Varicose veins are enlarged, twisted vessels often appearing just beneath the skin’s surface, signaling underlying chronic venous insufficiency. This condition occurs when valves inside the veins fail, causing blood to pool and the veins to stretch. Endovenous Laser Ablation (EVLA) is a modern, minimally invasive treatment that has largely replaced traditional vein stripping surgery. The physical disappearance of varicose veins after EVLA is a gradual biological process, not an immediate event. This procedure effectively treats the source of the problem, leading to both symptom relief and cosmetic improvement over time.
How Laser Energy Closes the Vein
Endovenous Laser Ablation works by delivering controlled thermal energy directly into the affected vein. A thin laser fiber is inserted into the vein, typically the great saphenous vein, through a small puncture and guided into position using ultrasound imaging. The laser light is absorbed by the blood components and the vein wall, converting the light energy into intense heat.
This generated heat damages the endothelial cells lining the vein wall, triggering ablation. The vein wall contracts and collapses inward, sealing the vessel shut. This closure redirects blood flow to adjacent, healthy veins in the leg, restoring proper circulation. The body then gradually absorbs the sealed vein segment, breaking down the non-functional tissue and turning it into scar tissue that eventually disappears.
Immediate Post-Procedure Timeline
The immediate period following EVLA focuses on the body’s reaction to the sealed vein and the beginning of the healing process. Patients often experience a noticeable reduction in symptoms like aching, heaviness, and swelling within the first few weeks, as the source of venous reflux is eliminated.
In the first one to three weeks, patients commonly observe tenderness, a tight sensation along the treated path, and bruising (ecchymosis). This bruising is a temporary side effect of the vein sealing process, often resolving within one to two weeks. The treated vein may initially feel like a firm cord beneath the skin, which is a sign that the vein has closed down and is hardening into scar tissue.
Wearing compression stockings during this initial phase is an integral part of the recovery protocol, often recommended for several weeks. The stockings provide external pressure that helps reduce swelling and supports the vein walls as they collapse and seal. Regular walking is also encouraged immediately after the procedure, as this low-impact activity promotes healthy circulation and minimizes complications.
Full Resolution and Visible Disappearance
The visible “disappearance” of the varicose vein is a slow process dependent on how quickly the body metabolizes the sealed vessel. Since EVLA ablates an underlying truncal vein, the visible, bulging varicose veins on the surface (connected tributaries) begin to shrink and regress once pressure is removed. The absorption of the remaining scar tissue is the final stage of cosmetic resolution.
For smaller, less prominent varicose veins, fading may become apparent within six to eight weeks. However, the most significant cosmetic improvements typically occur within the three to six-month window. During this period, the sealed vein is continually broken down and absorbed, leading to a significant flattening and lightening of the vessels.
Larger or more severe varicose veins, which had more extensive dilation, will naturally take longer to fully resolve. In these cases, complete resolution may take up to twelve months. Follow-up ultrasound assessments are often scheduled within the first week to confirm vein closure, but visual confirmation of disappearance is a long-term result.
Factors Influencing Healing and Longevity
Several patient-specific and procedural factors influence both the speed of healing and the long-term success of Endovenous Laser Ablation. The initial size and depth of the treated vein are primary determinants of the resolution timeline; thicker, larger veins require more time for the body to absorb the scar tissue. The extent of the underlying venous disease also affects how rapidly the superficial varicose veins regress.
Adherence to post-treatment instructions, particularly the consistent use of compression stockings, significantly affects the outcome and longevity. Compression helps maintain vein closure, reduces swelling, and supports the redirection of blood flow. General patient health, including age and overall circulation, influences the body’s metabolic rate and the speed at which the sealed vein is absorbed.
The technical success of the procedure, measured by the linear endovenous energy density (LEED) delivered, ensures permanent vein closure. Optimal energy delivery achieves the necessary thermal damage to the vein wall, minimizing the risk of the vein reopening (recanalization). While EVLA has a high success rate, new varicose veins can develop over time due to genetic predisposition or lifestyle, necessitating periodic follow-up with a specialist.