2. Lifestyle changes. Good skin hygiene, weight loss (if needed), and walking can help treat varicose veins and spider veins.
3. Sclerotherapy. This procedure, which has been available since the 1930s, is another treatment option. This procedure uses a highly concentrated saline (salt) solution or a specially made detergent that is injected directly into the vein, causing the vein to disappear gradually over three to six weeks. The procedure is simple, relatively inexpensive, and can be performed in an outpatient setting.
4. Endovenous laser treatment is a procedure in which a small laser fiber is inserted into the vein. Pulses of laser light are delivered inside the vein, which causes the vein to collapse. The procedure is done as an outpatient under local anesthesia.
5. Radiofrequency occlusion. A small catheter is inserted into the vein. The catheter delivers radiofrequency energy to the vein wall, causing it to heat, collapse, and seal shut. The procedure is generally done in an outpatient or office setting, sometimes under local anesthesia.
6. Surgery. Surgical techniques to treat varicose veins include ligation (tying off of a vein) and stripping (removal of a long segment of vein). Another procedure, ambulatory phlebectomy, allows for the removal of large surface veins through very small incisions that do not need stitches. Surgery may be performed using local, spinal, or general anesthesia. Most patients return home the same day as the procedure. Surgery is generally used to treat large varicose veins.
7. Lasers and intense pulsed light. Surface laser or intense pulsed light treatments, such as Vasculight and PhotoDerm, are other options. These devices use heat energy to selectively damage or destroy abnormal veins. An advantage of these treatments is that no needles or sclerosing solutions are required; however, there may be some minor discomfort. Side effects do occur, including discoloration or staining and blister formation. The results are often disappointing.
Not everybody with varicose or spider veins has pain or other symptoms. They might want the veins removed, however, for cosmetic reasons.