Jarring of vein walls) | Wear compression during exercise |
How to improve your long-term results
To prevent varicose veins from coming back, you must treat the health of your veins as a long-term commitment. In the UK, specialists recommend a combination of clinical follow-ups and daily habits.
- Post-Op Compression: Strictly following the 1–3 week compression protocol after surgery ensures the treated vein scars down permanently.
- Regular Walking: Walking is the best ‘natural’ treatment, as the calf muscle pump prevents the blood stagnation that leads to new valve failure.
- Annual Reviews: If you have a strong family history of veins, an annual check-up with a vascular nurse can catch new ‘leaky’ valves before they turn into large, bulging veins.
Differentiation: Varicose veins vs. Spider veins
Patients often worry that their treatment has failed because they notice small, red, or blue ‘spider veins’ appearing after surgery. It is important to differentiate these: spider veins are largely a cosmetic surface issue and do not indicate that the ‘deep’ treatment of your varicose veins has failed. However, a sudden ‘crop’ of new spider veins can sometimes be a sign of underlying pressure, so they are worth mentioning at your follow-up appointment.
Conclusion
Treatment is highly successful at removing the pain and risk of current varicose veins, but it does not provide a lifetime guarantee against new ones. By understanding that venous health is a progressive journey, you can use lifestyle changes and compression to significantly reduce your recurrence risk. For most patients, the improvement in quality of life after treatment far outweighs the 10%–20% risk of needing a minor ‘touch-up’ procedure in the future.
If you experience severe, sudden, or worsening symptoms, such as a painful red lump or skin that feels hot and hard, call 999 immediately.
Will the same vein ever come back?
If it was surgically removed, no. If it was treated with laser or foam, there is a very small chance (5%–15%) it could ‘recanalise’ or reopen, but usually, it is different veins that appear.
Does wearing stockings after surgery prevent new veins?
Yes, in the short term, they ensure the procedure is successful. In the long term, wearing them during high-risk times (like long flights) protects your remaining healthy veins.
Is recurrence higher with foam or laser?
Clinical data shows that laser (EVLT) has a slightly lower recurrence rate than foam sclerotherapy for large trunk veins.
Can I have treatment again if they come back?
Yes. Modern minimally invasive treatments can be safely repeated if new veins develop over the years.
Does exercise prevent recurrence?
Low-impact exercise like walking or swimming is excellent for prevention. High-impact weightlifting without proper breathing can actually increase the risk.
Why did my veins come back after pregnancy?
Pregnancy involves a huge increase in blood volume and hormones that relax vein walls. This is one of the most common ‘natural’ triggers for new varicose veins.
How can I tell if a new vein is serious?
If a new vein is accompanied by skin darkening, eczema, or swelling that doesn’t go away overnight, it requires a medical review.
Authority Snapshot
This article provides an evidence-based overview of venous recurrence based on NICE guidelines and clinical success data from UK vascular registries. It emphasizes the chronic nature of venous insufficiency and the role of patient adherence in long-term success. The information is intended to help patients set realistic expectations for their post-treatment recovery. Dr. Rebecca Fernandez is a UK-trained physician with an MBBS and experience in general surgery, cardiology, internal medicine, gynecology, intensive care, and emergency medicine. She has managed critically ill patients, stabilised acute trauma cases, and provided comprehensive inpatient and outpatient care. In psychiatry, Dr. Fernandez has worked with psychotic, mood, anxiety, and substance use disorders, applying evidence-based approaches such as CBT, ACT, and mindfulness-based therapies. Her skills span patient assessment, treatment planning, and the integration of digital health solutions to support mental well-being.
