J Korean Med Assoc.  2022 Apr;65(4):202-208. 10.5124/jkma.2022.65.4.202.

First-generation therapy for varicose veins: medication, compression, sclerotherapy, and stripping

  • 1Department of Surgery, Korea University Anam Hospital, Korea University College of Medicine, Seoul, Korea
  • 2Department of Surgery, Soonchunhyang University Seoul Hospital, Seoul, Korea


Improving the understanding varicose veins (VV) is increasing due to life extension and concerns regarding quality of life. Recently, endovascular treatment has become more common, even in mild cases. Excessive procedures are often performed before conservative and non-surgical treatments. We aimed to explain the efficacy of medication, compression, sclerotherapy, and stripping of treatments and to consider the appropriate indications for many treatment methods, including endovascular procedures.
Current Concepts
Venoactive drugs can be used as first-line agents for symptoms, such as edema, at all stages of varicose vein. These are effective adjuvant agents and can help achieve compression before and after procedures. Compression therapy is effective for skin change and ulcers and is excellent for the improvement of symptoms. Sclerotherapy has been widely used as an adjuvant treatment, but recently, its indications have been expanded for non-invasive causes. Traditional high ligation and stripping is still the recommended treatment option for recurrent or complicated varicose veins.
Discussion and Conclusion
The patients’ symptoms should be evaluated more critically than assessing only the venous reflux using ultrasound. Additionally, objective evaluation of various causes of lower extremity discomfort should be considered. Treatment according to appropriate indications, such as medication, compression, sclerotherapy, stripping, and endovascular therapy, can improve the patients’ quality of life and prevent complications.


Varicose veins; Drug therapy; Compression stockings; Sclerotherapy; 하지정맥류; 약물치료; 압박스타킹; 경화요법
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