Varicose vein removal

What are varicose veins and what treatments are available in Estonia?

Varicose veins are dilated, twisted superficial veins that develop when the vein valves stop working properly. The normal return of blood to the heart is disrupted, so the vein fills with too much blood and widens. Risk factors include a genetic predisposition, pregnancies, excess weight, prolonged standing, hormonal background (oestrogen in particular) and the connective tissue weakness that comes with age. Telangiectasias, or spider veins, fall into the same category but are smaller and lie closer to the surface.

The treatment methods used in Estonia depend on the size and type of the veins. Sclerotherapy is the most popular method for small and medium veins: the doctor injects a sclerosant (foam or liquid) into the vein, which triggers an inflammatory reaction, closes the vein and lets the body break it down gradually. Endovenous laser or radiofrequency ablation (EVLT, RFA) suits larger trunk veins — guided by ultrasound, the doctor passes a catheter into the vein and seals it with thermal energy.

Classic surgical removal (stripping) is used less often in Estonia than it once was — modern minimally invasive methods (sclerotherapy, EVLT/RFA) give a comparable result with a lower risk of complications and a faster recovery. A combined approach (EVLT on a large vein plus sclerotherapy on the surrounding spider veins, for instance) is used in more complex cases.

Varicose vein removal prices and how the procedure runs

The price of varicose vein removal depends on the method used, the size of the treatment area and the clinic. Sclerotherapy sessions usually start from 80–150 €; EVLT/RFA procedures are a larger investment. Combined treatment plans are priced individually. The Health Insurance Fund (Tervisekassa) covers surgical or endovenous treatment of varicose veins where it is medically justified (pain, swelling, skin changes, ulcers) — aesthetic treatment is paid for by the patient.

A typical visit begins with a consultation, where a phlebologist or vascular surgeon performs an ultrasound (Doppler) scan to assess the state of the venous system in the leg. This matters — underlying deep vein insufficiency can hide beneath superficial spider veins, and leaving it untreated means the aesthetic result will not last. At the consultation the doctor discusses which method is most suitable.

Sclerotherapy itself takes 15–45 minutes. Using a fine needle, the doctor injects the sclerosant into each vein being treated. Compression stockings are put on afterwards and worn for 1–4 weeks depending on the protocol. An EVLT/RFA procedure is done under local anaesthetic and takes 1–2 hours. Here too compression stockings follow, along with restrictions on sport for one to two weeks. Experienced clinics such as Health Clinic in Tallinn and Dr. Mari Laasma Ilukliinik provide a structured aftercare plan.

How do you choose a clinic for varicose vein removal?

Varicose vein removal is a medical procedure that requires a Health Board licence and a phlebologist, vascular surgeon or specially qualified doctor. Always check the doctor's background in the Health Care Professionals Registry (Tervishoiutöötajate register) and the clinic's licence on the Health Board website. Doppler ultrasound in the clinic is indispensable — without a full assessment of the venous system in the leg the most suitable treatment plan cannot be drawn up.

Prefer a clinic where the doctor is open about varicose veins being a chronic condition — treatment improves the situation now, but new varicose veins can appear over time. One treatment and gone for good is a sales pitch, not a medical fact. A quality clinic recommends maintenance treatments every one to two years and longer-term compression therapy (stockings) for patients with a predisposition.

At the consultation the doctor must assess both the aesthetic appearance and the functional state of the venous system. If the symptoms (heaviness, pain, swelling) are significant, treatment should address those alongside the cosmetic result. A promise to remove varicose veins in a single session with no follow-up visits is a warning sign — a realistic treatment plan usually involves 2–4 sessions at 4–6 week intervals.

Risks, side effects and contraindications

The side effects of varicose vein removal divide into the common (swelling, bruising, tenderness in the treated area, temporary pigmentation where the sclerosant was injected — which fades over months) and the more serious. The latter include deep vein thrombosis (DVT — requiring immediate medical attention), skin necrosis (if the sclerosant goes into the wrong place), extensive permanent pigmentation, allergy to the sclerosant, and with EVLT/RFA catheter misplacement and nerve damage. With an experienced doctor and Doppler-guided technique, serious complications are unlikely.

Contraindications are pregnancy and breastfeeding, allergy to the sclerosant, active deep vein thrombosis, severe cardiovascular disease, blood clotting disorders (inherited thrombophilia in particular), active skin infections on the leg and autoimmune disease in an active phase. Long-term use of blood thinners is not an absolute contraindication, but it does require assessment by the doctor.

After the procedure wear compression stockings as your doctor prescribes (1–4 weeks). For two weeks avoid the sauna, hot baths, intense exercise and prolonged standing. Light walking is good — it encourages venous return and reduces the risk of DVT. If severe pain in the leg, shortness of breath or chest pain develops, contact the clinic or the emergency services immediately (a possible clot).

Varicose vein removal in Estonia's larger cities

In Tallinn, varicose vein removal is offered by Health Clinic, Dr. Mari Laasma Ilukliinik and the leading phlebology centres, where all the methods are available (sclerotherapy, EVLT, RFA, surgery). The capital also has specialised vascular surgery clinics with experience of large and complicated cases. The wait for a consultation is usually 2–6 weeks.

In Tartu, varicose vein removal is offered by ProAge Ilukliinik, Medical Aesthetics and Tartu Ülikooli Kliinikum (for medically justified cases). Beauty clinics in Pärnu, Narva and the county centres mostly cover sclerotherapy for spider veins and smaller varicose veins — for larger trunk vein problems (EVLT/RFA in particular) patients are referred to the capital or to Tartu Ülikooli Kliinikum. Since treatment usually needs several sessions and maintenance procedures over the years, choose a clinic that is geographically convenient for a long-term relationship.