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Endovenous Laser Treatment (EVLA/EVLT)

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    Dermapure

    Treatment & technology

    If you’re dealing with varicose veins that cause heaviness, swelling, or visible bulging in the legs, endovenous laser treatment offers an effective, low-downtime alternative to traditional surgical procedures. This minimally invasive treatment targets the problem at its source: faulty veins that allow blood to flow backward and pool. Using a fine laser fiber guided by ultrasound, heat is delivered directly inside the vein, sealing it shut and restoring proper blood circulation. Over time, the closed vein is absorbed naturally, while healthy veins take over.

    The procedure is done as an outpatient treatment, usually taking less than an hour, and performed under local anesthesia. Most people return to their normal activity within 24 hours, although wearing compression stockings is recommended for a few days. Some mild bruising or tenderness may occur, but these symptoms are typically short-lived and manageable with over-the-counter pain medication. Compared to older methods like vein stripping or vein ligation, EVLA offers a shorter recovery time, fewer side effects, and excellent results — without major disruption to your daily routine.

    EVLA is considered a gold standard in treating larger varicose veins and is supported by strong safety data and a high success rate. Performed by experienced vascular surgeons or interventional radiologists, the risk of complications like deep vein thrombosis (DVT) or skin burns remains low. For many patients, this treatment provides not just cosmetic improvement, but long-term relief from discomfort and a significant improvement in quality of life.

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    Endovenous Laser Treatable Areas

    Endovenous laser treatment is used to treat varicose veins in the legs, specifically in the greater saphenous vein (from the groin to the ankle) and the small saphenous vein (from behind the knee to the ankle). These deeper veins are often the underlying cause of visible surface veins and are best treated with laser ablation guided by ultrasound.

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    What to Expect

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    Personalized Assessment

    Before treatment, you’ll meet with a vascular specialist to discuss your symptoms, health history, and goals. Using a detailed ultrasound assessment, your provider will identify the faulty veins responsible for your symptoms and determine whether endovenous laser ablation is the right solution for you. A personalized plan may also include sclerotherapy for any smaller surface veins connected to the deeper treated vessels.

    The Procedure

    Endovenous laser treatment is performed in-office under local anesthesia. A small puncture is made in the skin to insert a fine laser fiber into the affected vein. Once the fiber is guided into position, a protective solution is injected around the vein, and the laser energy is activated, heating the vein wall to over 800°C. This causes the diseased vein to collapse, seal shut, and eventually be absorbed by the body. The entry point is closed with a simple adhesive bandage — no stitches required.

    Aftercare & Recovery

    Most patients resume their normal activity within 24 to 48 hours. You’ll be advised to wear compression stockings for the first 24 hours continuously, then during the day for about two weeks. It’s normal to experience mild bruising or tenderness along the treated area, but this is temporary and rarely painful. Heavy lifting should be avoided for a few days, and physical activity like exercise can typically be resumed within 10 to 15 days, based on your provider’s advice.

    A follow-up ultrasound is usually scheduled within a few days to assess the closed vein and confirm the success of the procedure. If necessary, sclerotherapy can be started shortly after to treat any remaining superficial veins fed by the now-sealed saphenous vein. For most patients, the result is long-lasting relief from leg heaviness and swelling — and a visible improvement in circulation and vein appearance.

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    Cost of treatment

    The cost of endovenous laser treatment varies depending on your type of vein condition, the extent of the area treated, and whether additional procedures like sclerotherapy are required. Since each case is unique, a personalized consultation with one of our specialists is the best way to receive an accurate estimate. We invite you to contact your clinic directly to learn more about pricing and available options.

    Maintenance treatment

    In many cases, endovenous laser therapy is sufficient to treat the underlying diseased vein, and no further treatment is necessary. However, for optimal results, some patients may benefit from complementary procedures, such as surface vein injections or follow-up sclerotherapy, especially if superficial veins remain visible after the primary intervention. Your provider will guide you through the appropriate self-care strategies and long-term follow-up if needed.

    Contraindications

    While endovenous laser ablation is effective for most patients with varicose veins, it may not be suitable in certain situations. For example, veins that are too tortuous, too superficial, or located in areas at higher risk of skin burns may require a different type of treatment. Your provider will carefully evaluate your health conditions and vein structure during your initial assessment to determine if this procedure is safe and appropriate for you.

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    Frequently Asked Questions

    What are the treatment options for varicose veins?

    Several minimally invasive treatments are available depending on the size and location of your varicose veins:

    • Endovenous Laser Treatment (EVLA) uses a fine laser fiber to close deeper, non-functioning veins. It’s done under local anesthesia with minimal downtime and long-lasting results.
    • Radiofrequency Ablation (RFA) works similarly, using radiofrequency waves to seal the vein from within. It’s effective for larger veins and offers a fast recovery.
    • Sclerotherapy involves injecting a solution into small surface veins, causing them to collapse and fade. It’s ideal for spider veins or small varicose veins.
    • Foam Sclerotherapy is guided by ultrasound and used for deeper or twisted veins, offering precise closure when other methods aren’t suitable.

