Three common treatments for painful varicose veins all ease symptoms, though there may be small differences in quality of life months later.
That's the conclusion of a clinical trial that compared the three treatments -- surgery, laser ablation therapy and injections of a chemical foam (sclerotherapy). British researchers found that among nearly 800 patients they treated, all of the therapies relieved symptoms such as pain, swelling and itchy skin to a similar degree.
Laser therapy was least likely to cause minor complications such as bleeding or bruising during the procedure, the researchers report in the Sept. 25 issue of the New England Journal of Medicine.
Six months later, patients who'd received foam injections were giving slightly lower ratings to their quality of life, versus those who had surgery or laser therapy.
But the average difference was "minor," and unlikely to reflect a big impact on people's lives, according to Dr. Peter Gloviczki, a vascular surgeon at the Mayo Clinic in Rochester, Minn. Gloviczki was not involved in the study.
"Basically, this is a well-designed study that shows these treatments are similarly effective and safe," Gloviczki said.
Still, he added, the study followed patients for only six months, so the findings say nothing about the treatments' "long-term durability."
Varicose veins are a common condition where veins in the legs weaken, then gradually swell and become twisted. Up to 40 million Americans have varicose veins, according to the Society for Vascular Surgery -- often because of obesity, lack of exercise, or multiple pregnancies.
Visible varicose veins are usually no more than a cosmetic nuisance. But sometimes they cause symptoms like pain, leg cramps, swelling in the ankles and feet, and itchy skin.
Traditional surgery to remove the problem veins is no longer commonly used in the United States, Gloviczki said. But it may be necessary when the varicose veins are particularly large, he added.
The other two treatments -- laser ablation and foam injections -- work by causing varicose veins to close off, according to the Society for Vascular Surgery. In laser ablation, heat is applied to the interior of the vein, through a thin tube threaded into the vessel. Foam injections release chemical irritants into the vein wall, which eventually causes the vessel to collapse and disappear.
Studies have already shown that the therapies are good at "obliterating" problem veins, according to Dr. Julie Brittenden, the lead researcher on the study and a professor of vascular surgery at the University of Aberdeen in Scotland.
But this study, Brittenden said, is the first to compare the three treatments in terms of how patients rate their quality of life six months later.
Overall, her team found, patients were happier versus their pretreatment days.