Published on 25 February 2025
At Benenden Hospital, we’ve carried out over 10,000 varicose vein procedures (PHIN, 2024), so you can put your trust in our private vascular service.
We understand that older methods of varicose vein removal such as stripping, can put patients off seeking treatment, however, we’ve put together a guide to our Endovenous Laser Treatment (EVLT) to ease your biggest concerns.
Do you need EVLT for your veins?
Your Consultant Vascular Surgeon, Mr Aaron Sweeney, will examine your varicose veins and depending on their type, size and the impact they’re having on your quality of life, they’ll recommend the correct treatment for you.
Did you know that approximately 85% of people with varicose veins are suitable for EVLT? EVLT was recommended as the preferred surgical option for varicose veins by the National Institute for Health and Care Excellence (NICE) since 2013. If you have mid-sized or larger varicose veins, you may need EVLT.
I have a question about EVLT for varicose veins
What is Endovenous Laser Treatment (EVLT)?
I think it's helpful to think of veins like a Christmas tree. You have a main vein that runs up the centre of your leg and you've loads and loads of branches coming in. They can number hundreds. A varicose vein is one of the smaller veins that's draining your skin and it normally runs from your groin right the way down to your knee. Endovenous laser treatment is where I thread a small laser up the inside of that vein and essentially deliver heat, and that heat destroys the vein.
Is EVLT safe?
EVLT is a very safe and effective treatment. It has really superseded the older operation of stripping. We can do it for the most part, under local anaesthetic. Patients walk in and walk out - and that significantly reduces the risk of complications.
Are my varicose veins suitable for EVLT?
Most people are suitable for Endovenous laser treatment. Occasionally people are unsuitable when they've had multiple previous operations, for example, stripping. But in my practice, approximately 95% of people are offered Endovenous laser treatment.
What happens during Endovenous Laser Treatment for varicose veins?
We always perform Endovenous laser treatment in a sterile operating theatre. You would come into that theatre, lie on an operating bed and, after a few moments, I would inject some local anaesthetic in your leg. Subsequently, I thread the small laser up the inside of your vein. And that whole procedure takes somewhere between 15 and 20 minutes. Once it's finished, I would place you in a bandage. That bandage is non-sticky and can be removed very, very easily. And I use it instead of using an uncomfortable compression stocking.
Is the EVLT procedure painful?
EVLT in itself is not painful, but I have to give some local anaesthetic in order to make that happen. It usually involves some small injections of local anaesthetic on the inside of your thigh. I think most people think of that as similar to a trip to the dentist.
What should I expect after EVLT?
Well, most people following the procedure are relieved that it wasn't as bad as they thought it was going to be. They normally walk outside and are completely pain free. However, the next day it does feel like you've pulled a muscle. Most people can walk around the house with ease or could walk the dog or even walk their kids to school. I usually suggest that they take a painkiller of some sort and that normally allows full movement. However, it does feel a little uncomfortable and I think it takes about two weeks before you forget that I've done your operation.
How long will I need to be off work after EVLT?
In terms of taking time off work following Endovenous laser treatment, I think most people could work from home the following day, but it does feel uncomfortable - rather like a pulled muscle. So, if you have a long commute, many people take a little longer than that off.
How long after EVLT will I see results?
Following Endovenous laser treatment, you will normally see results very quickly. Any symptoms you had before the procedure usually subside really quickly. I think it takes between two and three weeks for discomfort to disappear. But I think it takes between six and eight weeks for them to appear cosmetically ok.
Will I need a follow-up after Endovenous Laser Treatment?
Most people do not require a follow up post EVLT. I'm very careful about asking you why you're having your vein operation. And I'm very clear about what your outcome will be. In general, it takes about six weeks to get the full effect following Endovenous Laser Treatment. And usually, people are pain free or symptom free and don't usually require a long trip back to see me again.
When can I go to the gym and start exercising after EVLT?
With regards to exercise and attending the gym following Endovenous laser treatment, most people can, for example, walk the dog the following day. But I think it takes a little longer before you can do any energetic exercise. Most people will play golf after a week or so. But running and cycling normally takes about two weeks.
How soon after EVLT can I fly?
You can fly whenever you like following EVLT. However, I do think it's a little uncomfortable, so I wouldn't fly for the first week or so. People are sometimes worried that flying is associated with deep vein thrombosis, but that is not really the case.
How is EVLT performed?
Endovenous Laser Treatment is a minimally invasive day case procedure which is performed using a laser in under 30 minutes! Using ultrasound, your Consultant Vascular Surgeon will position an EVLT laser fibre into your varicose via a point on your skin.
The laser will generate heat, causing your vein to close and prevent blood from flowing through it. This shrinks and blocks your varicose vein to the point where your body absorbs it and it disappears naturally rather like a resolving bruise.
Is EVLT painful?
You’ve probably heard of older, painful varicose vein removal treatments such as stripping, but this isn’t used anymore.
If you choose treatment under local anaesthatic we do need to inject local anaesthetic around the vein. Most patients say this is less troublesome than a minor dental procedure. After your procedure, you might experience some soreness, bruising or tingling near the treated vein. Over-the-counter medications can be used to manage any pain.
What is the recovery time like?
It is sometimes nice to but not absolutely necessary take a few days off work after your EVLT procedure. Patients who work from home often go back to work the next day. You will walk-in and walk-out of the hospital, and should be able to walk a dog the following day. Two weeks post treatment, most of our patients can return to the gym.
The area of the procedure can often feel like a pulled muscle. You can fly whenever you like post EVLT but you will be a little sore, it is recommended that you wait a couple of weeks before flying. There is very little evidence that flying increases the risk of a DVT.
Recurrent varicose veins are common and occur in as many as 1 in 5 (20%) patients after previous treatments. The chances of a new varicose vein occurring increases over time (NHS Foundation Trust).
Book your appointment with us to make the right decision for you
There are many ways to book and pay for your varicose vein treatment journey.
If you self-pay for your treatment, you may want to take advantage of our payment plans offered through our trusted partner, Chrysalis, and spread the cost of your treatment. Or if you have private medical insurance check with your provider to see if you’re covered. Benenden Health members can access 10% off EVLT.
It couldn’t be easier to book your initial consultation with one of our Consultant Vascular Surgeons – just use our online booking tool.
If you need more information on our varicose vein treatments, complete our online enquiry form, contact us using Livechat or call our Private Patient Team on 01580 363158.