    Your provider will recommend the right approach based on your needs and vein structure.

    Is endovenous laser treatment painful?

    The procedure is performed under local anesthesia, so you shouldn’t feel pain during treatment. Mild bruising or tenderness may occur afterward but is usually minimal and temporary.

    How long does recovery take after EVLA?

    Most patients return to normal daily activities within 24 to 48 hours, especially with the help of compression stockings and walking. However, it’s recommended to avoid heavy lifting, intense workouts, or prolonged standing for about 10 to 15 days to allow proper healing of the treated vein.

    Mild bruising, tightness, or a pulling sensation along the vein may occur and typically resolves within one to two weeks. Your provider will guide you on when to safely resume more demanding physical activity based on your individual case.

    Will my varicose veins come back after treatment?

    The treated vein is permanently closed and will not reopen. Once sealed with laser energy, the body gradually absorbs the closed vein, and it no longer contributes to poor circulation or visible bulging.

    However, new varicose veins can develop over time — especially if you have ongoing risk factors such as genetics, hormonal changes, pregnancy, or prolonged standing. Regular follow-up and maintaining healthy lifestyle habits can help prevent future vein issues.

    How do I know if I’m a good candidate for laser vein treatment?

    A proper ultrasound evaluation with a vein specialist is essential. It helps determine whether your varicose veins are caused by a deeper, straight enough vein like the saphenous vein, which can be effectively treated with endovenous laser therapy (EVLA).

    You may be a good candidate if you experience symptoms like leg heaviness, swelling, visible bulging veins, or if previous surface treatments haven’t provided lasting results. Your provider will also assess your overall health to ensure the procedure is safe and appropriate for you.

    What are the risks or side effects of endovenous laser treatment?

    Endovenous laser treatment (EVLA) is considered safe, with most side effects being mild and temporary. Common ones include bruising, tightness, and a pulling sensation along the treated vein, which usually resolve within 1–2 weeks. Some patients experience mild skin discoloration or a firm vein cord under the skin that fades over time.

    In 5–10% of cases, a superficial vein inflammation (similar to a mild phlebitis) may occur and can be treated with anti-inflammatories, walking, and compression stockings.

    Less common side effects include temporary numbness or tingling, especially near the saphenous nerve, but these symptoms typically resolve on their own. Rare complications, seen in fewer than 1% of cases, include deep vein thrombosis (DVT), skin burns, infection, or nerve injury. A proper ultrasound evaluation, use of tumescent anesthesia, and post-procedure walking greatly reduce these risks.

    Overall, EVLA has a very favorable safety profile, with fewer complications than surgical vein stripping.

    Do I need to wear compression stockings after the procedure?

    Yes — wearing compression stockings is an important part of recovery after endovenous laser treatment. They help support proper blood flow, reduce swelling, and lower the risk of complications such as bruising or deep vein thrombosis (DVT).

    You’ll need to wear them continuously for the first 24 hours, then during the day for about two weeks, depending on your provider’s advice. This simple step greatly enhances comfort and promotes faster healing.

    What’s the difference between laser treatment and sclerotherapy?

    Both endovenous laser treatment (EVLA) and sclerotherapy are used to treat varicose veins, but they target different types of veins and use different techniques.

    EVLA is best suited for deeper, larger veins, like the saphenous vein, which are often the root cause of surface varicose veins. It uses a thin laser fiber inserted into the vein under ultrasound guidance. The laser generates heat to seal the vein from the inside, stopping reflux and restoring healthy blood flow. This technique treats the problem at its source.

    Sclerotherapy, on the other hand, is used for smaller, superficial veins, including spider veins. A sclerosing solution is injected directly into the visible vein, causing it to collapse and fade over time. It doesn’t use heat, and it’s ideal for cosmetic improvement or for treating residual veins after deeper issues have been addressed.

    Will I see results right away?

    Many patients notice relief from symptoms like heaviness or swelling within a few days. However, visible improvements take more time. The treated vein is gradually reabsorbed by the body, so changes in appearance may take several weeks, sometimes up to a few months, depending on the size and depth of the vein.

    Are the results permanent?

    Yes — the treated vein is permanently closed and won’t reopen. However, if your body is prone to venous insufficiency, new varicose veins may appear in other areas over time. Maintaining a healthy lifestyle and attending follow-up evaluations can help prevent recurrence and catch early signs.

    Can this treat spider veins too?

    No — endovenous laser treatment targets deeper varicose veins and is not designed for spider veins, which are small, surface-level vessels. For spider veins, sclerotherapy or surface laser treatments are more appropriate and can often be combined with deeper treatments for full cosmetic and therapeutic results.